What is the best initial treatment for the skin disorder


Problem: A 55-year-old woman presents with itchy patches on her wrists for the past week. She reports no new exposures, medication changes, or other areas of involvement. She has no sick contacts or family members with similar symptoms. Physical exam reveals a papulosquamous eruption of flat-topped violaceous lesions on the volar wrist surfaces. Close inspection reveals tiny, white lines on the surface of the lesions. What is the best initial treatment for this skin disorder? Oral acitretin Oral diphenhydramine Oral ivermectin Topical fluocinonide Topical tacrolimus

 

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