Itchy Spreading Rash on Teen's Cheek

August 1, 2007
Volume 6, Issue 8

A 16-year-old girl is bothered by a spreading, itchy rash of 1 week’s duration on the left preauricular cheek. The otherwise healthy teenager denies taking any medications or using new cosmetics.

THE CASE: A 16-year-old girl is bothered by a spreading, itchy rash of 1 week’s duration on the left preauricular cheek. The otherwise healthy teenager denies taking any medications or using new cosmetics.

(Answer and discussion on next page.)

Impetigo is the correct answer.

DISCUSSION: A culture of material from one of the lesions confirmed the clinical impression of impetigo. When patients do not respond to appropriate impetigo therapy, consider candidiasis, which can mimic impetigo. Excoriated and factitial lesions typically are more eroded and feature blood crusting rather than the serum crusting noted in this eruption. A contact dermatitis generally does not erupt as several small, discrete lesions.

This patient’s impetigo responded to topical mupirocin. A topical cephalosporin is also an effective treatment.

 

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Case and image courtesy of David L. Kaplan, MD, University of Missouri Kansas City, University of Kansas.