A skin biopsy specimen from the lesion showed hyperkeratosis and irregular epidermal acanthosis with pallor and necrotic changes confined to the upper epidermis. These findings were consistent with NME.
Treatment with 1% hydrocortisone lotion and emollients had resulted in only limited improvement of the skin lesions. The patient's eruption began to improve during 1 month of zinc supplement therapy (oral zinc sulfate, 220 mg 3 times daily). At this stage, γ-linolenic acid (Epogam, 480 mg/d) was added to treatment regimen, but did not result in any additional improvement over the ensuing month.
Recurrent Annular Erythematous Scaly Patches. Arch Dermatol. 2002;138(3):405-410. doi:10.1001/archderm.138.3.405