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Make the diagnosis.

Clinical presentation

A 14 year-old previously healthy female presents to the dermatology clinic for evaluation of a persistent dermatitis on the trunk and abdomen. The patient reports the development of two distinct lesions covering the back and abdomen 6 months prior to initial presentation. The patient denies pruritus, pain, burning, or xerosis. Shortly after the lesions erupted, the pediatrician diagnosed her with tinea versicolor. The patient's rash failed to improve over the following 4 months, despite the intermittent use of clotrimazole 1% cream and ketoconazole 2% cream. The patient denies any recent travel or pets residing in the home. The family history is noncontributory.

Physical exam

The patient is a well-appearing non-obese teenage female who is in no acute distress, with normal affect. On skin examination, there are confluent tan-brown papules coalescing into plaques involving the back and abdomen, with a reticulated appearance around the periphery of the plaques. There are no other lesions present on the cutaneous surface. The patient is afebrile, and vital signs are within normal limits.

What is your diagnosis?

A) Acanthosis nigricans

B) Erythema ab igne

C) Confluent and reticulated papillomatosis of Gougerot and Carteaud

D) Tinea versicolor

E) Terra firma-forme dermatosis

See page 18.

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Article Details
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Title Annotation:persistent dermatitis
Publication:Pediatric News
Article Type:Case overview
Date:Feb 1, 2017
Words:211
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