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Prostatitis and pruritus

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A 47-year-old man had severe itching that started the previous day and kept him up all night. We examined his rash (Figure ) as we inquired about his history. He had no previous skin problems and no known allergies. He had no fever, pain, or malaise.

We discovered that a month ago he had started taking 1 trimethoprim-sulfamethoxazole double-strength tablet twice daily for chronic prostatitis. He was told he would need to take the medication for 3 months. Other than prostatitis, he had no other medical problems and was not taking any other medications.

FIGURE

This patient complained of pruritus and had wheals on his chest and arms.

What is the diagnosis?
What is the best course of management?

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