What caused this pruritic, papular eruption?

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

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.


Dermclinic


A Photo Quiz to Hone Dermatologic Skills


Case 1:
A pruritic, papular eruption arose on a 38-year-old woman’s forehead 1 week earlier. A day before the rash erupted, the patient was given a permanent wave.

Do you recognize this eruption?

A. Acne.
B. Rosacea.
C. Contact dermatitis.
D. Bacterial folliculitis.
E. Yeast folliculitis.


(Answer on next page.)


Dermclinic—Answer


Case 1: Contact dermatitis

The permanent wave caused a contact dermatitis, C, an allergic reaction that resembles acne and rosacea. The sudden onset, pruritic nature, and temporal relationship of the eruption to the permanent wave support this diagnosis. A topical corticosteroid cream cleared the rash.

Neither acne nor rosacea is pruritic. Bacterial folliculitis is usually tender and more inflamed. The sudden onset of this patient’s eruption is not typical of yeast folliculitis.  ■