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What is the red bumpy painful rash on this boy's face?

This 8 year old boy has a 2 month history of a progressive, painful, papulo-nodular eruption on his face with yellow crusting. It started out as a small itchy spot. The father treated it with some of his own eczema medications and it got better for a few weeks then started worsening. As a result, the father increased the use of the medication that initially made it better.

Case of the Month


Steroid acne, from daily use of clobetasol 0.05 % ointment x 2 months, producing 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 4-6 week "step down" program : westcort cream bid x 7 days, desowen cream bid x 7 days, Elidel bid x 14-21 days. For the secondary impetigo we gave him Keflex elixir, 250 tid x 10 days.





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Crutchfield Dermatology
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