A 43-year-old man presented with a 3-month history of discrete, dark red, circular lesions in his right axilla. He complained of severe pruritus at these sites that would wake him up at night. He denied any recent trauma or history of similar lesions. He denied any associated pain, blisters, or systemic symptoms (e.g., fever, chills). His medical history was unremarkable, and he noted no environmental triggers or new medications. Treatment with over-the-counter hydrocortisone cream, ketoconazole cream, and discontinuation of underarm deodorant yielded no improvement.
Physical examination revealed three well-circumscribed, violaceous, annular patches without scale or erosion that are limited to his right axilla (image). No other lesions were noted on his skin or mucous membranes. A wood lamp examination was negative. A punch biopsy specimen from a lesion was obtained (image). Source:…
