Patient reports having this rash for years. Other than occas | Figure 1

Patient reports having this rash for years. Other than occasional itch, that is mild in severity, patient is asymptomatic, with the exception of a few of the lesions on her knuckles, which are tender to the touch.

Patient does feel like sometimes the rash moves. She shares that it may also be worse when wet. Per patient, the rash is only on her hands (no where else on her body). She denies contacts with similar rash.

Patient received treatment in the past, triamcinolone, but was unable to take it as prescribed and then patient ended up giving the medication to her son for his eczema (he had no PCP).

Patient believes her rash is likely eczema, but would like to rule out scabies as she has had exposure in the past and wants to make sure she does not have a chronic version of it.

In terms of history, she has no personal history of melanoma or non-melanoma skin cancer. She does have a family history of skin cancers (her sister) and other cancers (breast cancer in the same sister). Patient denies any known autoimmune condition, but does explain that she is prediabetic and takes Metformin and Ozempic.

(First 2 photos are more recent than last 3 over a month apart)

The author made an update to this case

Update 1

Spongiotic Dermatitis per path results

Diagnosis Added
Spongiotic Dermatitis