A 16-Year-Old Boy Comes to the Office Due to an Itchy

A 16-year-old boy comes to the office due to an itchy rash on his back and shoulders.  The rash has been present for the last 3 months, but he has had similar symptoms intermittently in other body areas over the last 10 years.  The patient has no fever and has had no recent illnesses.  Current medications include daily cetirizine for seasonal allergies and topical benzoyl peroxide for acne.  Vital signs are normal.  On skin examination, there are excoriated lichenified plaques on the back and right shoulder, as shown in the exhibit.
Which of the following is the most appropriate advice to reduce this patient's symptoms?

A)Adhere to a gluten-free diet
B)Avoid wearing cotton clothes
C)Maintain skin hydration
D)Reduce exposure to dust mite antigen
E)Remove pets from the home

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