A 76-year-old woman presented with an 18-month history of a pruritic eruption on the flexures. She denied episodes of headache, nausea, vomiting, diarrhea, abdominal pain, or palpitations. Her medical history was remarkable for diabetes mellitus and hypertension. Her medications included atenolol and glyburide.
On physical examination, multiple confluent brownish macules and papules that formed a reticulate pattern were present symmetrically on the axillae (Figure 1), in the submammary region, and at the inguinal folds. A wheal and flare reaction was noted after the site was rubbed. The results of routine blood tests and urinalysis were within normal limits. Abdominal ultrasonography revealed a fatty liver, and the findings of isotopic scanning of bones with technetium 99m were normal. A biopsy was performed (Figure 2).
Peretz E, Grunwald MH, Hallel-Halevy D, Halevy S. Brownish Reticulate Maculopapular Eruption on the Flexures—Quiz Case. Arch Dermatol. 2003;139(3):381-386. doi:10.1001/archderm.139.3.381-a