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Is this worsening rash related to occupational exposures?

Is this worsening rash related to occupational exposures?

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Case 3:
During the past year, a 48-year-old man has had joint pain as well as this worsening rash on his hands. He is a construction worker, and he attributes the symptoms to his occupational exposure. He does not want to complain for fear of losing his job.

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