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"Can you follow the trail?"
Case preparation: Dr J Horton Images: Dr J Horton

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A 68-year-old man has a 10-month history of an intermittent, itchy rash on his right thigh. This settles with a topical steroid and between episodes the skin is normal. He occasionally has a similar eruption on his left chest but has had no rashes anywhere else.

He smokes a pipe but his personal and family history was otherwise non-contributory, and there were no abnormal findings elsewhere on general examination.