Young & Crusty

3. A 16-year-old Hispanic girl seeks consultation for a perioral rash that first appeared two weeks ago, shortly after she used an OTC depilatory agent. The rash has worsened despite application of topical neomycin ointment. The patient reports pruritus and occasional burning. Examination reveals erythema, hyperpigmentation, and excoriation of the skin around the corners of the mouth.

Diagnosis: An allergic contact dermatitis to both the depilatory agent and neomycin was suspected. The patient was advised to discontinue use of both products, and a medium-potency topical steroid was prescribed. She returned for follow-up in 10 days, at which time the condition had improved by about 75%. Therapy was changed to 1% hydrocortisone cream. The patient was instructed to return for patch testing if the dermatitis recurred.

Reprinted with permission from Emergency Medicine. 2010;42(8):19-20. http://www.mdedge.com/emed-journal/article/71585/dermatology/lesion-scrotum