The exam shows a superficial erosion in the right retroauricular sulcus.
Bacterial Culture: Positive for Many Staph aureus - resistant to Pen and Erythro
Pt. Started on mupirocin cream
Note: She is an obstetrical nurse and has contact with newborns. Her staph infection is of potential import here.
Reference:
Marks MB, Gluck JC, Lavi E, Halem-Sinclair E.
J Am Acad Dermatol. 1981 May;4(5):519-22
An unsuspected sign of cutaneous allergy.
An eczematous eruption in the superior retroauricular areas of the scalp and often on the posterior aspects of the pinnas may be seen in about 30% of allergic children. The eruption is not generally noticed because the overhanging hair covers the affected areas. The dermatitis is seen mainly in those children afflicted with bronchial asthma, perennial allergic rhinitis, or both. A previous history of atopic or seborrheic dermatitis is, as a rule, not elicited.
When we see such rash in the postauricular sulcus,is very suggestive of juicy psoriasis especially when it is unilateral.But still seborrheic dermatitis can not be excluded.Staph aureus is secondary infection.I have seen such picture in many children which stay for long time before the rash of psoriasis appear else where.So post-auricular fissure could be predictor sign of psoriasis.
ReplyDeletekhalifa sharquie