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Case of the Month
with Crutchfield Dermatology
What Is the Red, Bumpy, Painful Rash
on This Boy's Face?
T
His 8-yeaR-olD boy has a twomonth history of a progressive,
painful, papulonodular eruption on his face, with yellow
crusting. It started as a small, itchy
spot, which the boy's father treated with
some of his own eczema medications.
It got better for a few weeks but then
started to worsen. As a result, the father
increased the use of the medication that
initially made it better.
Diagnosis: steroid acne
This condition was caused by daily
use of clobetasol 0.05 percent ointment
for two months, which produced an
anceiform eruption with concomitant
weakening of the facial follicular walls,
with rupture and inflammation and
mild secondary impetiginization.
In this case, we educated the father
about the importance of using only the
medications specifically prescribed
for him.
We initiated a four- to six-week
step-down program: Westcort Cream
twice a day for seven days, DesOwen
Cream twice daily for seven days and
Elidel twice a day for 14–21 days. For the
secondary impetigo, we gave him Keflex
elixir, 250 mg, thrice daily for 10 days.
For m or e inf or m at i on , c on t a c t
Charles E. Cr utchf ield III, MD, at
Cr utchf iel d D e r m atolo g y or v i s it
www.CrutchfieldDermatology.com. ■
