Peter L. Mattei, MD 2nd Air Refueling Squadron, Joint Base McGuire-Dix-Lakehurst, NJ peterlmattei@gmail.com
Ryan P. Johnson, MD Department of Dermatology, Wilford Hall Medical Center, Lackland Air Force Base, Tex
Thomas M. Beachkofsky, MD 80th Fighter Squadron, Kunsan Air Base, Republic of Korea
Oliver J. Wisco, DO, FAAD Massachusetts General Hospital and Harvard Medical School, Boston
Chad M. Hivnor, MD, FAAD Department of Dermatology, Wilford Hall Medical Center, Lackland Air Force Base, Tex
Michael R. Murchland, MD, FAAD Department of Dermatology, Wilford Hall Medical Center, Lackland Air Force Base, Tex
DEPARTMENT EDITOR Richard P. Usatine, MD University of Texas Health Science Center at San Antonio
The authors reported no potential conflict of interest relevant to this article. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Defense.
The patient had been treated with topical antifungals and steroids without relief, but a more detailed history suggested a serious infectious etiology.
A Good-quality patient-oriented evidence B Inconsistent or limited-quality patient-oriented evidence C Consensus, usual practice, opinion, disease-oriented evidence, case series
A 48-YEAR-OLD HISPANIC MAN came into our dermatology clinic with a 2-month history of a pruritic rash that was confined mainly to the trunk. Prior to this visit, he had tried topical corticosteroids and antifungals, but they had not helped.
His trunk showed erythematous macules and reticulate patches with interspersed thin urticarial plaques without scale (FIGURE). Given that the patient had no vesicles or lichenification (which one would expect with eczematous dermatitis) and that the topical steroids did not provide any relief, we performed a biopsy.
FIGURE Erythematous macules and reticulate patches without scale
WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU TREAT THIS PATIENT?
