Dermatology Q 44

A 19-year-old man is evaluated for 4 to 5 months of persistent itching, thickening of the skin, and odor of the feet. He also has hyperhidrosis of the palms and soles. Medical history is otherwise unremarkable, and he takes no medications.

On physical examination, vital signs are normal. Skin findings are shown.

There is substantial odor of the feet. There are no changes to the toenails. The axillae and groin are unremarkable.

Potassium hydroxide preparation of skin scrapings does not reveal fungal elements.

Which of the following is the most likely diagnosis?

A Aquagenic keratoderma

B Erythrasma

C Keratoderma blenorrhagicum

D Pitted keratolysis

E Tinea pedis

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