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A 45-Year-Old Woman Comes to the Office with a 10-Day

question 411

Multiple Choice

A 45-year-old woman comes to the office with a 10-day history of a pruritic rash. The rash initially started on her hands and quickly spread to her fingers, wrists, and elbows. The itching is particularly pronounced at night. The patient works as a flight attendant and recently returned from an international trip, during which she stayed in a hotel for 3 days. Her roommate also developed similar symptoms a week after the patient did. The patient has no other medical conditions and takes no medications. She has one sexual partner and uses condoms for contraception. Her mother has a history of atopic dermatitis. Vital signs are normal. Skin examination shows small erythematous papules on the palms with scattered vesicles and pustules on the finger webs, palms, and wrist creases as shown below. There are numerous excoriations on the wrists and elbows. The remainder of the examination is within normal limits. Which of the following is the most likely diagnosis?

Definitions:

Keller and Nesse's

Refers to the work or perspectives of Randolph M. Nesse and perhaps his collaborations with others like George C. Williams or Keller, focusing on evolutionary psychology or Darwinian medicine.

Sociometer Theory

A psychological theory proposing that self-esteem is an internal gauge of the degree to which one is included versus excluded by others.

Negative Emotions

Emotions that are generally perceived as being harmful to our mental well-being, such as sadness, anger, and fear, often resulting from adverse or challenging situations.

Genome-wide Association Studies

Research efforts aimed at identifying genetic variations associated with specific diseases by scanning the genomes from many individuals.