Derm Dx: A farmer's rash that worsened with topical corticosteroid

A 76-year-old man presents for evaluation of a moderately pruritic rash on his chest that has been present for several weeks. His medical history includes hypertension and hypercholesterolemia but no diabetes or immunosuppression. The patient is a farmer and a dog owner. When the rash first appeared, he was prescribed triamcinolone cream, which he used for 3 weeks and which ...