Rapidly Fading Rash After Ski Weekend

The patient is a college-age woman with a history of moderately severe and extensive plaque psoriasis that has been managed with topical corticosteroids. She was snowboarding over a very cold weekend and developed a pustular rash at night after her activities. She comes to your office on Monday morning and shows you a rash on her hands, which is already fading. This rash is unlike any skin problem she has previously experienced. She recalls no trauma to the hands; however, she remembers removing her gloves to text on her phone while she was sitting on the chair lift.

Examination reveals drying pustules on the acral aspect of her hands. There is no involvement elsewhere.