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35-Year-Old Male with Itchy Eruption on Groin & Axillae

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

This 35-year-old male presents with a slightly itchy eruption in his groin and axillae of 1 month duration. He is an insulin-dependent diabetic and had a case of pityriasis rosea 2 years prior that resolved uneventfully. He denies any new exposure history, new medications, or recent illnesses.

To what would you attribute this new skin eruption?

Choose one to reveal diagnosis and discussion

Pityriasis rosea
Drug reaction
Seborrheic dermatitis
Candidiasis
Erythrasma

Answer: Inverse pityriasis rosea

See the full case at Consultant360

This patient had a case of inverse pityriasis rosea characterized by the characteristic oval-shaped salmon-colored scaling macules involving flexural surfaces rather than being seen on the trunk and proximal extremities. While repeated cases of pityriasis rosea are uncommon, they have been reported. Seborrhea, Candida infection, and erythrasma would be expected to be more confluent with satellite lesions for the Candida unlike what is seen here. This would be an unlikely appearance for a drug reaction.