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A woman presented with an irritating and itchy rash affecting her axillae and neck. Although the eruption waxed and waned throughout the year, it was more symptomatic during the summer. She recalled her father having a similar rash. The patient worked as a nurse in a neonatal intensive care unit. Except for a high school knee injury, she was otherwise healthy. Examination demonstrated sharply demarcated boggy and erythematous plaques with overlying crust in her axillae and on her posterior neck. In addition, multiple, longitudinal white bands were noted on her fingernails.

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