QUIZ SECTION
667 Advances in dermatology and venereology
ActaDV Acta Dermato-Venereologica ActaDV
Sudden Onset of an Itchy Papular Eruption: A Quiz
Manuel P. PEREIRA, Dieter METZE and Sonja STÄNDER Department of Dermatology, Center for Chronic Pruritus, University Hospital Münster, Von-Esmarch-Str. 58, DE-48149 Munster, Germany. E-mail: sonja. staender @ uni-muenster. de
A 47-year-old man presented with generalized pruritus, which had developed 15 years earlier and was continuously present with exacerbations during the day. The itch had begun on the chest and spread to the entire body. An itch intensity score of 7 on a visual analogue scale( VAS, 0 – 10) was reported during exacerbations. The patient had no known allergies, rhinoconjunctivitis or allergic asthma. Other than an enlarged thyroid, no other health issues were reported and iodine was the only regular medication.
Upon inspection, multiple small isolated skin-coloured papules could be seen, mostly in frontal and lateral aspects of the trunk( Fig. 1).
Since the onset of the disease 15 years previously the skin condition and the pruritus had been treated intermittently with topical steroids and antihistamine, respectively, with no substantial alleviation of symptoms.
What is your diagnosis? See next page for answer.
Fig. 1.( A) Multiple isolated skin-coloured or slightly red itchy flat papules distributed mostly across the frontal and lateral trunk.( B) Close-up of typical lesions seen in the condition shown in A( not the same patient).
This is an open access article under the CC BY-NC license. www. medicaljournals. se / acta Journal Compilation © 2017 Acta Dermato-Venereologica. doi: 10.2340 / 00015555-2588 Acta Derm Venereol 2017; 97: 667 – 668