Woman with Widespread Rash and Night Blindness – Let’s Diagnose

A 50-year-old woman went to urgent care because she hadn’t been feeling well for several weeks. A widespread rash of hyperkeratotic follicular papules or, as she said, “rough skin,” had developed. She was also experiencing ocular pain, significant night blindness, and chronic diarrhea. She lamented that being on disability, she hadn’t been able to eat well for several months because the local food cupboard was running low on supplies.

Is it vitamin A deficiency, keratosis pilaris, prurigo nodularis, or follicular lichen planus?

The correct answer is…

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