[29F] With persistent dry scaly skin patches

Patient Description

A 29-year-old Caucasian female has been experiencing persistent dry, scaly patches on her skin for the past few months. Initially, a small patch appeared on her face, followed by a whiter patch on her arm, and more recently, larger pink patches on her legs. These patches are round, scaly, and flaky, and they cause pain when scrubbed too hard. The patient has also noticed general dry skin and a slightly dry scalp but reports no improvement with moisturizers. She has been under significant stress and depression, affecting her appetite, and has observed changes in her menstrual cycle, with periods arriving later each month. There is no family history of skin conditions like psoriasis or eczema, and she has not started any new medications or skincare products recently. The patient denies any known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Psoriasis: This is a common skin condition that causes dry, scaly patches. It can appear pink or red on lighter skin tones and may be triggered or worsened by stress. Psoriasis patches can be painful when irritated. Treatment often involves topical treatments, light therapy, and sometimes systemic medications.

  • Eczema (Atopic Dermatitis): This condition causes dry, itchy, and inflamed skin. It can be exacerbated by stress and environmental factors. Treatment typically includes moisturizing the skin, using topical steroids, and avoiding irritants.

  • Hormonal Changes: The changes in your menstrual cycle and stress levels could be affecting your skin. Hormonal fluctuations can lead to skin changes, including dryness and the development of patches.

It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.

What you can do

While waiting to see a healthcare provider, you can try the following to help manage your symptoms:

  1. Moisturize Regularly: Use a thick, fragrance-free moisturizer to help soothe and hydrate your skin. Apply it immediately after bathing to lock in moisture.

  2. Avoid Irritants: Use gentle, fragrance-free skincare and laundry products. Avoid scrubbing your skin too hard, as this can worsen irritation.

  3. Manage Stress: Consider stress-reduction techniques such as meditation, yoga, or deep-breathing exercises to help manage your stress levels.

  4. Track Your Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider. This can help in identifying potential triggers and assessing the effectiveness of treatments.

What you should look out for

Seek medical attention if you experience any of the following:

  • If the patches become significantly more painful, swollen, or start to ooze.
  • If you develop a fever or feel generally unwell.
  • If your symptoms do not improve with self-care measures or worsen over time.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. They can provide personalized advice and may recommend specific tests or treatments based on your individual needs.

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28 d ago

People Also Ask


What are the common symptoms of psoriasis and how is it diagnosed?

Common symptoms of psoriasis include dry, scaly patches that can be pink or red, and may be itchy or painful. Diagnosis is typically made by a healthcare provider through a physical examination and sometimes a skin biopsy.


How can stress affect skin conditions like eczema or psoriasis?

Stress can exacerbate skin conditions like eczema and psoriasis by triggering inflammation and immune responses, leading to flare-ups. Managing stress through relaxation techniques can help reduce these effects.


What role do hormonal changes play in skin health?

Hormonal changes, such as those related to menstrual cycles, can affect skin health by altering oil production and skin cell turnover, potentially leading to dryness or the development of patches.


What are some effective ways to manage dry, scaly skin patches at home?

To manage dry, scaly skin patches at home, use thick, fragrance-free moisturizers, avoid harsh soaps and irritants, and apply moisturizers immediately after bathing to lock in moisture. Additionally, managing stress and avoiding excessive scrubbing can help.


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