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What clue in the photo points to the cause of this chronic hand dermatitis?

What clue in the photo points to the cause of this chronic hand dermatitis?

Case 1:
A 46-year-old dentist presents for evaluation of chronic hand dermatitis of 1 year’s duration. He has no other rashes. Standard patch testing was negative. Another physician prescribed a high-potency corticosteroid cream that controls the rash but does not clear it. The patient takes no other medications.

What are you looking at here?

A. Contact dermatitis.
B. Psoriasis.
C. Lichen planus.
D. Dermatophyte infection.

E. Atopic dermatitis.

Bonus question: What clue in one of the photos shown here can assist you in making the diagnosis?

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