Scaly papules in sun-exposed areas

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CASE #1

A man aged 44 years presented to the dermatology clinic with an eight-month history of an asymptomatic progressive rash on his arms and legs. He had never experienced any similar rash previously nor had anyone in his family. Scattered erythematous scaly papules on the patient's bilateral dorsal forearms and lower legs were noted on physical examination. The patient did not have any findings on his face or trunk. The papules ranged in size from 3 mm to 8 mm, and a very thin, raised, threadlike border was perceptible on some lesions.

CASE #2

A man with a history of multiple nonmelanoma skin cancers presented with asymptomatic scaly lesions on his hands, arms, and head. He had had similar lesions in the past that were treated with cryotherapy and resolved. On physical examination, he had numerous erythematous scaly papules on his bilateral dorsal hands and forearms, neck, bilateral ear helices, scalp, forehead, and nose. The lesions varied from small scaly papules to scaly papules measuring almost 1 cm in size. Some lesions were more apparent with palpation than with visualization.

What is the diagnosis?

For CASE #1, click "NEXT." For CASE #2, click "3."

 

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