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Mar 2012

A Serpiginous Eruption —Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2012;148(3):385-390. doi:10.1001/archderm.148.3.385-b

A 47-year-old man presented with a 10-month history of a scaly erythematous eruption affecting his torso and limbs. The eruption was episodic in nature and seemed to have spontaneous exacerbations and remissions. More confluent areas of erythema seemed to expand and then clear centrally. It was unresponsive to potent topical steroids. The patient reported recent slight weight loss but was otherwise well. He had no relevant social or travel history.

Physical examination revealed a thin man with a distended abdomen. He had crusted papules and plaques with a serpiginous border mainly involving the central chest, back, and pubic area in a rather seborrheic distribution (Figure 1 and Figure 2). He had no mucosal involvement. The nails and scalp were not affected. Results from viral serologic tests, including a test for human immunodeficiency virus, were negative. Serum zinc and glucose levels were within the normal range. A punch biopsy specimen was taken for histologic examination and stained with hematoxylin-eosin (Figure 3).

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