Clinical Challenge: A 32-Year-Old Man With Multiple Itchy, Malodorous Papules

A 32-year-old man presents with multiple rough, crusted, itchy, malodorous skin papules on the chest, back and forehead.

Further examination reveals flat wart-like papules on the dorsa of the feet and hands. The patient’s nails are chipped and have longitudinal ridges. Family history is not available, as the patient was adopted as a child.

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