The Geriatric Patient with Neurodermatitis

Abstract

Mrs. Hightower is a 79-year-old African-American female, who presents to the office with her husband with a chief complaint of persistent bug bites and edema of the lower extremities. The lesions in question are reported on both arms from the wrist to mid upper arm, and the lower extremities from just proximal to the toes to below the knee. The extremities appear erythematous, swollen, and scaly with multiple vesicles and areas denuded of overlying skin. The patient is insistent that the cause of her discomfort is parasites. She claims to have had this complaint constantly for 6 years, starting just after a quadruple bypass and continuing without interruption till the current visit. She reports a history of kidney failure, fatigue, and fluid retention, but denies any other symptoms.