A scaly brown rash on the lower legs

Case presentation

A 45-year-old man presents after noticing that the skin of his lower legs has become unusually scaly and brown during the winter months (Figure 1). The rash is not itchy.

The patient has a long history of ‘dry skin’, dating back to his early childhood. He mentions that his younger brother also has dry skin but his parents, sister and two daughters do not. Until a recent move to Victoria, the patient had lived in northern Queensland all his life.