A 54-year-old man presented with a rash on his arms and chest. The rash had been present for several years and remained unchanged. It was slightly pruritic and had been previously treated with hydrocortisone cream without improvement. On physical examination, hyperpigmented follicular papules with fine scale were noted over his chest, upper back, bilateral shoulders, and antecubital fossae. A potassium hydroxide preparation of a scraping from a lesion on his chest was positive for spores and hyphae.
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