Desquamative erythematous rash in a young woman

• Main Authors: Lim, Delwyn Zhi Jie, Cai, Sophie Carrie Shan, Lim, Joel Hua-Liang, Lee, Joyce Siong See, Tey, Hong Liang
• Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
• Format: Article
• Language: English
• Published: 2024
• Subjects: Medicine, Health and Life Sciences; Biotin deficiency; Granular parakeratosis
• Online Access: https://hdl.handle.net/10356/173632
• Institution: Nanyang Technological University

A 22-year-old woman presented with a worsening nonpruritic rash on the anterior aspect of her chest and underarms for the past 6 months. The rash was associated with dryness, desquamation, and a burning sensation. She had no preceding new contactants or medications. In addition, she had discontinued all contactants upon the onset of her rash; however, her condition continued to progress despite the cessation of contactants for more than a month. Her rashes also persisted despite continual use of topical corticosteroids and topical tacrolimus. She reported going on a crash diet one year ago for weight loss and lost a total of 6 kg in the first 3 months. Currently, she only consumes 500 to 800 calories a day and currently weighs 38 kg with a body mass index of 16.78 kg/m2 . She denies any bulimic symptoms, recent stressors, or mood problems. Her medical history is significant for asthma, allergic rhinitis, and a previous anxiety disorder.