History:

The largest lesion has appeared first on the flank. Few days later multiple similar but smaller lesions developed on the abdomen, chest, back and proximal extremities. The rash was slightly pruritic and composed of oval erythematous plaques with peripheral trailing scales. The longitudinal axes of the lesions were parallel to rib cleavage lines giving the rash a christmas tree appearance. Stretching individual lesions revealed more prominent scales especially in the centers of the plaques.