What's the Diagnosis?
A 22 year old patient presented with itchy lesions Over face, neck, cubital fossa, hands and feet since 4 months. There was no history of oozing or bleeding. Patient gave history of fissuring with pain and burning. She also gave history of burning sensation and excessive lacrimation and inability to close her eyes. There was no blurring of vision. She complained of increased hair loss since 6 months. There was no history of diarrhea/oral ulcers/Raynauds phenomena and photosensitivity. She gave no history suggestive of any systemic illness. No contributory family history was present. She was not on any medications. She is a strict vegetarian and consumes mostly cereals.On clinical examination, well defined erythematous scaly and shiny plaques with crusting over the periorbital, perioral and perianal region and all around the neck were seen .Erythematous fissured plaques were seen over bilateral cubital fossa, tips of fingers, toes and soles of feet .Scalp showed diffuse thinning of hair. There was ectropion of both lower eyelids. Patient gave history of necrotizing fasciitis of the left foot for which debridement and amputation was done a year ago Histopath- mildly Acanthotic epidermis with parakaratosis dimunition of granular layer with dyskeratosis CBC- mild anaemia LFT/ RFT - normal ANA - negative Serum zinc - marginally low Diagnosis? A. Pellagrous dermatitis B. Photodermatitis C. Acrodermatitis Enteropathica D. Irritant contact Dermatitis
