Derm Dx: Bright plaques, papules on the thumb

A patient, aged 34 years, presented for evaluation of a rash on his dorsal proximal right thumb and right wrist. The rash was first noted three weeks ago on the thumb. The patient applied clobetasol spray, but the rash became more red and diffuse.

Upon further questioning, the patient revealed that he was a salesman who enjoyed gardening in his ...