Hyperkeratotic papules with nail changes

A black woman, aged 52 years, presented for follow-up of an eruption on the central chest, back, and scalp. Other than a history of depression, she was healthy. Family history was negative for first-degree relatives with similar skin findings. 


Current medications included isotretinoin, fluocinolone acetonide oil, and fluoxetine. Physical exam was notable for greasy hyperpigmented and hyperkeratotic papules in a ...