A Man With a Rash on Nearly Half of His Body for 8 Years

Richard Harold Flowers IV, MD; Stephany Lynn Vittitow, BA; Corina Rusu, MD, PGYIII


August 25, 2020

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An 80-year-old man with a history of diverticulosis, osteoarthritis, and hypertension presents to a general dermatology clinic with a gradually worsening diffuse rash (Figure 1).

Figure 1.

The occasionally pruritic rash has been present on his face, trunk, and upper and lower extremities for approximately 8 years. He had previously applied hydrocortisone 2.5% ointment to his face and betamethasone 0.05% cream to his extremities without significant effect.

The patient has no personal or family history of skin disease. He reports no recent medication changes and takes only hydrochlorothiazide for hypertension and naproxen occasionally for his osteoarthritis. Over the past few months, he has had a weight loss of 4-5 pounds. No lymphadenopathy is noted. The results of the remainder of his review of systems are normal.


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