Her medical history indicated that her symptoms started five years ago, with cramping and spasms of her arms. She noted that her wrists felt like they were falling asleep at times, along with needle-like pain that would occasionally erupt. Additionally, she reported a significant amount of fatigue and stress. The patient’s medical record indicated a diagnosis with depression; her initial visits for the skin condition included initial diagnoses of atopic dermatitis and urticaria before the biopsy was taken. The patient was prescribed ibuprofen, fluoxetine and hydroxyzine.