HPI: The patient has has a five week history of a dermatitis on the face, torso and lower legs. He is in good general health and on no new medications. Only oral med is lisinopril. For the past two months he has been working indoors mainly with Western Knotty Cedar and has been exposed to dust from that. He wondered if this could be a cause. He's had cbc, chem profile done by his nurse practitioner and all was normal.
O/E: Fiery erythema of face (sparing lower lids), chest, back (sparing axillary vaults) and less advanced dermatitis of legs. Doubly covered areas appear spared. Generalized scaling on the scalp.
Clinical Photos (shown with patient's permission):
Diagnosis: The patient's suspicion may be right. This could fit with airborn allergic contact dermatitis from cedar.
Reference:1. Allergic contact dermatitis from cedar wood (Thuja plicata) Bleumink E, Mitchell JC, Nater JP. Br J Dermatol. 1973 May;88(5):499-504.