Image IQ: 62-Year-Old Diabetic with Persistent Rash

Case Report:

A 62-year-old man with a long history of type 2 diabetes went to a dermatologist after a rash that had been diagnosed as eczema by his primary care doctor failed to resolve with treatment after nine months. In fact, it seemed to have worsened despite his careful adherence to treatment recommendations. The lesions developed first on his lower extremities but were now widespread and included his face and perianal region. The lesions were annular and sometimes serpiginous with crusting and distinctive borders with central clearing. The patient said the lesions could be quite itchy. Over the same period of time he had also noticed some weight loss and a few bouts of abdominal pain and diarrhea. Blood tests revealed mild anemia but were otherwise normal.

1. Tinea corporis
2. Subacute cutaneous lupus erythematosus
3. Erythema gyratum repens
4. Glucagonoma syndrome

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