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JAMA Dermatology Clinicopathological Challenge
August 2015

Erythematous Papules on the Forearms

Author Affiliations
  • 1Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio
  • 2Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio
JAMA Dermatol. 2015;151(8):891-892. doi:10.1001/jamadermatol.2015.74

A 72-year-old man with a medical history of atrial fibrillation, type 2 diabetes mellitus, chronic kidney disease, hypertension, and congestive heart failure presented with a 2-month history of scaly erythematous papules on both forearms (Figure, A). The lesions were pruritic at times and the patient reported no improvement with chlorhexidine wash or hydrocortisone, 1%, cream. He was otherwise asymptomatic, and review of his systems revealed no abnormalities. His medications included amiodarone, furosemide, nifedipine, insulin glargine, and allopurinol. He denied preceding trauma, recent travel, or new medications.