Abstract
A 22-year-old Black man presented to our clinic for an asymptomatic rash on the epigastrium that had expanded and thickened over the previous 2 years. Brown, hyperkeratotic papules and plaques with central confluence and a peripheral reticulated appearance covered a 30 × 20-cm area on the patient’s upper abdomen and lower chest at the midline. A similar, milder rash appeared in a 6-cm area at the midline of his upper back. The rash hadn’t responded to scrubbing with soap and water, ammonium lactate lotion 12% bid, or over-the-counter moisturizing lotions.What’s your diagnosis?
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