This 28-year-old man presented for evaluation of an enlarging pruritic patch on his arm that had developed over a 4-month period. His only medications were fluticasone and azelastine, which he takes to treat seasonal allergies. He uses only his hands, not a washcloth, to bathe, and he does not apply any topical creams or lotions. He does not have pets, and he denies any other exposure history.
Answer: EczemaSee the full case at Consultant360
This atopic patient (based on his use of medications for seasonal allergies) had developed nummular eczema as a result of his bathing habits—long, hot showers and a lack of moisturizing—which resulted in the asteatosis seen here.
He was instructed on how to bathe and moisturize to maintain skin integrity after applying a short course of a topical corticosteroid cream.