Scaly erythema develops gradually on the head, neck and dorsa of the hands in light exposed areas. The eruption progresses and becomes lichenified. Thick pruritic plaques develop which may become confluent and form furrows.
In severe cases, the eruption may involve the hairy scalp, shielded areas of the face and most of the body surface.
Pruritus may be severe and intractable, and can cause depression.
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