A healthy 15-year-old African American male adolescent presented with a 3½-week history of a pruritic, papular eruption that was localized to his face. He had been previously treated by a primary care provider, who had prescribed cetirizine hydrochloride and a 10% benzoyl peroxide wash. The treatment was unsuccessful, and the eruption appeared to be spreading from a small area concentrated around the patient's mouth to a larger area also involving the skin around his nose. There was no history of contact allergen exposure or topical steroid use, and the patient reported no systemic complaints, such as fatigue, cough, shortness of breath, or bone and joint pain. No other areas of skin were affected. His only oral medication was methylphenidate hydrochloride (54 mg/d).
Cox ES, Shannon AB. Papular Facial Eruption in an African American Adolescent—Quiz Case. Arch Dermatol. 2006;142(6):775-780. doi:10.1001/archderm.142.6.775-b