An Accountant on a Weight-Loss Program Has a Rash, Poor Sleep

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A 43-year-old man who was recently diagnosed with hyperlipidemia presents with a rash that affects both axillae. He also has diffuse itching on his trunk and extremities. What's the diagnosis?

The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, pleaseA 43-year-old man presents to the dermatology clinic with a rash that affects both axillae.

He acknowledges that he is overweight and had signed up for a weight-loss workout program 3 weeks ago. Despite expressing his discomfort about having to wear workout clothes, he has experienced significant progress in mood and energy levels. However, his intense itching is substantially decreasing his quality of sleep.

 

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