A 65-year-old man presented to the dermatology clinic with a 6-month history of worsening lesions on his hands and forearms as well as fingernail thickening. His medical history included end-stage renal disease and untreated hepatitis C virus infection.
Physical examination showed crusted erosions and atrophic scars on the dorsal hands and forearms as well as scattered tense vesicles on the fingers and forearms. Onychodystrophy and subungual hyperkeratosis were observed in the fingernails.
What’s the diagnosis ?
