Image of the Week: What's causing this greasy underarm rash? - Clinical Advisor

Image of the Week: What’s causing this greasy underarm rash?

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A 17-year-old male presents with a one-year history of a recurrent pruritic rash on his back, shoulders, hands, and axillae. He mentions that the rash is typically worse in the summer months and similar in appearance to one his mother has. Examination reveals numerous brown keratotic papules with a greasy texture and multiple cobblestone lesions in the mouth. A skin biopsy demonstrates a dermal inflammatory process, with acantholysis at all epidermal levels, as well as significant dyskeratosis. What other clinical feature would be consistent with this patient’s most likely diagnosis? Learn more about this case, take the quiz, and join the conversation on Figure 1.

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