A 67-year-old man presented with painless blisters on the hands for 2 weeks. He denied pruritus, trauma, or contact with allergens or irritants. His medical history includes hypertension, benign prostatic hyperplasia, hypothyroidism, and chronic obstructive pulmonary disease, for which he takes finasteride, tamsulosin, levothyroxine, lisinopril, pantoprazole, and trospium. He recently quit smoking and reduced his alcohol intake to 2 drinks daily but has an approximately 50 pack-year smoking history and a history of heavy alcohol consumption. He denied use of illicit substances. He works outdoors. Family history and review of systems were unremarkable.
Shih A, Damsky W, Zubek A. Painless Vesicular Eruption on the Dorsal Surfaces of the Hands. JAMA. 2016;316(12):1312-1313. doi:10.1001/jama.2016.11260