A healthy 12-year-old boy with eczema shows up at the office with an incredibly itchy rash on his legs that has exploded over the last 48 hours. He has a history of dry skin to which his mother regularly applies various moisturizers, including calendula oil.
Dermatologists should note that a new contact allergen is becoming a more prevalent cause of irritation as it is now found more frequently in personal care and laundry products, which are resulting in a greater number of contact allergies now than fragrances and dyes.
You are called to the emergency room to evaluate a healthy 2-year-old boy with black spots on his legs that were noted yesterday evening. His younger brother developed similar black spots this morning. The boys are healthy, and the lesions are not symptomatic and appear to be superficial.
Although the vast majority of children who present with a challenging eczematous eruption have refractory atopic dermatitis or poor medication compliance, clinicians need to perform a good history and clinical examination to rule out other underlying causes or comorbidities.
Whatever the medical indication, patients with a clinical history of jewelry or metal allergy who are scheduled to receive metal implants could benefit from patch testing prior to prosthetic device implantation, as the screening test can help identify a patient’s potential hypersensitivity to the implant chosen by the surgeon, says James Taylor, M.D.