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A 75-year-old white man presented with a year-long history of a nonpruritic rash on his upper body. He denied fatigue, weight loss, or other systemic symptoms. He had applied Selsun Blue (Ross Products, Abbott Laboratories, North Chicago, Illinois) without relief. The patient's medical history included hepatitis B and arthritis, and his only medications were potassium and a daily aspirin. The patient had lived as a monk for most of his life and had no known risk factors for human immunodeficiency virus infection. His last travel overseas had been to India 3 years previously. He denied any known exposures and claimed to have been back in the United States for over a year prior to onset of his skin lesions.
Koger C, Kallgren D, Pacocha C. Persistent Skin Lesions in a 75-Year-Old Man—Quiz Case. Arch Dermatol. 2011;147(3):345-350. doi:10.1001/archdermatol.2011.35-a