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January 2010

Pruritic Reticular Eruption on the Chest of a 24-Year-Old Woman—Quiz Case

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Arch Dermatol. 2010;146(1):81-86. doi:10.1001/archdermatol.2009.334-a

A 24-year-old Spanish woman presented with an 8-year history of a pruritic eruption on her chest and submammary region. Her medical and family histories were unremarkable. She only reported playing basketball in tight leotards. Physical examination revealed multiple erythematous, urticarial papules and brownish, reticulated patches in a symmetrical distribution on her chest (Figure 1). There were no other signs or symptoms. Despite therapy with methylprednisolone aceponate ointment, 1%, twice a day, tacrolimus ointment, and oral antihistamines, the first eruption was followed by several recurrences. The results of all laboratory investigations, including liver, kidney, and thyroid function tests, blood glucose levels, and antinuclear body titers, were within the normal range. After an initial clinical diagnosis of contact dermatitis, with a differential diagnosis of confluent and reticulate papillomatosis, also known as Gougerot-Carteaud syndrome, standard and textile patch tests were performed to identify any contact allergens that might have triggered the eruption, but the results were all negative. A skin biopsy specimen was obtained for microscopic examination (Figure 2 and Figure 3).

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