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JAMA Clinical Challenge
October 27, 2015

Widespread Scaly Eruption in a Patient With Multiple Comorbidities

Author Affiliations
  • 1Department of Dermatology and Cutaneous Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
  • 2Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
JAMA. 2015;314(16):1740-1741. doi:10.1001/jama.2015.9391

A 73-year-old African American woman presented with a widespread scaly pruritic rash lasting 2 months. Her medical history included hypertension, diabetes, pulmonary sarcoidosis, and acid reflux, for which she takes amlodipine, carvedilol, repaglinide, hydroxychloroquine, and pantoprazole. Her history also included chronic renal insufficiency and chronic hepatitis C, for which she takes no medications. She reported no fevers, new skin exposures, oral ulcers, arthritis, alopecia, or photosensitivity and no worsening pulmonary symptoms of cough or shortness of breath. The rash did not improve after 2 weeks of applying topical triamcinolone ointment (0.1%).