Presenter: Tracy Favreau, DO; Asfa Akhtar, DO; Merrick Elias, DO; Kristen Aloupis, DO; David Bonney, DO; Brian Feinstein, DO; Chris Buckley, DO; Marcus Goodman, DO; Allison Schwedelson, DO
Dermatology Program: NSUCOM/NBHD
Program Director: Stanley E. Skopit, DO, FAOCD
Submitted on: October 1, 2006
CHIEF COMPLAINT: Intensely pruritic lesions
CLINICAL HISTORY: The patient is a 60-year-old Latin male presenting for evaluation of itchy patches in his bilateral axillae, inguinal region, and gluteal folds. The patient states this eruption is ongoing for the previous three months and is progressively worsening. He feels as if it began after starting a new medication. He started taking Lipitor, Metformin, and Lotrel four months prior to the onset of lesions.
PHYSICAL EXAM:
Evaluation of the bilateral axillae reveals two well-demarcated erythematous plaques with a pinkish sheen. There is no scale present. The inguinal region bilaterally as well as the gluteal folds reveal similar lesions; however, much larger. No excoriations or signs of secondary infection are present.
LABORATORY TESTS:
The CBC and CMP were within acceptable limits. ANA was found to be negative and the RPR was non-reactive.
DERMATOHISTOPATHOLOGY:
PAS stain negative for fungi.
DIFFERENTIAL DIAGNOSIS:
1. Contact Dermatitis
2. Tinea
3. Mycosis Fungoides
4. Inverse Psoriasis
5. Drug Eruption
