How would you diagnose this woman's eczema?

David L. Kaplan—Series Editor
University of Missouri Kansas City, University of Kansas

A 46-year-old female with a history of eczema presents with a 2-month history over the summer of itching on her arms, mostly in a sun distributed pattern. She has some rash on her legs but it is mild and asymptomatic. She denies taking any new medications or exposures. She feels she actually flared a little on a methylprednisolone dose pack. 


How would you diagnose her eczema?

A. Cutaneous lupus erythematosus
B. Atopic dermatitis
C. Psoriasis
D. Leukocytoclastic vasculitis
E. Poymorphous light eruption

(Answer and discussion on next page)

AnswerAtopic dermatitis

This patient had a biopsy that confirmed the diagnosis of an eczema flare. It was concluded that the sun had produced an exacerbation without any evidence of a photodermatitis. She was given a new topical regimen and placed on dexamethasone in case she was developing a sensitivity to methylprednisolone and did much better.