A 13-year-old girl is brought to the office because she has had the pruritic rash shown for the past 11 months. Her parents say none of the small tubes of moisturizers provided relief, including hydrocortisone 1%, which they applied for 4 days with minimal improvement. Daily bathing and petrolatum application are performed at home. Her medical history is unremarkable except for a peanut allergy, which she strictly avoids. Which one of the following options is the most appropriate next step in management?

A. Add oral cetirizine

B. Add topical metronidazole 1% ointment

C. Perform patch testing

D. Prescribe topical retinoid nightly

E. Start oral prednisone

F. Use topical corticosteroid until clear

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