
02/08/2025
A 56-year-old woman with rheumatoid arthritis presented to the dermatology clinic with a 2-month history of an extremely itchy rash. She had been treated with tofacitinib and methotrexate for the previous 4 years. On physical examination, large patches of erythematous skin with overlying scales, crusting, and deep fissures were seen on the chest, upper arms, neck, abdomen, buttocks, and thighs. Similar findings were noted on the hands, with sparing of the nails. What is the most likely diagnosis?