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JAMA Dermatology Clinicopathological Challenge
October 2014

Erosive Plaques in the Intertriginous Regions of a Woman

Author Affiliations
  • 1Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Dermatol. 2014;150(10):1105-1106. doi:10.1001/jamadermatol.2014.1176

A woman in her late 30s presented for evaluation and management of tender, reddish brown, slightly pruritic papules and plaques on the scalp, in the inframammary region, and in the perineum that had been present for approximately 1 year. Previous treatment with multiple courses of topical and systemic antifungals, topical and systemic corticosteroids, and oral antibiotics had failed. She reported pain, pruritus, and serous discharge associated with the plaques but denied any systemic symptoms. Her medical history was unremarkable, and she was not taking any medications at the time of presentation. Results of a physical examination revealed well-demarcated, moist, erythematous plaques and erosions in the bilateral inframammary regions (Figure 1A) and the intertriginous regions of the groin and scattered excoriated papules on the scalp. A punch biopsy specimen of the plaque along the left inframammary region was sent for pathologic evaluation (Figure 1B-D).

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