A 9-Year-Old Girl Is Evaluated Because of a Rash

A 9-year-old girl is evaluated because of a rash.  Multiple light patches appeared on the patient's face, chest, back, and arms a week after she began attending a swim camp and became more pronounced over the past month.  The spots are mildly itchy but not painful.  No dietary changes or use of new soaps has occurred.  The patient applies a new suntan lotion 5 days a week while swimming in the camp's chlorinated pool; however, the spots do not tan even though the surrounding skin does.  She has a history of allergic rhinitis and takes oral antihistamines.  She has no history of major illness or hospitalization.  Vital signs are normal.  On examination, the patient is awake, alert, and comfortable.  There is mild nasal congestion with enlarged turbinates and clear postnasal drip but no pharyngeal erythema.  Lung sounds are clear.  No heart murmurs are present.  Multiple pale macules appear on the face, trunk, back, and upper arms, as shown in the image below. Some of the spots have slight scaling, and they are not tender to palpation.  Which of the following is the most likely diagnosis in this patient?

A) Atopic dermatitis
B) Irritant contact dermatitis
C) Mycosis fungoides
D) Pityriasis rosea
E) Seborrheic dermatitis
F) Tinea versicolor
G) Vitiligo

Correct Answer:

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