A 17-year-old male was referred to the dermatology service for a pruritic scaly rash over his trunk and extremities. The eruption, which had first appeared eight months earlier, was not responding to superpotent topical steroids. Numerous erythematous scaly plaques were visible on his chest, abdomen, back, axillae, and extremities. No one in the patient’s family had a similar skin condition. He reported that he had two cats. A KOH skin scraping of the abdominal plaque revealed numerous branching hyphae.
The patient, a 42-year-old man, complained of a mildly pruritic rash that had been present for 15 years on his abdomen, chest, lower back, elbows, and knees. Physical examination revealed numerous well-demarcated erythematous scaly plaques with overlying silvery scale. No family history of skin problems was reported. Mid-potency topical steroids alternating with topical calcipotriene had yielded mild improvement over the past few years, but the patient was looking for better control of his condition.