Photosensitive erythematous skin rash.

Volume 88, Number 7 www.aafp.org/afp American Family Physician 457 A 41-year-old man presented with a painful, erythematous, erosive, and scaly rash. It was symmetrically distributed over sun-exposed areas, involving his face, neck, dorsum of his hands and feet, and upper back (Figures 1 and 2). The rash and frequent loose stools had been present for several months. Neuropsychiatric evaluation revealed short-term memory loss, speech problems, and difficulties with activities of daily living. He had a long history of heavy alcohol use. He was not taking any medications. Results of routine laboratory testing were normal.