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HISTORY
A 41-year-old man is seen for routine physical examination. Apart from mildly elevated cholesterol 2 years ago and a bout of bacterial bronchitis last winter, he has been healthy. Says he has had “bad acne” since age 21. Has applied drying agents that worsened it and that sting; has “sensitive skin” problems from creams. Now prefers to ignore his facial skin.
PHYSICAL EXAMINATION
Moderately unkempt-appearing but well-spoken man. Vital signs normal. Face and skin as shown. No lesions seen elsewhere on skin or in mucous membranes of his mouth.
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