Case 1: Chronic Stable Rash

History
Healthy 15 year old female presents with skin changes as noted below which first appeared at the beginning of puberty. Patient reports minimal symptoms. The rash is slowly progressive and involves her posterior neck, axilla, and torso.

She has seen four Dermatologists prior to this visit today and has been told various diagnoses including a fungus infection, a common skin change from being overweight, and most recently a genetic condition with no treatment.

She is very distressed because it has begun to affected her social life in the past couple of years.

Questions
1) What is your Differential Diagnosis (please include the reason for listing each diagnosis)?

2) Would you order any tests?

3) What would be your initial treatment plan?

4) Summarize your most likely diagnosis

Submit your response

Review Discussion of Case 1

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