A 69-year-old white woman presented with a 1-year history of pruritic lesions limited to the postauricular areas. She first noticed blisters in these areas, which then crusted. The lesions had been recurrent but almost never resolved completely. They never involved the scalp or face. The patient stopped wearing earrings 9 months earlier and placed tape around her glasses, with no change in the skin lesions. She had no history of allergic contact dermatitis but used hair dyes and perfume. Her medical history was significant for systemic lupus erythematosus (SLE), which had been diagnosed 5 years earlier, when physical examination and laboratory tests revealed inflammatory polyarthritis, fever, serositis, fatigue, and a positive antinuclear antibody titer of 1:2560. She had never had skin lesions associated with lupus. She had an excellent response to her symptoms of lupus with hydroxychloroquine sulfate therapy (200 mg/d), which she had been receiving for almost 5 years.
Kroumpouzos G, Margolis RJ, Cohen LM. Crusted Erythematous Postauricular Plaques. Arch Dermatol. 2001;137(8):1095-1100. doi: