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Erythematous rash on face

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The patient initially thought the rash was an eczema flare-up and applied a steroid cream. But the rash worsened and spread.



Strength of recommendation (SOR)

A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series

A 27-year-old Caucasian woman came into our clinic with an erythematous, papulopustular rash on her face. The small papules and pustules formed a confluence around her mouth and on her chin; the vermilion border was spared (FIGURE). The patient said that the rash started as a dry scaly patch on the corner of her mouth, and it spread over the course of a few weeks.

The patient had a history of eczema for which she used mometasone furoate cream. Initially, she thought the rash was a flare-up of her eczema, so she used her steroid cream. After using the cream on her face for a month, the patient reported that the rash continued to worsen and spread. She said that the rash was mildly itchy and that when she opened her mouth, it was moderately painful.

Patient confused rash with eczema flare

The rash on this 27-year-old patient’s face started as a dry, scaly patch on the corner of her mouth and spread into the pattern shown above. The rash spared the vermilion border.



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