Dermatology Q32

A 60-year-old man is evaluated for dry skin and a pruritic rash of 6 months' duration. He is a farmer and has extensive exposure to the sun. The rash is transient, occurring most frequently during the winter and spring when his skin is dry, and is worsened by heat and sweating during the summer. The patient is otherwise well, has no other medical problems, and takes no medications.

On physical examination, vital signs are normal. Skin findings on the upper torso are shown.

The arms, legs, face, and mucous membranes are unaffected. The remainder of the examination is unremarkable.

Which of the following is the most likely diagnosis?


 

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