REPORT OF A CASE
A 65-year-old man was referred for evaluation of a diffuse, pruritic eruption affecting his skin, conjunctiva, tongue, and oral cavity. The lesions first appeared on his face 2 years earlier and had slowly spread to involve most of his skin and mucous membranes (Figure 1). An ophthalmologist had removed verrucous papules from his eyelids and was treating chronic conjunctivitis. His voice had been hoarse for 1 month. He had a myocardial in- farction 8 years earlier and a 40 pack-year smoking history. Otherwise he felt well.Physical examination revealed a well-nourished white man. Bilateral ectropion was present with a thickened granular appearance to the conjunctiva (Figure 2). Verrucous papules were present on his eyelid margins and lips. The tongue was enlarged and deeply fissured (Figure 3). The buccal mucosa appeared rough and thickened. Brown, papillomatous thickening of the skin was present over most of his body.
Turner C, Katz A, From L, Sibbald RG. Pruritic Plaques on the Skin and Mucous Membranes. Arch Dermatol. 1994;130(5):651-652. doi:10.1001/archderm.1994.01690050119020