Question special

A 46-year-old African American woman presents with a 3-month history of rash. She describes the rash as very itchy and bumpy. The location involves her inner wrists and anterior ankles. Skin examination reveals deep purple pigmented papules. She has no other associated symptoms. The patient believes the rash may be eczema because her daughter was recently diagnosed with this. However, she denies any personal history of eczema, rash, skin sensitivity, seasonal allergies, or asthma. She reports having tried various oils, moisturizers, and over-the-counter hydrocortisone cream to treat the rash, all without notable improvement.

What is the most likely diagnosis?
A. Psoriasis
B. Dyshidrotic eczema
C. Lichen planus
D. Discoid lupus
E. Atopic dermatitis

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