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Updated: Jun 11, 2025

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
Published on: March 4, 2014
[Special lesion on back of the hand]
Lotte J van den Oord1,2, Saskia de Mare1
1Rijnstate, afd. Dermatologie, Arnhem.
Abstract:
A 74-year-old man, previously healthy, presented at the Dermatology department with an asymptomatic hand lesion persisting for two months. The general practitioner initially treated the lesion with betamethasone and fusidic acid cream. Examination revealed a 3 cm livid plaque with central crusts. A biopsy confirmed cutaneous leishmaniasis tropica. The patient travelled to Greece, Spain, and Southern France before the lesion occurred, which is consistent with the endemicity of leishmaniasis in the Mediterranean. Treatment involved cryotherapy and antimony injections, resulting in lesion resolution after two sessions. This case underscores the importance of considering travel history and endemic diseases in diagnosing and managing dermatological conditions, especially in regions prone to specific infections.
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