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JAMA Dermatology Clinicopathological Challenge
April 29, 2020

A Patient With a 10-Year History of Generalized Pruritus

Author Affiliations
  • 1Department of Dermatology, Hospital Universitari Son Espases, Palma de Mallorca, Spain
  • 2Department of Pathology, Clinica Rotger, Palma de Mallorca, Spain
JAMA Dermatol. 2020;156(6):697-698. doi:10.1001/jamadermatol.2020.0886

A white woman in her early 40s presented with generalized pruritus of 10-years’ duration. She had no other medical history. The patient provided the report of a skin biopsy performed 2 years before presentation. It was described as indicating spongiotic dermatitis. She had been treated with topical corticosteroids with no control of the symptoms. Physical examination revealed erythematous papules, some of them crusted, and some excoriations located over the trunk and upper extremities (Figure 1A). In addition, some scales and fissures were seen on her lower lip (Figure 1B), sparing the surrounding skin, as well as inner mouth and upper lip. A new biopsy sample was taken to rule out actinic cheilitis.

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