Review Question - QID 211089

A 41-year-old woman comes to the office for an evaluation of a rash. She reports the rash started 2 months ago on her knees and the rash has now appeared on her elbows. She denies pain or burning, but says the areas are mildly itchy and when she scratches them, they bleed. The patient is embarrassed because she works as a massage therapist. She reports some fatigue, but attributes it to stress. She denies headache, weight loss, or joint pains. She has seasonal allergies and takes daily loratadine. She had a tonsillectomy as a child. Her sister has alopecia and her son has vitiligo. She smokes 1 pack a day and denies alcohol or other recreational drug use. She is sexually active with her husband of 15 years. Her temperature is 98.7°F (37°C), blood pressure is 112/71 mmHg, pulse is 81/min, respirations are 12/min, and oxygen saturation is 98% on room air. On physical examination, there are symmetric erythematous plaques with overlying scales on the extensor surfaces of bilateral knees and elbows. One of the plaques is shown in Figure A. Which of the following is the most likely diagnosis?