June 2002
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History: The patient is a 42 year-old black female with a history
of dry, thick, scaly rash since infancy, that varies in severity over time
(Figs 1,2). Occasionally she has also noted nonpruritic erythematous rashes,
particularly over her torso. Previously, she has been treated unsuccessfully
for presumed atopic dermatitis with triamcinolone ointment. She does report
that she has had some relief with Salicylic acid gel and Tazorac gel. Her
past medical history includes Graves disease. Current medications include
Synthroid, Tazorac gel, triamcinolone ointment, and Doxepin. The patient
has a sister with similar complaints.
Physical Exam: 42 year old well developed, well nourished, black
female with lichenified, hyperpigmented, hyperkeratotic, symmetric plaques
over much of her upper torso, upper arms, and lower shins with accentuation
along the flexural areas. The patient's face, scalp, eyes, and lips were
unremarkable. No erythematous patches were noted on initial exam.
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