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Itching and rash in a boy and his grandmother

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A boy came to the office with a rash and progressively severe itching for approximately 2 months (FIGURE 1). Examination showed an excoriated generalized papular eruption, including some urticarial-type papules and chronic eczematoid changes near the waist, axillae, hands, and wrists.

His grandmother, with whom he spends most weekends and a lot of time after school, also has had a rash and progressive itch for approximately 3 weeks. One feature of the dermopathy observed clinically, first located by hand lens examination and then confirmed by dermoscopy, is depicted in FIGURE 2.

FIGURE 1
Excoriated eruptions

Clinical presentation: Pruritic dermatosis near the waist, axillae, wrists, and hands.

FIGURE 2
Dermoscopic photograph of the dermatosis

Dermoscopic photograph illustrating a suggestive feature of the dermatosis. A scalp hair is included in the photograph to provide relative size.

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