Pruritic rash

March 31, 2010

A 60-year-old laboratory technician complained of a pruritic rash on and around her left ear. It had appeared a few days earlier, shortly after she cleaned her telephone receiver with a disinfectant. A tentative diagnosis of contact dermatitis was made, and treatment with a hydrocortisone cream was initiated.



Case 1:

A 60-year-old laboratory technician complained of a pruritic rash on and around her left ear. It had appeared a few days earlier, shortly after she cleaned her telephone receiver with a disinfectant. A tentative diagnosis of contact dermatitis was made, and treatment with a hydrocortisone cream was initiated.

The patient returned a week later, at which time this photograph was taken. There had been no change in the appearance of the rash.

What other cause might you consider?


Answers on Next Page



Case 1: Tinea incognito

Since the patient mentioned that she had chronic tinea pedis, a fungal infection was suspected. Scrapings from the rash revealed long, branching hyphae, and culture on dermatophyte test medium confirmed the presence of a dermatophyte. This is a typical case of tinea incognito, and it proves that not every itchy rash responds to topical corticosteroids.

(Case and photograph courtesy of Drs Yelva Lynfield and Jennifer Goldwasser.)