Generalised itching with wrist lesions

Case history

A 35-year-old man gave a six-week history of intense generalised pruritus that was worse at night. The itching spared the face and head. Examination revealed multiple excoriated urticarial papules over the trunk and some linear crusted lesions on both wrists (Figure 1) and in the interdigital clefts. Skin biopsy demonstrated cuticular lined structures under the stratum corneum and superficial dermal eosinophilia (Figure 2).