A previously healthy, fully immunized 7-year-old girl presents to the dermatology clinic for evaluation of a rash on her left eyelid, forehead, and scalp. Her symptoms started 1 week earlier, first with pain of the left eyelid and subsequently, 2 days later, with scattered red papules around her left eye. She was evaluated by her pediatrician and treated with prednisolone for presumed allergic contact dermatitis to poison ivy. The rash evolved into vesicles distributed on the left eyelid and then spread to her forehead and scalp, prompting an emergency department visit. She was diagnosed as having cellulitis and was treated with oral clindamycin. Despite this therapy, she developed progressive edema of her left eyelid associated with eyelid pain. Her pediatrician urgently referred her to an ophthalmologist, who notes significant left periorbital edema but otherwise normal ophthalmic examination findings, including normal visual acuity and normal corneal examination without evidence of keratitis...
Visual Diagnosis: 7-year-old Girl with a Facial Rash
Drs Le, Jamison, and Kirkorian have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
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Jenny Le, Megan O’Brien Jamison, A. Yasmine Kirkorian; Visual Diagnosis: 7-year-old Girl with a Facial Rash. Pediatr Rev April 2018; 39 (4): e18–e20. https://doi.org/10.1542/pir.2017-0022
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