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39-Year-Old Male from India with Itchy Eruption on Face

Can you diagnose this case?

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

Signs and Symptoms

This 39-year-old man from India has had an itchy eruption on his face for a few months. He is otherwise healthy, takes no medications, and has no other rashes.

A skin biopsy was performed, and the findings were interpreted as consistent with seborrheic dermatitis. Desonide cream and ketoconazole cream were prescribed. When the patient returned 2 months later, there was no improvement.

What would you do next?

Choose one to reveal diagnosis and discussion

Order an antinuclear antibody titer
Prescribe a mid-potent corticosteroid cream, such as fluticasone
Prescribe metronidazole gel
Repeat the skin biopsy
Prescribe oral minocycline
Prescribe oral ketoconazole

Answer: Repeat the skin biopsy

See the full case at Consultant360

A second skin biopsy, (this time a 2-mm punch) revealed changes supportive of cutaneous lupus erythematosus, B. Treatment was started with hydroxychloroquine and a mid-potent topical corticosteroid. The patient was told to limit sun exposure and to use sunscreen with a high SPF.