Clinical features
- well circumscribed, raised, coin shaped lesions ranging from 4 to 10 cm or more in diameter
- usually symmetrical affecting the extensor surfaces of limbs (especially in older patients) and dorsal aspects of hands and feet (especially in younger patients); occasionally, they occur on nail folds causing ridging; rarely, the face
- usually subacute with erythema, mild oedema, and in some cases, vesiculation; scaling and lichenification in more chronic cases
- surface may be moist and secondary infection is common
- pruritus is variable
- lesions usually persist for many months, fade spontaneously, then relapse. In older patients the rash tends to be more persistent.
- rare in patients less than 20 years of age
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