We recently received this email from Kevin Wang regarding Irene’s skin condition:

Dear Mr Dias-

Hope this email finds you well.  Dr Fox and I apologize for the delay in getting this to you…I wanted to send you a couple of quick notes on asteatotic eczema, which is what we thought Irene had all along, with perhaps a small contribution from a drug reaction.

Asteatotic eczema is a very common condition characterized by itchy, dry, cracked, and polygonally fissured skin with irregular scaling.  It most commonly occurs on the shins of middle-aged to elderly persons, but it may occur on the hands and the trunk.  The eruption can be generalized or localized (as is in Irene’s case), and is often caused by changes secondary to age, dehydrated skin, and/or malnutrition (and that’s why we see a lot in hospitalized patients or in patients who have trouble with nutritional absorption through their gastrointestinal tract).  The treatment of choice is with mid potency topical steroids to calm down the inflammation, then with aggressive use of moisturization agents.  As you already have found out, her skin is now much much improved on this regimen.

With respect to a possible allergy to a medication, I want to emphasize that the type of drug reaction that she may have had (as evidenced by a skin rash) is NOT life-threatening, and has in fact been resolving over the past 10 days.  It is not uncommon for patients receiving so many medications at once to have a drug allergy, and we have discussed it with her team and they have discontinued the likely culprits.  We don’t expect her to have another flare of the rash.

Hope this is helpful! please feel free to let us know if you have other questions or concerns—the best way is to direct the questions to the CRI team and they can call us!

best wishes
Kevin