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November 2009

Confluent Scaly Erythematous Plaques on the Trunk of a 16-Year-Old Boy—Quiz Case

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Arch Dermatol. 2009;145(11):1325-1330. doi:10.1001/archdermatol.2009.255-a

A 16-year-old white male referred to our center for evaluation of an erythematous papulosquamous eruption on his trunk and extremities that had been present for approximately 2 years. The eruption was asymptomaticwith the exception of mild intermittent pruritus. He was otherwise healthy without any medical problems. A complete review of systems was unremarkable, and he was not taking any medications. Several topical treatments had been tried including emollients, ammonium lactate lotion, 12%, and desonide cream, 0.05%, without effect. The patient denied having contact allergies, sun sensitivity, pain, and blistering. No family members showed similar skin findings nor was there a family history of this eruption. Physical examination revealed a healthy young man with widespread erythematous papules and plaques with large areas of confluence and minimal fine scale present on the chest, back, axilla, and antecubital regions. Some areas had a reticulate or digitate pattern (Figure 1). The remainder of the skin and physical examination was unremarkable. Cutaneous shave biopsy specimens were obtained and stained with hematoxylin-eosin (Figure 2 and Figure 3).

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