An 18-Year-old caucasian female sought care at our dermatology clinic for a progressive, erythematous eruption on her face, neck, trunk, and extremities (FIGURES 1A AND 1B). She noted that the eruption had developed suddenly and that it was itchy.
The patient had no significant past medical history and denied being sexually active. The only medication she was taking was mestranol/norethisterone.
The patient denied any new exposures to medications, detergents, or foods. Upon questioning, she did note that about 1 to 2 weeks prior to the skin eruption, she had a mild sore throat and cough. However, her upper respiratory symptoms had resolved by the time she arrived at the clinic.
On physical exam, the patient had multiple erythematous papules and plaques with a fine scale over her face, neck, trunk, and lower legs (FIGURE2). There were areas of confluence on her face and neck. Her palms, soles, nails, and intertriginous areas were spared.
The patient’s mucous membranes were moist and there was no erythema or tonsillar exudate in her pharynx. A complete blood count, basic metabolic panel, and urinalysis were all within normal limits; a rapid plasma reagin (RPR) was nonreactive.
FIGURE 1
Papules and plaques with fine scale
This 18-year-old patient had multiple, erythematous papules and plaques with a fine scale over her face, neck, trunk, and lower legs. We performed a punch biopsy on her left posterior shoulder.
FIGURE 2
Papules and plaques on lower legs
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