After a few days at play on the beach, young brothers present with similar erythematous eruptions on their abdomens. Can you Dx?
Sandy and Clark are 10- and 11-year-old brothers with a one- to two-day history of non-pruritic erythematous bumps on their abdomens.
Physical examination: Multiple papules that abruptly cut off at the waistline…not lichenified, or at least not yet.
Erythematous papular lesions on the abdomens of two young boys, that cut off abruptly at the waistline
Recap of current information: The boys are at the beach, having fun; kids’ work is their play, so we’re taking an "occupational history" of sorts.
Frictional lichenoid dermatitis is the technical name for this boogie board eruption, aka, juvenile papular dermatitis and recurrent summertime pityriasis of the elbows and knees.
Characterized by aggregates of discrete lichenoid papules that are 1-2 mm in diameter; secondary to frictional trauma.
Differential diagnosis: Psoriasis, guttate psoriasis, Gianotti-Crosti syndrome (papular acrodermatitis), lichenoid drug eruptions.
Drugs associated with lichneoid eruptions: diuretics, beta-blockers, antimalarials, phenothiazines, acetylsalicylic acid, carbamazepine, chlorpropamide, enalapril.
Drugs associated with lichneoid eruptions: gold, iodides, levamisole, mercury, methyldopa, norflex, penicillamine, others.
Two young boys have been enjoying time at the beach; both end up with erythematous papular lesions on their abdomens that cut off abruptly at the waistline. After a brief history, the diagnosis seems fairly certain. What's in your differential?