Flegel disease

LAST UPDATED: Nov 22, 2021

Introduction

Flegel disease is a rare, benign, autosomal dominant condition of adults characterised by multiple reddish‐brown keratotic papules affecting the extremities. This chapter is set out as follows:

History
Clinical findings
Images
Management

History

The condition arises during or after the third or fourth decade.
Lesions can occasionally itch

Clinical findings

Distribution

Lesions first appear over the dorsa of the feet and on the lower legs. The lesions may spread to the upper legs, also disseminating over the arms and trunk or concha of the ear. Occasionally the palms and soles are affected. On the limbs the lesions mainly affect the extensor surfaces

Morphology

2-3 mm keratotic red‐brown papules with discrete irregular margins
Removal of the scale reveals a bright red base, often with pinpoint bleeding

Clinical Images

Please refer to notes on image rights at bottom of the page with regards to individual image ownership.

Management

There is no reliably effective treatment. Topical and systemic retinoids, calcipotriol, Efudix ® cream, phototherapy and dermabrasion have all been tried with variable efficacy

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Image Rights - The PCDS would like to thank Dermatoweb, DermQuest (Galderma), and others who have contributed images. All named individuals and organisations maintain copyright for the relevant images.