48 old lady with 6 months history of itch rash on her left l | Figure 1

48 old lady with 6 months history of itch rash on her left lower leg. She is otherwise well. She is not on any regular medication. There is no response to topical steroids. Diagnosis and management please.

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38 year old female presented to pcp for this painful and pruritic rash. Patient stated that this has been present for about six months and is getting worse. She said there was a patch on the back of her hand that resolved a couple of months ago. There is also a small patch on left eyelid that was difficult to photograph. First picture is right shin, second picture is opposite leg, and third picture is abdomen.](https://app.figure1.com/case-detail/22ca58cc-da18-4fa1-ad26-b0ca3281e13f)



Female, 32 years old, started one month ago with a numular lesion on the back, erythematous and with some burning pain; this border emerged now. She didn't use any medication. And now no symptoms.](https://app.figure1.com/case-detail/294866f2-dc34-4371-912c-16c2738c51e2)



37 years old lady developed this itch skin discoloration 2 years ago on her back and abdominal wall, she came to the clinic complaining from sever colicky abdominal pain generalized mainly epigastric, the colicky pain last few mins and come back several times/day. her family doctor told her the skin condition is #Acanthosis-nigricans and she need to do some tests but she didn’t go back. she was given steroids 3 months ago for 1 month for allergic rhinitis after that she had abnormal period and bleeding that lasted 20 days and was given norethisterone 5 mg by her gynecologist. She stated that she lost 5 kg in the last month. What do u think and is her family doctor right about the #Acanthosis-nigricans ??? What’s ur next step in management ??](https://app.figure1.com/case-detail/2ca88775-49dd-4104-898e-566ddfdf6335)



This is female patient presents for new pregnancy with this dermatitis. Has had very little treatment other than topical steroids. She has had this for several years. ++pruritis.
Patient is from India.](https://app.figure1.com/case-detail/43f125b8-6e13-48eb-99c1-33ad4f6b5233)