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Off-Center Fold
March 2013

Periorificial Dermatitis and Erosive Inguinal Plaques in a 57-Year-Old Woman—Quiz Case

JAMA Dermatol. 2013;149(3):358-363. doi:10.1001/archderm.149.3.358-b

A 57-year-old woman with a history of bipolar disorder and alcoholism was referred for evaluation of a nonpainful eruption in her groin that had developed over the preceding 3 months. Skin examination revealed well-demarcated pink, shiny plaques with minute (1- to 3-mm) peripheral crusted erosions localized to the bilateral inner buttocks and inguinal folds (Figure 1). Punched-out–appearing shallow erosions with scaly crust were also noted on the bilateral nasal alar creases and labial commissures (Figure 2). Her oral mucosae were unremarkable. She denied any associated pain or pruritus. She had no alopecia or nail plate changes. A punch biopsy was performed of a representative plaque of her right upper medial thigh (Figure 3).