Acta Dermato-Venereologica 99-6CompleteContent | Page 27

QUIZ SECTION 623 Erythematous Rash in a Transgender Patient: A Quiz Francisco GALEANO-VALLE 1 and Jeehea Sonya HAW 2 1 Internal Medicine, Hospital General Universitario Gregorio Marañón, C/. Doctor Esquerdo, 46, ES-28007 Madrid, Spain, and 2 Department of of Medicine, Division of Endocrinology, Department of Medicine, Emory University, Atlanta, GA, USA. E-mail: [email protected] A 23-year-old transgender male (born female, male gender identity) had commenced hormone therapy consisting of intramuscular injections of testosterone in the thighs 5 months prior and intramuscular injection of medroxypro- gesterone 2 months prior to presentation. He presented to the endocrinology clinic in winter after experiencing increased facial acne, voice deepening and decreased breast tissue. Additionally, he noticed a growing bruise in the lateral lower left leg that appeared one month before (Fig. 1). This bruise had spread upwards to his lateral thigh. He denied pain, pruritus, fever or swelling. Physical examina- tion showed a reticular erythematous rash that stretched along his lateral left leg to the top of the thigh. Blood tests showed testosterone 1,241 ng/dl, estradiol 40 pg/ml. All other results including full chemistry panel and complete blood count were unremarkable. What is your diagnosis? See next page for answer. Fig. 1. Reticular erythematous rash that stretched along his lateral left leg to the top of the thigh. This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica. doi: 10.2340/00015555-3151 Acta Derm Venereol 2019; 99: 623–624