Presentation

Patient #1 was a 12 year old boy who presented with a 3 day history of a pruritic rash on the lips and perioral area which was so uncomfortable it was difficult for him to open his mouth.  He had a history of severe sensitivity to poison ivy, but no recent history of outdoor plant exposure.  The rash responded to use of class 1 topical corticosteroids for several days followed by tapering.

 
Patient #1 (click image to enlarge)


Patient #2 was a 42 year old woman who presented with a 4 day history of  an erythematous, pruritic eruption of the lips and chin.  She was seen by her primary care physician who placed her on oral acyclovir and hydroxyzine without improvement.  She had a history of poison ivy, but denied recent exposure.


Patient #2 (click image to enlarge)

 
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