Photo Quiz 360 ® www.consultant360.com • CONSULTANT 1 A 73-year-old woman presented to our dermatology clinic with a chief concern of a rash on her upper back. She had a medical history of essential hypertension, hypothyroid- ism, and breast cancer, the latter of which had been treated with surgery, chemotherapy, and radiation 4 years prior. The patient stated the rash had been present for 3 months and was associated with a burning sensation; however, she denied asso- ciated pain, pruritus, purulent drainage, or bleeding. The lesion previously had been treated with topical antibiotics and anti- fungals without relief; therefore, she had been referred to us for dermatologic evaluation. On physical examination, well-demarcated pink to erythem- atous plaques and nodules were noted on the patient’s left up- per back (Figure 1). Based on the patient’s history and physical examination findings, which one of the following is the most likely diagnosis? A. Cellulitis B. Herpes zoster C. Cutaneous metastasis of breast cancer D. Dermatofibrosarcoma protuberans Mara Leyendecker, BS 1 • Taylor Gray, DO 2 • Krina Chavda, DO 2 • Richard Miller, DO 2 A 73-Year-Old Woman With a Burning Rash on Her Upper Back 1 AFFILIATIONS: 1 Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio 2 HCA Healthcare/USF Morsani College of Medicine GME Programs, Largo Medi- cal Center, Largo, Florida CITATION: Leyendecker M, Gray T, Chavda K, Miller R. A 73-year-old woman with a burning rash on her upper back. Consultant. Published online October 14, 2020. doi:10.25270/con.2020.10.00020 Received August 19, 2020. Accepted October 7, 2020. DISCLOSURES: The authors report no relevant financial relationships. DISCLAIMER: This research was supported in whole or in part by HCA Healthcare and/or an HCA Healthcare–affiliated entity. The views expressed in this article represent those of the authors and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities. CORRESPONDENCE: Mara Leyendecker, BS, Ohio University Heritage College of Osteopathic Medi- cine, 35 W Green Dr, Athens, OH 45701 (ml893412@ohio.edu)