History: 24-year-old woman 34 weeks pregnant with her second child presented with a "rash" on her hands since the first trimester. She denied pain or pruritus and had a similar eruption during her first pregnancy which resolved after delivery. Her past medical history was significant only for gestational diabetes.
Physical Exam: The patient had well demarcated erythematous patches symmetrically over her distal phalanges as well as her thenar and hypothenar eminences. The areas completely blanched with pressure. (Figures 1 and 2)
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