Chronic hyperpigmented patches increased by medication | Figure 1

eosinophil

Chronic hyperpigmented patches increased by medication

47 yo M with months of diffuse gradually worsening hyperpigmented macules and patches that itch within 15 minutes of taking ED medications. Normal CBC CMP CRP TSH ANA RPR SPEP. ESR sightly elevated at 41. Normal allergy tests (environmental prick, true test patch, prick and patch to medications: OTC rhino/libimax and RX cialis). PCP and patient resistant to the idea of formal Dermatology consultation and Bx as lesions itch within minutes of taking medication. Therefore they would know Figure 1 community opinion of whether Dermatology input would assist. I vote yes!

AI analysis of images DDx: Fixed drug eruption, prurigo nodularis, lichen simplex chronicus, tinea, cutaneous lymphoma.

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