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A 41-year-old woman with a history of alcohol abuse, hypertension, and type 1 diabetes mellitus complicated by retinopathy, nephropathy, and end-stage renal disease presented with a five-month history of alopecia and fine, brittle scalp hair, diarrhea, angular cheilitis, and a pruritic, scaly erythematous eruption (Panel A) that preferentially involved the distal extremities, the perineum (Panel B), and the buttocks. The patient did not have any neurologic symptoms. The skin eruption was treated unsuccessfully with topical corticosteroids and antifungal agents and with oral antibiotics. A skin-biopsy specimen from the left inner thigh revealed confluent parakeratosis with an absence of the granular . . . [Full Text of this Article] |
A correction has been published: N Engl J Med 2005;352(16):1731.
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