Skill Checkup: A 27-Year-Old Woman With Erythematous Plaques on Her Elbow, Thighs, and Scalp

William James, MD


December 20, 2021

The Skill Checkup series features quick, case-style interactive quizzes highlighting key guidelines- and evidence-based information to inform clinical practice.


A 27-year-old woman, a pharmaceutical sales representative, presents with several thick, scaly, well-defined, erythematous plaques that are silvery in color. Prominent plaques cover her elbows and thighs, and there is a patch on her scalp. Her lesions cover about 15% of her body. She applies moisturizing lotion or witch hazel when the lesions become irritating but it brings little relief. The patient wants to know whether this is eczema, as a friend suggests, or something more serious. She also asks how quickly these skin eruptions can be cleared.

She uses an inhaler to control mild asthma. She is 5 ft 6 in and 175 lb (body mass index 28.2). Although she has made efforts to stop, she smokes about half a pack of cigarettes a day.


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