Pediatric Annals

CME Article 

A 12-year-old Girl with Irritated Earlobes

Aimee Smidt, MD; Anne Laumann, MBChB, MRCP(UK), FAAD

Abstract

A 12-year-old African-American girl complained of dark, flaky, often irritated, wet, and bloody earlobes for more than 1 year. At times, similar but less troublesome areas occurred on each side of her neck. The patient’s mother had been told it was eczema, and the patient was applying triamcinolone acetonide 0.025% ointment once daily, with minimal effect. At 7 years, the patient’s ears had been pierced using a spring-loaded gun in a commercial salon. Healing had been uncomplicated, taking the anticipated 5 weeks. Now, however, her ears hurt when she wore earrings. Medical history was significant for frequent rashes during infancy. Two older siblings had asthma, and one suffered from seasonal allergies.

ABOUT THE AUTHORS

Aimee Smidt, MD, is a Resident Physician, and Anne Laumann, MBChB, MRCP(UK), FAAD, is Associate Professor, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Address correspondence to: Anne Laumann, MBChB, MRCP(UK), FAAD, e-mail a-laumann@northwestern.edu.

Dr. Smidt and Dr. Laumann have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Define the differential diagnosis of allergic contact dermatitis in children.
  2. Determine the most common causes of allergic contact dermatitis.
  3. Discuss the most appropriate management for children with allergic contact dermatitis.

Abstract

A 12-year-old African-American girl complained of dark, flaky, often irritated, wet, and bloody earlobes for more than 1 year. At times, similar but less troublesome areas occurred on each side of her neck. The patient’s mother had been told it was eczema, and the patient was applying triamcinolone acetonide 0.025% ointment once daily, with minimal effect. At 7 years, the patient’s ears had been pierced using a spring-loaded gun in a commercial salon. Healing had been uncomplicated, taking the anticipated 5 weeks. Now, however, her ears hurt when she wore earrings. Medical history was significant for frequent rashes during infancy. Two older siblings had asthma, and one suffered from seasonal allergies.

ABOUT THE AUTHORS

Aimee Smidt, MD, is a Resident Physician, and Anne Laumann, MBChB, MRCP(UK), FAAD, is Associate Professor, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Address correspondence to: Anne Laumann, MBChB, MRCP(UK), FAAD, e-mail a-laumann@northwestern.edu.

Dr. Smidt and Dr. Laumann have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Define the differential diagnosis of allergic contact dermatitis in children.
  2. Determine the most common causes of allergic contact dermatitis.
  3. Discuss the most appropriate management for children with allergic contact dermatitis.

A 12-year-old African-American girl complained of dark, flaky, often irritated, wet, and bloody earlobes for more than 1 year. At times, similar but less troublesome areas occurred on each side of her neck. The patient’s mother had been told it was eczema, and the patient was applying triamcinolone acetonide 0.025% ointment once daily, with minimal effect. At 7 years, the patient’s ears had been pierced using a spring-loaded gun in a commercial salon. Healing had been uncomplicated, taking the anticipated 5 weeks. Now, however, her ears hurt when she wore earrings. Medical history was significant for frequent rashes during infancy. Two older siblings had asthma, and one suffered from seasonal allergies.

ABOUT THE AUTHORS

Aimee Smidt, MD, is a Resident Physician, and Anne Laumann, MBChB, MRCP(UK), FAAD, is Associate Professor, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Address correspondence to: Anne Laumann, MBChB, MRCP(UK), FAAD, e-mail a-laumann@northwestern.edu.

Dr. Smidt and Dr. Laumann have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Define the differential diagnosis of allergic contact dermatitis in children.
  2. Determine the most common causes of allergic contact dermatitis.
  3. Discuss the most appropriate management for children with allergic contact dermatitis.

10.3928/00904481-20080201-10

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