Recognizing and Treating Allergic Contact Dermatitis: A Case from Village Dermatology in Katy & Houston, TX
By: Dr. Caroline Vaughn
At Village Dermatology, we’re committed to providing personalized skin care to patients throughout Katy and Houston, Texas. In this case report, we explore the diagnosis and treatment of a 51-year-old female patient who presented with a moderately severe rash on her face, neck, chest, and upper back. This case highlights the importance of early diagnosis and effective management of allergic contact dermatitis, a common condition we see in our Texas dermatology clinics.
Patient Presentation: Unexplained Facial and Neck Rash
Our patient, a healthy woman in her early 50s, reported a five-day history of bumpy, red, and itchy rash. It began with lip swelling and progressed to involve her cheeks, upper back, and chest. She denied introducing new skincare products, but reported recent use of Avene Cicalfate and a new lip gloss—notable because of her history of allergic reactions to lip products.
Clinical Evaluation and Diagnosis
A thorough full skin exam was performed, using a dermatoscope to evaluate the affected areas. Her skin exhibited well-demarcated, geometric eczematous patches, consistent with allergic contact dermatitis.
This condition occurs when the skin comes into contact with a substance that triggers an immune response. Common allergens include:
Fragrances
Cosmetics
Lip products
Metals (like nickel)
Preservatives and sunscreens
In this case, the patient’s symptoms and history strongly suggested a reaction to her new lip gloss.
Treatment and Management Plan
The patient was prescribed a tapered oral prednisone regimen to reduce inflammation, along with triamcinolone acetonide 0.1% topical cream for application to the chest and back. She was counseled on avoiding high-potency topical steroids on the face or neck and educated about the potential side effects of corticosteroids, including:
Skin thinning
Pigment changes
Increased risk of infection
Mood changes or insomnia with oral prednisone
We also advised her to eliminate all potential allergens, including cosmetics, scented soaps, and hair or nail products. Hypoallergenic and fragrance-free alternatives were recommended.
Finally, we discussed patch testing, which can help identify the specific allergen, and advised her to follow up in one month for further evaluation once the acute inflammation resolves.
Why It Matters: Allergy Awareness and Skin Health in Texas
This case underscores how important it is for patients in Katy and Houston to be aware of the cosmetic and environmental products they use—especially those with a known history of sensitivity. Allergic contact dermatitis can mimic other skin conditions, so early and accurate diagnosis is essential.
At Village Dermatology, we empower our patients through education, individualized care, and evidence-based treatment options. Whether you’re dealing with chronic skin issues or sudden flare-ups, our board-certified dermatologists are here to help.
📍 Looking for a Dermatologist in Katy or Houston, TX?
Village Dermatology offers full-body skin exams, patch testing, and treatment for allergic contact dermatitis, eczema, acne, rosacea, and other skin conditions. Book your dermatology consultation today.
