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Images in Dermatology
July 21, 2021

Epidermolytic Hyperkeratosis

Author Affiliations
  • 1University of Louisville School of Medicine, Louisville, Kentucky
  • 2Division of Dermatology, University of Louisville, Louisville, Kentucky
JAMA Dermatol. Published online July 21, 2021. doi:10.1001/jamadermatol.2021.2325

A 28-year-old African American woman was referred to the dermatology department for a rash that was unresponsive to oral and topical steroids. On examination, the patient had annular erythematous plaques (Figure, A) and corrugated scaling of the flexures (Figure, B). Punch biopsy results of the rash revealed epidermolytic keratosis, and the patient received a diagnosis of annular epidermolytic ichthyosis. Genetic testing was performed, the results of which are pending. The patient was administered methotrexate and cyclosporine with improvement, and was later transitioned to receive ustekinumab, which was followed by disease control.

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