SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD
An 83-year-old woman with urinary incontinence was referred to our clinic with a 2-year history of pruritic and painful lesions in the genital and suprapubic area. Repeated cycles of topical corticosteroid therapy resulted in a minimal and transitory response. The patient also reported a constant burning sensation that she treated with several daily applications of topical benzocaine. Dermatologic examination of the vulva, mons pubis, inner thighs, and suprapubic area revealed multiple, flesh-colored to erythematous violaceous papules, nodules, and plaques, some of which displayed superficial erosions (Figure 1). Culture of the lesional tissue did not demonstrate clinically significant bacterial or fungal pathogens. A skin biopsy specimen was obtained for histologic analysis (Figure 2).
Galeone M, Arunachalam M, Scarfì F, Bassi A, Massi D, Difonzo EM. Nodular Lesions in the Diaper Area—Quiz Case. JAMA Dermatol. 2013;149(4):475-480. doi:10.1001/jamadermatol.2013.1172a