Author Affiliations: Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia (Mr Friedman, Dr Rosenbach, and Ms Richardson); Department of Pathology, University of Michigan School of Medicine, Ann Arbor (Dr Carlos).
A 48-year-old woman with diabetes mellitus, chronic kidney disease, chronic hepatitis C virus infection, and a history of cocaine abuse was admitted to the hospital for confusion in the setting of Clostridium difficile infection. Our dermatology department was consulted to evaluate the patient for intense pruritus. On examination, she had marked xerosis with areas of ichthyosiform scaling over the extremities, most pronounced on the arms and hands (Figure). There was diffuse lichenification and hyperpigmentation of her face, upper trunk, and thighs. A working diagnosis of chronic eczematous dermatitis was rendered, and topical corticosteroids and emollients were prescribed.
Friedman BJ, Carlos CA, Richardson V, Rosenbach M. A Fatal Case of Mothball Intoxication Presenting With Refractory Pruritus and Ichthyosis. Arch Dermatol. 2012;148(3):404–405. doi:10.1001/archdermatol.2011.2297