55-Year-Old With Diffusely Dry Skin

Published on May 30, 2025

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Differential Diagnosis

• Acquired ichthyosis
• Atopic dermatitis
• Eczema craquelé
• Xerosis

Diagnosis

The correct diagnosis in this case is xerosis—a condition of rough, dry skin texture with associated fine scales, which is often pruritic. Incidence increases with age, and xerosis is typically caused by a decrease in the amount of lipids in the stratum corneum and a deficiency in the water-binding capacity of this layer. Environmental causes include factors such as low humidity, frequent bathing, and harsh soaps. Disease states such as ichthyoses, atopic dermatitis, hypothyroidism, Down syndrome, renal failure, malnutrition, HIV, lymphoma, liver disease, Sjögren syndrome, and carcinomatosis can also cause the condition.

What To Look For

• Xerosis is more common in older patients
• Dry ashy skin with fine scale will be visible
• Pruritus is frequently present

Pearls for Urgent Care Management

• Encourage the patient to use mild skin cleansers and minimize skin washing
• Use a humidifier indoors to increase air humidity
• Moisturize the skin with thick and greasy emollients