Picture Quiz: A smoker's hand
A 64 year old man with a 40 pack year smoking history presented to an outpatient clinic after an acute asthma attack. He had no other relevant medical history. Upon general examination, however, doctors noted abnormalities on his right hand (see figure). He described a loss of sensation confined to this area that had lasted for 10 years. But, for the past couple of years, this area of his hand had become dry and itchy. The man was a painter-decorator. He said that he did not always wear gloves when decorating and that he used white spirit to remove paint.