# When Classic Signs Deceive: A Widespread Papulosquamous Eruption in Skin of Colour

## TL;DR

A 29-year-old man with African descent had a long-lasting skin rash that was diagnosed through a biopsy.

## Contribution

The case highlights the importance of biopsy in diagnosing persistent skin conditions in people of color.

## Key findings

- The patient had a widespread papulosquamous eruption on the trunk, upper arms, and thighs.
- A skin biopsy of a fresh lesion provided a definitive diagnosis.
- The eruption was characterized by scaly, hyperpigmented papules and plaques.

## Abstract

A 29-year-old gentleman of African descent presented to the emergency department with a three month history of a rash affecting the trunk, upper limbs, and thighs. The patient was unsure of any triggers and denied any preceding illness, new medications, illicit drug use, or recent vaccinations. On examination, there was a widespread papulosquamous eruption characterised by scaly, hyperpigmented papules and plaques involving the trunk, upper arms, and upper thighs. A definitive diagnosis was established through a diagnostic skin biopsy of a fresh lesion.