Why has this itchy rash resisted corticosteroids?

2/14/2013 - 3:20pm
2303 reads

Citation:

Consultant. 2013;53(2):73-74

Authors:

DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas

David L. Kaplan, MD––Series Editor: Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

Dermclinic
A Photo Quiz To Hone Dermatologic Skills

A 68-year-old woman has had itchy spots on the anterior neck and left arm for 2 months. Over-the-counter antipruritic creams have been ineffective. She denies using any new preparations that may have caused the rash, such as perfumes, moisturizers, or other cosmetics.

A potassium hydroxide (KOH) evaluation performed a month ago was negative; a potent corticosteroid cream was prescribed, but the rash has failed to clear.

What is the most appropriate next step?

A. Prescribe a short-term tapering course of prednisone.

B. Perform a skin biopsy.

C. Perform a second KOH evaluation.

D. Perform patch testing for possible contactants.

E. Recommend that she use hypoallergenic skin products.

(Answer on next page.)

Resource Center Index

Dermclinic

	Why is this man’s leg painful, swollen, and red? DermclinicA Photo Quiz to Hone Dermatologic Skills For the past few days, a 63-year-old man’s...
	Can you identify this spreading, itchy rash? A 16-year-old girl is bothered by a spreading, itchy rash of 1 week’s duration on the left...
	What is this changing pigmented lesion? A 44-year-old man presents for evaluation of a changing pigmented lesion on his trunk. What does...

	Breast Cancer in Older Men Neil Baum MD and Neeraj Kohli MD MBA 4/17/13 \| 1,025 reads
	Lactose Intolerance in the Genes Toni Brayer MD 3/28/13 \| 1,385 reads
	Statins Lower Testosterone! GASP! Alvin B. Lin MD FAAFP 3/20/13 \| 1,861 reads

	Acrocyanosis Cyanosis involving the hands and toes of a 12-year-old girl was first noted 3 months before medical...
	Jejunal Diverticulosis During routine exploration of the abdominal viscera before rectal carcinoma resection, diverticula...
	Subperiosteal Abscess A 3-year-old boy was brought to the emergency department with left eye swelling, which had doubled...
	Candidal Intertrigo A 79-year-old woman presented with this highly pruritic rash of several weeks’ duration; it had...