What caused this pruritic rash under a woman’s breast?

March 30, 2010

Tinea presents as a pruritic rash and is often seen under skin folds.

Case 1:

A pruritic rash under the left breast has bothered a 67-year-old woman for the past month. She takes an antihypertensive and is otherwise healthy.

What does this look like to you?

A. Candidiasis.
B. Intertrigo.
C. Erythrasma.
D. Tinea.
E. Contact dermatitis.

 

 

Answers on Next Page

Case 1: Tinea

A potassium hydroxide evaluation for dermatophytes confirmed a diagnosis of tinea, D, although no obvious source could be identified. The rash responded quickly to an antifungal cream.

 

Candidiasis usually has satellite lesions extending from the periphery. Intertrigo is a diagnosis of exclusion; it is caused by heat and chafing. Erythrasma resembles this patient's rash, but it responds to topical antibacterial therapy. Contact dermatitis is typically bilateral.