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Cutaneous eruption on chest and back

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The cause of this “dirty” rash was fairly obvious to us, but only because we’d encountered this rare skin disorder before.


 

References

A 22-year-old African American man sought care at our clinic for an asymptomatic, “dirty-looking” rash on the epigastrium that had expanded and thickened over the previous 2 years. The rash hadn’t responded to scrubbing with soap and water, ammonium lactate lotion 12% BID, or over-the-counter moisturizing lotions.

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 (FIGURE). A similar, milder rash appeared in a 6 cm area at the midline of his upper back.

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