History: 65 yo WM with a persistent rash on his right scrotum for 1-2 years. He denied any drainage, pain or itch, but he felt that the rash was enlarging in size without any significant change in color. Prior treatment with triamcinolone ointment 0.1% for 4 weeks and antifungal creams did not improve the rash. He denied having sexual contact for more than 10 years prior to presentation.
Past Medical History: hypertension, dyslipidemia, coronary artery disease (MI in 2001 s/p 3 vessel bypass), prostate cancer s/p prostatectomy, osteoarthritis, post traumatic stress disorder, glaucoma
Medications: non-contributory except per HPI
Allergies: no known drug allergies
Physical Exam: Right scrotum: 4 cm annular erythematous plaque with normal testicular exam (Fig. 1)
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