Pruritic, erythematous, arcuate, and serpiginous smooth plaques

Kimberly Blain,Elliot Blue,Jamie Zussman,Jennie T Clarke

doi:10.1016/j.jdcr.2021.04.030

Kimberly Blain, Elliot Blue + Show 2 more

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A 59-year-old man with diabetes mellitus, hypertension, coronary artery disease, and gout presented to the dermatology clinic with an 18-month history of a pruritic widespread rash (Fig 1). Dull, erythematous, arcuate, and serpiginous smooth plaques, involving the chest, abdomen, arms, and back with a few scattered, scaly, erythematous plaques intermixed were observed. Episodes of the rash lasted for several months at a time, had no clear triggers, and resolved spontaneously. Previous treatments included triamcinolone 0.1% cream, fluconazole 150 mg weekly for 4 weeks, and terbinafine 1% cream without improvement.

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From the Department of Dermatology, University of Utaha; and Department of Internal Medicine, Medical College of Georgia at Augusta University.b
Secondary syphilis is nicknamed ‘‘the great mimicker’’ because it exhibits a variety of cutaneous morphologies and histological findings.[1]
Patients presenting with erythema gyratum repens, which is a rare, transient, paraneoplastic, figurate erythema, exhibit multiple, annular, or polycyclic patches or plaques with overlying scale

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Sarcoidosis patients and may present with a variety of morphologies, including papules, nodules, plaques, and infiltrated scars. Mycosis fungoides is the most common type of cutaneous T-cell lymphoma and classically presents with scaly erythematous patches and plaques with a predilection for the trunk, the buttocks. Secondary syphilis is nicknamed ‘‘the great mimicker’’ because it exhibits a variety of cutaneous morphologies and histological findings.[1] While cutaneous findings vary, the most common clinical presentation is a widespread, nonpruritic, coppercolored, papulosquamous eruption involving the palms and soles.[2] Histopathology demonstrates mild vacuolar interface alteration with superficial and deep perivascular lymphohistiocytic inflammation. Patients presenting with erythema gyratum repens, which is a rare, transient, paraneoplastic, figurate erythema, exhibit multiple, annular, or polycyclic patches or plaques with overlying scale.

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