REPORT OF A CASE
A 60-year-old man complained of a persistent rash on his neck, chest, and forearms of three years' duration. He stated that the rash was not progressing, but that it showed no signs of resolution. The onset was insidious, with initial symptoms consisting of a stinging sensation in sun-exposed skin while sitting on his porch. The abnormal cutaneous sensation initially resolved on returning inside, but gradual, persistent pruritus occurred after several months.Two years prior to presentation in the dermatology clinic, the patient had undergone total gastrectomy for adenocarcinoma of the stomach. A feeding jejunostomy was put in place at that time and he received therapy with 3/4-strength Vivonex, a nutritionally complete elemental diet, in an attempt to ameliorate his persistent diarrhea. A rash on the neck and extremities had been noted on admission to the hospital at the time of surgery, but further investigation was postponed.
Horn TD. A Photodistributed Rash. Arch Dermatol. 1987;123(9):1229-1230. doi:10.1001/archderm.1987.01660330140029