Case 6: 17-year-old Girl with a Skin Reaction from a Home Remedy

Presentation

A 17-year-old previously healthy girl with no chronic medical conditions presents to the clinic with a rash on her face. Three days before presentation, she awoke with the painful red rash. The day before onset she had pruritus of her chin without any other signs or symptoms and no other changes to the skin per her report. She has no history of eczema or allergies. She uses foundation for makeup and has not changed brands in more than a year. She notes no changes in soap or skin care products. There is no new exposure to detergents, plants, latex, nickel, or jewelry. No family members have similar skin lesions. She has not applied any other creams/lotions to the rash. Over the next 2 days the rash became more erythematous and painful but less pruritic. On presentation to the clinic the rash is erythematous and patchlike, with central ulcerations, well-demarcated borders, and overlying healing bullae along the chin and lower face (Fig). Vitals are all within normal limits. No other rashes are present on physical examination, and there are no other abnormal findings on examination.

On further …