Case Report: Managing Allergic Contact Dermatitis, Hemorrhoids, and Warts in a 37-Year-Old Male
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we frequently see patients presenting with skin conditions that are not only uncomfortable but also affect daily routines and quality of life. This case highlights the management of allergic contact dermatitis, external hemorrhoids, and a facial wart in the same patient.
Patient Case Overview
A 37-year-old male presented with multiple concerns, including:
Itchy rash in the underarms (axillae)
Chronic hemorrhoid discomfort
Facial wart on the left cheek
1. Allergic Contact Dermatitis (ACD)
The patient reported a persistent, itchy rash in both armpits that developed after using deodorant. On exam, the rash was well-demarcated, red, and consistent with allergic contact dermatitis.
Treatment Plan:
Discontinue use of the current deodorant.
Begin hydrocortisone 2.5% cream applied twice daily.
Switch to hypoallergenic, fragrance-free skin care products.
Counseling provided on avoiding common triggers (fragrances, cosmetics, scented soaps, metals).
If symptoms persist, patch testing may be recommended to identify allergens.
2. External Hemorrhoid
The patient also reported ongoing hemorrhoid irritation. Exam revealed a flesh-colored varicosity on the right perianal skin, consistent with an external hemorrhoid.
Treatment Plan:
Continue hydrocortisone cream for inflammation.
Increase dietary fiber (e.g., Metamucil).
Avoid wipes, which may worsen irritation.
Warm baths to soothe discomfort.
If bleeding develops, further evaluation for internal hemorrhoids would be warranted.
3. Wart (Verruca Vulgaris)
On the left cheek, the patient had a viral wart. These common growths are caused by the human papillomavirus (HPV).
Treatment Plan:
Cryotherapy with liquid nitrogen was performed during the visit (two freeze-thaw cycles).
Counseling provided regarding risks (blistering, pigment changes, recurrence).
Discussed at-home adjunct options such as topical salicylic acid or OTC cryotherapy if lesions recur.
Why Dermatology Evaluation is Important
This case demonstrates how multiple skin conditions can occur simultaneously. Without expert evaluation, patients may misinterpret symptoms—leading to ineffective treatment or worsening conditions.
At Village Dermatology in Katy and Houston, our board-certified dermatologists provide comprehensive, individualized care, whether for rashes, infections, growths, or chronic skin concerns.
Takeaway
Allergic contact dermatitis often results from fragrances or chemicals in deodorants or skin products.
External hemorrhoids can be managed conservatively with topical medications and lifestyle adjustments.
Warts can be treated effectively with in-office procedures such as cryotherapy.
If you’re struggling with persistent rashes, skin growths, or irritation, contact Village Dermatology in Katy and Houston, Texas for expert diagnosis and treatment.
