Sudden onset of generalized scaly eruptions
The fact that the lesions occupied the lines of cleavage proved to be telling.
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
A 35-YEAR-OLD MAN came to our clinic for treatment of a slightly pruritic rash that had begun as a singular, annular erythematous plaque at the sixth intercostal space. The initial plaque erupted around the time he’d had a cold, with fever.
The present rash involved several similar, but smaller, eruptions on the anterior trunk and flank region (FIGURE 1A). Each lesion was surrounded by erythema and collarette scaling. The pattern of the secondary lesions ran parallel to the lines of cleavage. When looking at the patient head on, the pattern resembled a Christmas tree (FIGURE 1B).
The posterior trunk showed similar, but fewer, eruptions. The patient’s palms, soles, and mucous membranes were spared.
WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?
FIGURE 1
Scaly plaques and papules
This 35-year-old patient had plaques and papules with collarette scales that followed the lines of cleavage (A) and formed a Christmas tree pattern (B).
