October 1997

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History: The patient is a 66 yo male who presented with a generalized pruritic eruption of 5 months duration. He was initially seen by his family physician and diagnosed as having psoriasis. He received hydroxyzine, amitryptyline, doxepin, lortab, cyclobenzaprine and Zestril for pruritus without relief. He received multiple injections of corticosteroids and p.o. prednisone, and betamethasone ointment prior to presentation to our clinic. One week before his initial clinic visit he was started on cephalexin for a wound infection secondary to scratching.

Physical Exam: Generalized erythroderma with scaling including the face and linear scaly lesions on hands (Fig. A), torso and arms (Fig. B) and feet (Fig. C).

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