Clinical Quiz
The Hong Kong Practitioner VOLUME 25 / November 2003

An old lady presenting with resistant itchy rash in her face
H F Ho 何慶豐

A monthly clinical quiz is published in The Hong Kong Practitioner. Readers are invited to participate and a prize draw, sponsored by Pfizer Corporation Hong Kong Limited, will be undertaken among the successful entries each month. For entry into the draw, simply answer the question, fill in the reply slip and return it to the College by December 4, 2003. Each reader is allowed to submit one entry only. The name of the winner and the answer will be published in the December issue.

Clinical history:

A 70 years old lady presented to us with a three years' history of itchy rash on her hairline, face, ears, and neck. Physical examination found chronic eczematous rash distributed over the above-cited areas with lichenification. She had been treated by various doctors as eczema and tinea, with topical treatments without success. Personal habits were asked and a detailed history of use of skin products and cosmetics was obtained. The tone of her hair was noticed and a clinical diagnosis was made.

The slide and the question were prepared by:
Dr H F Ho, FHKAM(Med)
Medical Officer,
i/c Chai Wan Social Hygiene Clinic, Social Hygiene Service, Department of Health.

What is the most likely diagnosis?

A. Seborrheic dermatitis
B. Psoriasis
C. Allergic contact dermatitis
D. Atopic dermatitis

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