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History

A 40 year old man presents with a 12 month history of a scaly and itchy rash on the palm of his left hand. There is no relevant medical history, no past history of atopic disease or psoriasis, and there are no known allergies nor rashes elsewhere. He works as a builder and is generally well.

Topical treatments tried to no avail include moisturizers, steroids and antifungal creams.