Jess is a 43-year-old woman who presents with a one-month history of mildly itchy patches in both axillae.

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<p>Jess is a 43-year-old woman who presents with a one-month history of mildly itchy patches in both axillae.</p><p>The lesions began as red-brown macules and gradually expanded, merging into larger patches.</p><p>Jess has trialled a topical antifungal, with no improvement.</p><p>She is overweight and has hypertension and type 2 diabetes — both well controlled with lifestyle measures, an ACEI and metformin.</p><p>On examination, there are well-defined, wrinkled, erythematous-brownish plaques with minimal scaling in both axillae (pictured on left).</p><p>Wood’s lamp examination findings are also pictured (right).</p><p>No other lesions or lymphadenopathy was noted.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.