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September 1991

Widespread Eczematous Dermatitis With Erythematous Facial Plaques

Author Affiliations

The Johns Hopkins Medical Institutions, Baltimore, Md

Arch Dermatol. 1991;127(9):1397-1398. doi:10.1001/archderm.1991.01680080133018

REPORT OF A CASE  A 49-year-old man presented with a 10-year history of widespread pruritic patches and plaques that had progressively increased in size and number. The patient first noticed the development of pruritic papules and pustules on the dorsal aspect of his right hand while traveling in West Africa approximately 10 years ago. The eruption slowly spread to his arms, legs, trunk, and back over the ensuing years, with increasing pruritus despite application of topical corticosteroids. He was also treated with oral and topical antibiotics for staphylococcal folliculitis without improvement. The lesions became generalized plaques, including the face.The patient's medical history was remarkable for hypertension, pulmonary embolus, and chronic sinusitis.Findings from the physical examination revealed a mildly obese man with widespread erythematous, scaling plaques sparing only his palms, feet, scalp, and axillae (Fig 1). His face displayed prominent erythematous, infiltrated plaques on the forehead, the bridge of

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