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"It's the Pits"


 

The several-week duration of this 14-year-old boy’s rash is worrisome to him and his family, despite a lack of other symptoms. Located on his right axilla, the rash was previously diagnosed as “yeast infection” but was unaffected by topical anti-yeast medications (nystatin and clotrimazole creams) and oral fluconazole.

A serious family crisis preceded the appearance of the rash: The parents lost custody of their children, who were then placed under the care of grandparents in another state. The boy lost his family and friends and had to start again in a new school.

EXAMINATION
Additional rashes are present on his face, in and behind his ears, and on focal areas of his genitals. They are all orangish red with faintly scaly surfaces. The scale on his face, ears, and genitals is coarser than that of his axilla, but it is the same salmon-pink. Focal areas of his brows and scalp are also involved.

What is the diagnosis?

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