47 year old female with painful fissuring of hands and feet as well as scaly erythematous plaques on the abdomen

    47 year old female presents with several years of painful fissuring of the hands and feet as well as a few new scaly erythematous plaques on the abdomen. The patient had a patch test in 12/2012 that showed positive reactions to nickel, cobalt, and formaldehyde. The patient has since changed all of her personal care products without much improvement. In the past, the lesions on the hands and feet have responded to Clobetasol. The patient had a biopsy of the abdominal lesions prior to grand rounds. Pathology shown here.