Acute Contact Dermatitis

A 17-year-old girl presented with an “itchy rash” on the cheeks.

Key point: Circumscribed areas of swelling, erythema, oozing, and crusting were seen on both cheeks. The patient, concerned about mild to moderate papulo-pustular acne, began applying an over-the-counter 5% benzoyl peroxide preparation without her parents’ knowledge.

Treatment: Twice-daily application of hydrocortisone 2.5% cream led to prompt resolution of this prototypical case of acute contact dermatitis. The patient was warned to never again use any acne product containing benzoyl peroxide.

Note: Initially, the patient denied applying any topical agents to the face. She admitted to using a medication only when questioned without a parent present in the room.