Factitious dermatitis

Can you identify this asymptomatic rash?

DAVID L. KAPLAN, MD—Series Editor University of Missouri Kansas City, University of Kansas

DAVID L. KAPLAN, MD—Series Editor: Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

Volume 52 - Issue 9 - September 2012

Factitial dermatitis

A 16-year-old boy presents with a 1-month history of an asymptomatic rash on his sacral area. There are no other rashes on his body.

What does this look like to you?

A. Dermatophyte infection. 
B. Candidiasis. 
C. Confluent and reticulate papillomatosis.D. Psoriasis. 
E. Factitial dermatitis. 

(Answer on next page)

 

Answer: Factitial dermatitis

 Factitial dermatitis

The correct answer is E. Further history taking elicits additional important information; the rash developed after the teenager started a daily regimen of sit-ups. The eruption gradually disappeared when the patient began to exercise on a thick pad instead of on carpeting.