Thursday, February 04, 2016

Unusual Facial Dermatosis

Abstract:  16 yo girl with 3 month history of annular dermatosis mid-forehead.

HPI:  This healthy 16 yo has had a 4 cm roughley circular plaque on the mid-forehead.  Takes no medications by mouth and is not aware of any OTC meds taken infrequently,  She has bued 1% hydrocortisone cream and also a topical imidazole without improvement.

O/E:  The lesion has fairly sharp borders.  The surface is somewhat gready.  KOH prep failed to demonstrate hyphae or spores.  The remainder of the cutaneous examination is unremarkable.

Clinical Photo:

Diagnosis:  The picture is suggestive of seborrheic dermatitis, but the circular nature is unusual. What are your thoughts?

Plan:  Betamethasone valerate 0.1% cream b.i.d. x 2 weeks sand then Elidel cream.  If it does not respond or if it recurs a biopsy will be done.

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