52 M presenting with PMH of atopic and seborrheic dermatitis | Figure 1
Patient Case Overview
52 M presenting with PMH of atopic and seborrheic dermatitis presenting with highly pruritic papular rash localized in his upper and lower extremities, abdomen and his lower back since 4 days ago. Patient pointed out that he has had similar events in the past; last one 2-3 years ago.
He says that he can't recall how the previous episodes subsided nor what medications were used. He says that he uses coconut oil in his face, upper thorax and inguinal region to avoid common flares in those areas. More or less, 2 weeks ago, he changed to a new shampoo, but no skin lesions on his head, neck or thorax.
No change in his diet and no known food allergy. 5-6 days ago, he had little (10-15 mins) exposure to rain while working on a rain leak in his house ceiling. Pruritus disturbs his sleep. He describes having occasionally goosebumps related to the most pruritic moments.
A dermatologist indicated a short course of deflazacort, ivermectin and desloratadine. Little-moderate improvement for pruritus.
Physical Examination
Lesions are erythematous, papular distributed as described not affecting the head, neck, chest and upper back. No ichthyosis, pityriasis alba. Presence of liquenification on his lower right leg; present since more than 6 months ago.