Pediatric Eczema and Hand-Foot-Mouth Disease in a 9-Year-Old Male | Village Dermatology Katy & Houston, TX
A 9-year-old male was treated at Village Dermatology in Katy & Houston, TX for chronic eczema and hand-foot-mouth disease. Learn about his treatment with tacrolimus ointment, moisturizers, and supportive care for viral rash.
By: Dr. Ashley Baldree
Introduction
Chronic skin irritation and viral rashes are common dermatologic concerns in children. Eczema (atopic dermatitis) and hand-foot-mouth disease (HFMD) may sometimes appear concurrently, particularly in pediatric patients with sensitive skin. This case describes a 9-year-old male who presented to Village Dermatology in Katy and Houston, Texas, with a chronic dry rash on his hands and arms, as well as recent vesicular lesions consistent with HFMD.
Patient Presentation
A 9-year-old male presented for evaluation of a painful, dry rash affecting the hands and arms for approximately two years.
The rash was lighter than the surrounding skin, itchy, and worsened during cold, dry weather.
Recently, he also developed small vesicles and erosions on both palms.
No prior prescription treatments had been used—only over-the-counter moisturizers.
Examination
A focused dermatologic exam included the hands, wrists, and feet.
Findings included:
Hypopigmented, dry patches on the dorsal hands and wrists, consistent with eczema.
Vesicular and erosive lesions on the right and left ulnar palms, consistent with hand-foot-mouth disease.
The rest of the exam was unremarkable.
The patient appeared well developed, alert, and in no acute distress.
Diagnosis
Dermatitis, Unspecified (L30.9) – consistent with eczema flare related to environmental triggers.
Hand-Foot-Mouth Disease (B08.4) – viral vesicular eruption of the hands and feet.
Management Plan
1. Eczema
The likely diagnosis of eczema was discussed in detail with the patient’s mother, including the chronic nature of the condition and environmental factors such as cold, dry air and frequent hand washing.
Treatment Plan:
Topical tacrolimus 0.1% ointment, applied twice daily to affected areas.
Continue liberal use of emollients 2–3 times daily, particularly after bathing.
Avoid scented soaps, detergents, and fabric softeners.
Recommended lukewarm bathing and use of gentle cleansers.
Discussed use of KattaMD resources for eczema-friendly nutrition and lifestyle guidance.
Counseling:
Reviewed the side effects and proper use of topical steroids and non-steroidal alternatives like tacrolimus.
Advised follow-up in 3 months to assess progress.
2. Hand-Foot-Mouth Disease
Findings: Vesicles and erosions on both palms.
Plan:
Explained that HFMD is a self-limited viral infection that typically resolves within 7–10 days.
Recommended supportive care, including topical anesthetics for any painful lesions.
Advised good hand hygiene and avoidance of close contact with others until lesions crust over.
Discussion
This case illustrates the overlap of chronic eczema and acute viral infection in a pediatric patient. Children with eczema are prone to increased skin sensitivity and may experience flares triggered by viral illnesses or environmental factors. Management focuses on restoring the skin barrier, controlling inflammation, and preventing secondary infections.
Conclusion
At Village Dermatology in Katy and Houston, TX, pediatric patients with chronic rashes receive comprehensive evaluation and care. This case highlights the importance of identifying both chronic conditions like eczema and acute viral infections such as hand-foot-mouth disease, and providing gentle, evidence-based treatment tailored to each child’s needs.
Managing Chronic Rash, Nail Discoloration, and Psoriasis in a 49-Year-Old Female
A 49-year-old female presented to Village Dermatology in Katy, Texas, with chronic rash, nail discoloration, and plaques on the elbows. Diagnosed with onychomycosis, tinea pedis, and psoriasis, she began topical antifungal and steroid therapy with close follow-up planned for optimal results.
At Village Dermatology in Katy and Houston, Texas, we recently evaluated a 49-year-old female who presented as a new patient with a one-year history of itchy, hardened skin on her fingers. The rash was moderate in severity and had not responded to over-the-counter treatments. A comprehensive skin, nail, and hand examination was performed, including dermatoscopic evaluation.
Clinical Findings
The patient exhibited several dermatologic conditions affecting the skin and nails:
Onychomycosis (Nail Fungus) – The right toenail showed discoloration, onycholysis (nail lifting), and subungual debris, classic findings consistent with a fungal nail infection.
Tinea Pedis (Athlete’s Foot) – Fungal infection was also noted on the feet, with scaling and itching between the toes.
Plaque Psoriasis – The patient had erythematous, well-demarcated plaques with silvery scale on both elbows, consistent with chronic plaque psoriasis.
Diagnosis
Onychomycosis (B35.1)
Tinea Pedis (B35.3)
Plaque Psoriasis (L40.0)
Treatment Plan
1. Fungal Infections (Onychomycosis and Tinea Pedis)
The patient was counseled that onychomycosis often fails to respond to topical agents and that oral antifungal therapy, while more effective, carries potential risks such as liver toxicity.
To minimize systemic risks, the patient was started on topical antifungal therapy with:
Ketoconazole 2% cream, applied twice daily to the toenail, feet, and affected hand areas for two weeks, then continued for one additional week after clearing.
She was advised that fungal infections tend to recur, particularly in humid climates such as Houston and Katy, Texas, and should report any side effects immediately.
2. Psoriasis Management
For the plaque psoriasis on her elbows, the patient was counseled on the chronic nature of psoriasis, potential triggers (such as stress, cold weather, and infections), and the importance of consistent skincare.
Treatment was initiated with:
Triamcinolone acetonide 0.1% cream, applied twice daily for 2 weeks, then as needed for flares (not exceeding 14 days per month).
Emollient moisturizers and gentle cleansing routines to support the skin barrier.
The patient was encouraged to use tar-based or zinc pyrithione shampoos, get moderate natural sunlight exposure, and maintain regular follow-ups for flare management.
Patient Counseling and Education
The patient was counseled extensively on:
The chronic and relapsing nature of psoriasis and fungal infections.
The importance of adherence to topical therapies for best outcomes.
Lifestyle factors, such as keeping feet dry, avoiding skin trauma, and reducing stress.
Follow-up was scheduled in 6 weeks to assess the response to therapy and adjust treatment as necessary.
Dermatology Insight
This case highlights how multiple overlapping dermatologic conditions—such as psoriasis and fungal infections—can complicate diagnosis and management. At Village Dermatology, our specialists in Katy and Houston take a comprehensive, individualized approach to skin and nail disorders, emphasizing both medical efficacy and patient education to prevent recurrence and improve quality of life.
Case Report: Dermatographic Urticaria in a 67-Year-Old Female | Village Dermatology Katy & Houston, TX
A 67-year-old female with itchy, red rashes on the arm and leg was diagnosed with dermatographic urticaria at Village Dermatology in Katy & Houston, TX. Learn about her treatment with antihistamines, topical steroids, and follow-up care.
Introduction
Dermatographic urticaria, also known as “skin writing,” is a form of physical urticaria where light scratching or pressure on the skin causes red, raised, itchy welts. While often benign and self-limiting, the condition can be bothersome and impact quality of life. At Village Dermatology in Katy and Houston, Texas, we evaluate and manage urticaria with individualized care plans to reduce discomfort and improve skin health.
Patient Presentation
A 67-year-old female presented with:
An itchy, red rash on the right arm and right leg
Moderate severity, ongoing for several months
Rash appears intermittently and typically resolves within 30 minutes
Past treatment included oral prednisone with limited improvement
Examination
A focused dermatologic exam revealed:
Erythematous, linear, edematous plaques induced by scratching
Findings consistent with acute urticaria with dermatographism
No other concerning lesions identified
The patient was otherwise well-nourished, alert, and in no acute distress.
Diagnosis
Dermatographic Urticaria (L50.3)
Management Plan
Medications
Zyrtec (cetirizine): Patient was already taking 10 mg twice daily; dose increased to 20 mg twice daily as tolerated
Triamcinolone acetonide 0.1% cream: Prescribed for application twice daily to affected areas for 2 weeks, with instructions to use as needed for flares
Counseling & Education
The patient was counseled on:
Skin care: Use bland emollients to reduce scratching and maintain skin barrier health
Expectations: Dermatographism affects 2–5% of the population and is often idiopathic; most cases are benign
When to contact office: If symptoms worsen, fail to improve, or become more symptomatic
Follow-Up
Return in 2 weeks for reassessment
If symptoms persist beyond 6 weeks, initiation of Xolair (omalizumab) may be considered
Conclusion
This case illustrates the clinical presentation and management of dermatographic urticaria in an older female patient. At Village Dermatology in Katy and Houston, TX, we provide both immediate symptom relief with antihistamines and long-term strategies, including advanced therapies like Xolair, when needed.
Full Body Skin Exam in a 73-Year-Old Female: Benign Findings and Sun Protection Counseling
A 73-year-old woman underwent a full body skin exam at Village Dermatology in Katy and Houston, TX. Findings included benign moles, sun spots, seborrheic keratoses, and cherry angiomas. Learn why yearly skin checks are essential for prevention and peace of mind.
At Village Dermatology in Katy and Houston, Texas, we encourage patients of all ages to schedule routine full body skin exams. These comprehensive evaluations are an essential way to monitor for skin cancer, track changes in moles, and identify other skin conditions. This case highlights a 73-year-old female who presented for a preventive exam.
Patient Presentation
A 73-year-old female came to our clinic as a new patient for a full body skin examination. She reported new but stable lesions on the right and left upper back. The lesions had been present for several months, were moderate in severity, and had not changed recently.
She had no history of skin cancer but wanted reassurance and preventive counseling.
Dermatologic Examination
A head-to-toe exam was performed, including the scalp, face, trunk, extremities, nails, and mucosal surfaces. A dermatoscope was used to assess pigmented lesions.
Findings included:
Benign Nevi (Moles): Symmetrical, evenly colored macules and papules throughout.
Seborrheic Keratoses: Flat, waxy pigmented growths, common with aging.
Lentigines (Sun Spots): Light tan macules in sun-exposed areas, consistent with sun damage.
Cherry Angiomas: Bright red vascular papules scattered across the skin.
No suspicious or malignant lesions were detected during the exam.
Impression and Plan
Benign Nevi
Stable, non-worrisome moles.
Counseling: Monthly self-skin checks recommended.
When to call the office: Any mole that changes in size, shape, or color, or begins to itch, burn, or bleed.
Seborrheic Keratoses
Benign age-related growths.
Counseling: No treatment necessary unless irritated or for cosmetic reasons.
Lentigines (Sun Spots)
Result of chronic sun exposure and damage.
Treatment options discussed: sunscreen, bleaching creams, retinoids, chemical peels, and laser therapy.
Daily regimen recommended:
Broad spectrum SPF 30+ sunscreen
Vitamin C serum in the morning for added antioxidant protection
Lip balm with SPF
Wide-brimmed hats and sun-protective clothing for long outdoor exposure
Cherry Angiomas
Small, benign blood vessel growths.
Counseling: Treatment not required, but removal possible with laser or electrodesiccation if cosmetically desired.
Key Takeaway
This case demonstrates the importance of full body skin exams for older adults, even when lesions appear stable or benign. Routine evaluations provide reassurance, early detection of skin cancers, and personalized skin care guidance.
At Village Dermatology in Katy and Houston, TX, we specialize in comprehensive skin exams, mole evaluations, and preventive sun care counseling.
Case Report: Oral Minoxidil and PRP Therapy for Androgenetic Alopecia in a 41-Year-Old Male | Village Dermatology Katy & Houston, TX
A 41-year-old male with androgenetic alopecia was treated at Village Dermatology in Katy & Houston, TX with oral minoxidil and platelet-rich plasma (PRP) therapy. Learn about his treatment plan and follow-up strategy.
by: Caroline Vaughn
Introduction
Androgenetic alopecia (AGA), also known as male pattern hair loss, is the most common cause of progressive hair thinning in men. Many patients initially try over-the-counter treatments like topical minoxidil without success. At Village Dermatology in Katy and Houston, Texas, we offer advanced therapies such as oral minoxidil and platelet-rich plasma (PRP) therapy to help slow progression and stimulate regrowth. This case highlights a 41-year-old male with longstanding hair loss.
Patient Presentation
The patient, a 41-year-old male, presented with:
Generalized hair thinning on the scalp
Symptoms present for 2 years, gradually worsening
Prior trial of over-the-counter topical minoxidil, without significant improvement
He sought evaluation and treatment options for hair restoration.
Examination
A focused scalp examination revealed:
Patterned thinning at the vertex and mid-occipital scalp
No scarring or evidence of inflammatory alopecia
Dermatoscopic findings consistent with androgenetic alopecia
The patient was otherwise well developed, alert, and in no acute distress.
Diagnosis
Androgenetic Alopecia (L64.8)
Management Plan
Diagnostic Approach
A punch biopsy was recommended to confirm the diagnosis and rule out other causes of hair loss.
Treatment Options Discussed
The patient was counseled extensively on treatment choices:
Medical therapies: oral minoxidil, oral finasteride, topical minoxidil, spironolactone
Adjuncts: low-level laser therapy, nutritional supplements, hair transplantation
Procedural options: platelet-rich plasma (PRP) injections and Alma TED therapy (cosmetic, not insurance-covered)
Risks, benefits, and expectations of each were reviewed in detail.
Treatment Chosen
The patient elected to start:
Oral minoxidil 2.5 mg daily (with monitoring for low blood pressure)
PRP therapy, initiated during the visit, with additional sessions planned
Follow-Up
4–6 months for reassessment of response
Baseline photos taken to document progress
AGA handout and PRP pricing reviewed with the patient
Conclusion
This case highlights a comprehensive approach to male pattern hair loss, combining oral minoxidil with PRP therapy. At Village Dermatology in Katy and Houston, TX, we tailor treatment plans to each patient’s goals, offering both medical and procedural options for optimal hair restoration outcomes.
Full Body Skin Exam in a 56-Year-Old Male: Benign Findings, Actinic Keratosis, and Lipoma
A 56-year-old male underwent a full body skin exam at Village Dermatology in Katy and Houston, TX. Findings included benign moles, lentigines, cherry angiomas, a lipoma, and actinic keratosis treated with cryotherapy.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, annual full body skin exams are a cornerstone of preventive care. These visits allow for the monitoring of existing lesions and early detection of skin cancer or precancerous growths. This case highlights a 56-year-old male with multiple skin findings, including benign nevi, actinic keratosis, lentigines, cherry angiomas, and a lipoma.
Patient Presentation
A 56-year-old male presented for a full body skin examination as a new patient. He reported longstanding lesions on the right upper back and chest, which had been present for years and remained asymptomatic. His primary concern was preventive screening and reassurance.
The patient declined genital examination but agreed to a full inspection of all other body areas.
Dermatologic Examination
A comprehensive skin exam was performed, including dermatoscope evaluation. Findings included:
Benign Nevi: Symmetrical, evenly pigmented macules and papules with no concerning features.
Actinic Keratosis (AK): One precancerous lesion located on the left forehead.
Lentigines (Sun Spots): Light tan macules in sun-exposed areas.
Cherry Angiomas: Bright red vascular papules scattered on the trunk and extremities.
Lipoma: A soft, 6 cm mass on the left posterior shoulder, consistent with a benign fatty tumor.
Impression and Plan
Benign Nevi
Plan: Observation only.
Counseling: Monthly self-skin checks recommended. Patient educated on the ABCDEs of melanoma (Asymmetry, Border, Color, Diameter, Evolution).
Actinic Keratosis
Treatment: One lesion treated with liquid nitrogen cryotherapy.
Risks explained: Crusting, blistering, pigment changes, incomplete removal, recurrence, and infection.
Counseling: AKs are precancerous and should be treated promptly to prevent progression to squamous cell carcinoma.
Lentigines
Plan: Sun protection counseling.
Recommendations: Daily broad spectrum SPF 30+ sunscreen, reapplied every 2 hours during sun exposure. Suggested options included mineral sunscreens and lip balm with SPF.
Optional treatments discussed: bleaching creams, retinoids, chemical peels, and laser.
Cherry Angiomas
Plan: Observation only.
Counseling: Removal with laser or electrodesiccation is optional if desired for cosmetic reasons.
Lipoma
Findings: 6 cm soft tissue mass on left posterior shoulder.
Plan: Referral to plastic surgeon Dr. Rodger Brown for surgical excision due to size and location.
Counseling: Lipomas are benign and often stable, but removal can be considered for comfort or cosmetic reasons.
Key Takeaway
This case demonstrates the value of comprehensive annual skin exams. Even when lesions appear stable or benign, dermatology visits provide reassurance, allow for the treatment of precancerous conditions like actinic keratoses, and guide patients on cosmetic or surgical options for benign growths.
At Village Dermatology in Katy and Houston, TX, we provide expert full body skin checks, mole monitoring, cryotherapy, and referrals for surgical removal of large benign growths.
Case Report: Molluscum Contagiosum and Verruca Vulgaris in a 7-Year-Old Female | Village Dermatology Katy & Houston, TX
A 7-year-old girl was treated at Village Dermatology in Katy & Houston, TX for molluscum contagiosum and warts on the knee and buttocks using cantharidin therapy. Learn about her diagnosis, treatment, and follow-up care.
Introduction
Skin infections caused by viruses are common in children, with molluscum contagiosum and warts (verruca vulgaris) among the most frequent. These lesions may persist for years, spread to other areas, and cause parental concern. At Village Dermatology in Katy and Houston, Texas, we offer safe and effective treatments, including cantharidin therapy, to help children achieve clear skin.
Patient Presentation
The patient, a 7-year-old female, presented with:
Growing warts on the right knee, present for years
Shiny bumps on the abdomen and buttocks, suspected to be molluscum contagiosum
She had not received prior treatment for these lesions.
Examination
A focused dermatologic exam revealed:
Verruca vulgaris (common warts): cauliflower-like papules on the right knee
Molluscum contagiosum: pink, shiny, dome-shaped papules with central umbilication on the abdomen, right buttock, and left buttock
The patient was otherwise well-nourished, alert, and in no acute distress. A dermatoscope was used to confirm clinical features.
Diagnosis
Molluscum Contagiosum (B08.1)
Verruca Vulgaris (B07.8) with associated cutaneous inflammation
Treatment Plan
Molluscum Contagiosum
Diagnosis discussed with the patient’s mother
Cantharidin (Cantharone) applied to 2 enlarging lesions on the buttocks
Counseling provided:
Lesions may blister before resolving
Spread occurs via direct contact or swimming pools
If lesions spread rapidly or cause a rash, return to clinic
Verruca Vulgaris (Common Warts)
Cantharidin therapy applied to 3 inflamed warts on the right knee
Counseling provided:
Warts are caused by human papillomavirus (HPV)
Can spread via direct contact
Other treatment options include salicylic acid, retinoids, Aldara cream, or cryotherapy
Warts may recur despite treatment
Post-Treatment Instructions
Leave Cantharone on for 6–8 hours, then wash off thoroughly with soap and water
Watch for possible side effects: blistering, scabbing, or pigmentary changes
Follow-up as needed if lesions persist, spread, or recur
Conclusion
This case demonstrates the effective use of cantharidin therapy for treating molluscum contagiosum and warts in pediatric patients. At Village Dermatology in Katy and Houston, TX, we provide comprehensive and child-friendly dermatologic care for viral skin infections, helping families manage both the medical and cosmetic aspects of these conditions.
Guttate Psoriasis in a 32-Year-Old Male: Case Study and Treatment with Light Therapy
A 32-year-old male was diagnosed with guttate psoriasis at Village Dermatology in Katy and Houston, TX. Learn how phototherapy and topical treatments can help manage red, flaky, itchy lesions covering 20% of the body.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we treat a wide range of skin conditions, including psoriasis. This case highlights a 32-year-old male with guttate psoriasis, a form of psoriasis that often appears suddenly and can be triggered by infections such as strep throat.
Patient Presentation
A 32-year-old male presented for evaluation of red, flaky, itchy skin lesions. The psoriasis had been present for several months and was distributed across multiple areas of the body.
He reported no family history of psoriasis and had not previously tried biologic therapies or other systemic treatments. At presentation, he was using only a prescription topical steroid (triamcinolone cream).
Dermatologic Examination
A comprehensive skin exam was performed, including use of a dermatoscope.
Findings included:
Guttate psoriasis: Multiple small, red, scaly papules scattered across the body.
Body Surface Area (BSA) Involvement: Estimated at 20%.
Skin type: IV (moderate brown skin).
No other significant abnormalities were detected.
Impression and Plan
Diagnosis: Guttate Psoriasis (L40.4)
This type of psoriasis is typically associated with an immune response, often following strep throat infections. It presents with numerous small, red, scaly spots resembling “raindrops” on the skin.
Treatment Plan
Continue topical triamcinolone cream as needed.
Initiate light therapy (phototherapy) to reduce inflammation, slow down excessive skin cell turnover, and promote clearance of lesions.
Patient agreed to proceed with treatment.
Counseling
Guttate psoriasis often resolves with treatment of the triggering infection.
Other options include topical steroids, UV therapy, and systemic therapies (reserved for severe or persistent cases).
Patients with a history of guttate psoriasis have an increased risk of developing chronic plaque psoriasis later in life.
Advised to return if symptoms worsen or fail to improve after several months of treatment.
Key Takeaway
This case illustrates the importance of early recognition and treatment of guttate psoriasis. With proper dermatologic care, patients can achieve significant improvement through therapies such as topical treatments and phototherapy.
At Village Dermatology in Katy and Houston, TX, we provide comprehensive evaluation and treatment for psoriasis and other chronic skin conditions.
Case Report: Full Body Skin Examination in a 52-Year-Old Female with Multiple Benign Lesions | Village Dermatology Katy & Houston, TX
A 52-year-old female presented for a full body skin exam at Village Dermatology in Katy & Houston, TX. Findings included benign nevi, lentigines, cherry angiomas, seborrheic keratoses, and dermatofibromas. Learn about her counseling, cryotherapy treatment, and prevention plan.
by: Caroline Vaughn
Introduction
Full body skin examinations are a vital part of preventive dermatology, particularly for patients with a history of tanning bed use or multiple skin lesions. At Village Dermatology in Katy and Houston, Texas, our dermatologists carefully evaluate the skin for concerning growths while providing patient education about sun safety and skin cancer prevention. This case highlights a 52-year-old female who presented for her annual skin examination.
Patient Presentation
The patient, a 52-year-old female, presented for a routine full body skin exam. She reported skin lesions on the chest that had been present for several months. They were asymptomatic and of moderate severity. She has a history of tanning bed use, which increases her risk of skin cancer.
Examination
A comprehensive full body skin exam was performed, including the scalp, face, trunk, extremities, nails, and groin (patient declined underwear removal). A dermatoscope was used for detailed mole evaluation.
Findings included:
Benign nevi: Regular, symmetrical moles without concerning features
Lentigines: Sun-induced pigmented lesions (sunspots)
Cherry angiomas: Small vascular growths
Seborrheic keratoses: Benign, warty growths
Dermatofibromas: Firm nodules on right calf and left buttock
Rash on right ear: Possible dermatitis, differential includes seborrheic dermatitis vs. eczema
Neoplasm of uncertain behavior: Courtesy liquid nitrogen (LN2) treatment performed
The patient was otherwise well-appearing, alert, and in no acute distress.
Counseling & Management
1. History of Tanning Bed Use
Counseling on increased melanoma, basal cell carcinoma, and squamous cell carcinoma risk
Emphasized sun avoidance, sunscreen SPF 30+, and protective clothing
2. Benign Nevi (D22.9)
No treatment required
Patient educated on monthly self-skin checks and to return for changes in size, color, or symptoms
3. Lentigines (L81.4)
Benign, but may be treated with sunscreen, retinoids, chemical peels, or laser if desired
Counseling on consistent broad spectrum SPF 30+ use
4. Cherry Angiomas (D18.01)
Benign vascular lesions, no treatment required
May be removed with laser or electrodesiccation if cosmetic concerns arise
5. Seborrheic Keratoses (L82.1)
Common, benign growths that increase with age
No treatment needed
6. Dermatofibromas (D23.71, D23.5)
Benign scar-like nodules
Stable, but may be surgically removed if symptomatic or enlarging
7. Dermatitis, Unspecified (L30.9)
Rash on right ear treated with over-the-counter hydrocortisone cream
Patient advised to return if not improving
8. Neoplasm of Uncertain Behavior
Treated with liquid nitrogen cryotherapy today
Monitored for resolution; follow-up in 1 year
Conclusion
This case demonstrates the importance of comprehensive annual skin exams, especially in patients with risk factors such as tanning bed history. At Village Dermatology in Katy and Houston, TX, we provide thorough evaluations, identify both benign and concerning lesions, and counsel patients on skin cancer prevention and sun safety.
Case Study: Pilar Cyst, Benign Nevi, and Sun Damage in a 37-Year-Old Female
A 37-year-old female underwent a full body skin exam at Village Dermatology in Katy and Houston, TX. Findings included a pilar cyst, benign moles, lentigines (sun spots), and seborrheic keratosis. Learn why regular skin exams and sun protection are essential.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we routinely evaluate patients for skin lesions to identify both benign and potentially concerning findings. This case highlights a 37-year-old female presenting for a comprehensive skin exam, with findings including a pilar cyst, benign moles, lentigines (sun spots), and seborrheic keratosis.
Patient Presentation
A 37-year-old female presented as a new patient for evaluation of brown skin lesions present throughout the body. The lesions had been present for years, were moderate in severity, and had not been treated in the past. She reported no personal history of skin cancer.
Dermatologic Examination
A full-body skin exam was performed with a dermatoscope. Key findings included:
Pilar Cyst: A firm, subcutaneous cyst located on the mid-occipital scalp.
Benign Nevi (Moles): Symmetrical, evenly pigmented macules and papules throughout, including a 4 mm mole on the left midback, documented for monitoring.
Lentigines (Sun Spots): Reticulated, light tan macules distributed in sun-exposed areas.
Seborrheic Keratosis: A pigmented, waxy papule and flat lesion on the right leg.
No evidence of skin cancer was noted.
Impression and Plan
Pilar Cyst
Counseling: Pilar cysts are benign keratin-filled sacs that often run in families.
Plan: No treatment required unless cyst becomes painful, red, or ruptures.
Benign Nevi
Plan: Observation, with a 6-month recheck of the mole on the back.
Counseling: Monthly self-skin checks recommended; patient advised to report any changes in size, shape, or color.
Lentigines (Sun Spots)
Plan: Emphasis on sun protection with broad spectrum SPF 30+ sunscreen.
Treatment options: Topical bleaching creams, retinoids, chemical peels, or laser for cosmetic improvement.
Seborrheic Keratosis
Counseling: Benign, age-related growths that require no treatment unless irritated or cosmetically undesired.
Key Takeaway
This case illustrates the importance of regular skin exams for early detection and reassurance. While all findings were benign, the patient received counseling on sun safety, mole monitoring, and when to seek medical attention.
At Village Dermatology in Katy and Houston, TX, we specialize in comprehensive skin exams, mole monitoring, sun protection counseling, and cosmetic dermatology for both prevention and peace of mind.
Case Report: Atopic Dermatitis and Folliculitis in a 28-Year-Old Patient | Village Dermatology Katy & Houston, TX
A 28-year-old patient with itchy rashes and acne-like bumps was diagnosed with atopic dermatitis and folliculitis at Village Dermatology in Katy & Houston, TX. Learn about their treatment plan with topical steroids, clindamycin, and skin care counseling.
Introduction
Chronic skin conditions like atopic dermatitis (eczema) and folliculitis can significantly affect quality of life if not properly treated. At Village Dermatology in Katy and Houston, Texas, our dermatologists specialize in evaluating persistent rashes, providing targeted treatment, and educating patients on long-term skin care strategies. This case highlights a 28-year-old patient presenting with eczema flare-ups and folliculitis.
Patient Presentation
The patient, a 28-year-old, presented with:
Itchy, red rash on arms and left hand, present for several months
History of childhood eczema
New acne-like bumps on the buttocks, especially after wearing tight clothing
The patient was not on any treatment prior to evaluation.
Examination
A dermatologic examination revealed:
Eczema patches: well-demarcated, eczematous, inflamed patches on the arms and hands
Folliculitis: follicular-based pustules on the buttocks
The patient appeared well-nourished, alert, and in no acute distress.
Impressions & Treatment Plan
1. Atopic Dermatitis (Eczema, L20.89)
History of flares since childhood
Prescribed triamcinolone acetonide 0.1% cream, applied BID during flares for up to 14 days/month
Advised on proper skin care:
Use lukewarm water with mild cleansers
Apply emollients (CeraVe, Cetaphil, Vanicream) 2–3 times daily
Avoid scented detergents and fabric softeners
Moisturize immediately after bathing
Counseling on triggers: stress, scented soaps, detergents, dry skin, weather changes, and scratching
Education on side effects of long-term steroid use, including skin thinning and hypopigmentation
2. Folliculitis
Likely exacerbated by tight-fitting clothing and friction
Patient already using benzoyl peroxide wash (Panoxyl bar)
Prescribed clindamycin 1% gel, applied once to twice daily for prevention and treatment
Counseled that post-inflammatory hyperpigmentation (brown spots) may remain temporarily but fade with time
If resistant, future treatment may include oral doxycycline
Counseling & Education
The patient was instructed to:
Continue moisturizers daily for eczema
Use benzoyl peroxide wash and clindamycin for folliculitis
Avoid overuse of topical steroids to minimize side effects
Return for follow-up in 2 months or sooner if symptoms worsen
Conclusion
This case highlights the importance of personalized dermatologic care for patients with both eczema and folliculitis. At Village Dermatology in Katy and Houston, TX, our team provides tailored treatment plans combining medications, lifestyle guidance, and preventive care to ensure healthy skin and improved quality of life.
Case Study: Epidermal Inclusion Cyst on the Neck in a 33-Year-Old Female
A 33-year-old female presented to Village Dermatology in Katy and Houston, TX, with a firm nodule on the posterior neck. Diagnosis: epidermal inclusion cyst. Learn why observation was recommended and when removal may be needed.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we often evaluate patients who present with long-standing nodules or growths on the skin. This case features a 33-year-old female who presented with a firm nodule on the posterior neck, ultimately diagnosed as an epidermal inclusion cyst.
Patient Presentation
A 33-year-old female presented for evaluation of a firm nodule on the right posterior neck, which had been present for 10 years. The lesion was moderate in severity but had not been previously treated.
She declined a full skin examination and requested evaluation only of the symptomatic area.
Dermatologic Examination
A focused exam of the head, lips, and neck was performed with dermatoscopy.
Findings included:
Subcutaneous cyst with a prominent follicular pore, consistent with an epidermal inclusion cyst.
Size: approximately 1.5 cm, located on the right medial trapezial/posterior neck region.
No other concerning findings were identified.
Impression and Plan
Epidermal Inclusion Cyst (L72.8)
Counseling: Epidermal inclusion cysts are benign sacs beneath the skin filled with keratin.
Expectations: They typically remain stable, though they can enlarge, rupture, or become tender if inflamed.
Plan: Observation. No treatment required at this time.
Instructions: Patient was advised to return if the cyst ruptures, becomes red, painful, or shows signs of infection.
Key Takeaway
Epidermal inclusion cysts are benign, slow-growing lesions that can often be managed conservatively. While removal may be considered for cosmetic reasons or if the cyst becomes inflamed, observation is appropriate when the lesion is stable and asymptomatic.
At Village Dermatology in Katy and Houston, TX, we provide expert evaluation and management of cysts, nodules, and other skin growths, offering both reassurance and treatment options tailored to patient needs.
Case Report: Hair Loss, Allergic Contact Dermatitis, and Seborrheic Dermatitis in a 44-Year-Old Female | Village Dermatology Katy & Houston, TX
A 44-year-old female with generalized hair loss, seborrheic dermatitis, and allergic contact dermatitis was treated at Village Dermatology in Katy & Houston, TX. Learn about her second opinion evaluation, oral minoxidil and finasteride therapy, and scalp treatments.
by: Caroline Vaughn
Introduction
Patients often present to dermatology clinics with more than one skin or hair concern. At Village Dermatology in Katy and Houston, Texas, we take a comprehensive approach, addressing each condition with both medical treatment and patient education. This case highlights a 44-year-old female with generalized hair loss, seborrheic dermatitis of the scalp, and allergic contact dermatitis affecting her toes.
Patient Presentation
The patient is a 44-year-old female who sought a second opinion for hair loss. She had been on oral minoxidil (half a tablet daily) for three months without noticeable improvement. In addition, she reported:
Recurrent rashes on her toes triggered by beach visits (suspected allergic contact dermatitis)
Scalp scaling and itching consistent with seborrheic dermatitis
Examination
A focused exam revealed:
Diffuse thinning of scalp hair, consistent with female pattern hair loss
Well-demarcated, geometric eczematous patches on toes consistent with allergic contact dermatitis
Scaling and erythema on the scalp, consistent with seborrheic dermatitis
The patient was otherwise well-developed, oriented, and in no acute distress. A dermatoscope was used for scalp evaluation.
Impressions & Treatment Plan
1. Allergic Contact Dermatitis (L23.9)
Triggered by beach exposure, etiology unclear
Prescribed clobetasol 0.05% cream, applied BID during flares (up to 2 weeks/month)
Counseling provided on hypoallergenic products, potential need for patch testing, and steroid side effects
2. Seborrheic Dermatitis
Chronic scalp condition with flares
Prescribed ketoconazole 2% shampoo, used daily during flares and 1–3 times weekly for maintenance
Prescribed fluocinonide 0.05% solution, BID PRN during flares
Counseling on long-term management, stress as a trigger, and steroid side effects
3. Androgenetic Alopecia (Female Pattern Hair Loss, L64.8)
Patient counseled that 3 months of oral minoxidil is too early for results (typically 6–12 months needed)
Treatment plan updated:
Continue oral minoxidil
Add oral finasteride 5 mg daily
Discussed additional options: PRP (platelet-rich plasma), AlmaTED treatments, supplements (Nutrafol, Viviscal), and at-home red light therapy
Counseling on expectations: Female pattern hair loss is genetically determined, slowly progressive, and typically presents with widened midline parting while maintaining the frontal hairline
Conclusion
This case highlights the importance of comprehensive dermatology care in managing overlapping skin and hair conditions. At Village Dermatology in Katy and Houston, TX, our specialists combine advanced medical treatments, patient education, and cosmetic options to provide tailored care for conditions like hair loss, seborrheic dermatitis, and allergic contact dermatitis.
Case Study: Androgenetic Alopecia in a 22-Year-Old Male and Treatment with PRP Therapy
A 22-year-old male with androgenetic alopecia was evaluated at Village Dermatology in Katy and Houston, TX. After reviewing treatment options, he elected to begin PRP therapy for hair loss.
by : Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we see many young men concerned about progressive hair loss. This case highlights a 22-year-old male presenting with diffuse scalp thinning, ultimately diagnosed with androgenetic alopecia (male pattern hair loss) and opting for platelet-rich plasma (PRP) therapy.
Patient Presentation
A 22-year-old male presented as a new patient for evaluation of generalized hair loss on the scalp. The hair thinning had been ongoing for 5 months, was moderate in severity, and had gradually worsened.
He had no prior treatments other than over-the-counter Nutrafol supplements.
Dermatologic Examination
A focused exam of the scalp and face was performed with dermatoscopy. Findings included:
Diffuse non-scarring hair loss across the scalp.
Patterned thinning in the vertex and frontotemporal regions, consistent with androgenetic alopecia (AGA).
Impression and Plan
Androgenetic Alopecia (Male Pattern Hair Loss)
Diagnosis: Clinical findings consistent with AGA. Punch biopsy was discussed for further confirmation, but not pursued at this time.
Treatment Options Reviewed:
Oral minoxidil
Finasteride
Spironolactone (off-label in men, rarely used)
Topical Rogaine (minoxidil)
Low-level laser therapy
Microneedling
Hair transplant surgery
PRP (platelet-rich plasma) therapy
Side effects, benefits, and expectations were reviewed thoroughly.
Patient Decision
After an in-depth discussion, the patient elected to proceed with PRP therapy.
Counseling included the fact that PRP is cosmetic and not covered by insurance.
Patient was advised on what to expect from the procedure and the importance of follow-up.
Counseling
Hair Care: AGA can be slowed with medications such as minoxidil and finasteride; hair transplantation is an option in advanced cases.
Expectations: AGA is genetically pre-determined, slowly progressive, and most prominent in the vertex and frontal scalp.
Monitoring: The patient was instructed to return if hair loss worsens or fails to improve with therapy.
Follow-Up
The patient was scheduled to begin PRP therapy and will follow up in 4 months for re-evaluation.
Key Takeaway
This case underscores the importance of early diagnosis and treatment in male pattern hair loss. With a combination of modern therapies such as PRP, oral medications, and topical treatments, patients can often achieve significant improvement in hair density and quality.
At Village Dermatology in Katy and Houston, TX, we specialize in advanced hair restoration options, including PRP therapy, oral and topical treatments, and counseling for hair loss prevention.
Case Report: Punch Excision of an Epidermal Inclusion Cyst in a 39-Year-Old Male | Village Dermatology Katy & Houston, TX
Village Dermatology in Katy & Houston, TX presents a case of a 39-year-old male with a benign epidermal inclusion cyst on the upper back, successfully treated with punch excision. Learn about diagnosis, procedure, and recovery.
by: Caroline Vaughn
Introduction
Epidermal inclusion cysts are among the most common benign skin lesions seen in dermatology. While often harmless, patients may choose removal for cosmetic, diagnostic, or preventive reasons. At Village Dermatology in Katy and Houston, Texas, we provide expert evaluation and removal of cysts with safe, in-office procedures. This case highlights a 39-year-old male who presented with a cyst on his upper back.
Patient Presentation
The patient, a 39-year-old male, reported a cyst on his right upper back/superior thoracic spine that had been present for nearly a year. The lesion was enlarging, moderate in severity, and persistent. The patient denied pain, drainage, or episodes of inflammation.
Examination
Focused exam of the back revealed:
Well-nourished, well-appearing male
Epidermal inclusion cyst measuring 1.6 x 1.2 cm on the superior thoracic spine
No erythema, tenderness, or drainage at the time of evaluation
Diagnosis
Epidermal Inclusion Cyst (L72.8)
Associated cutaneous inflammation
Management & Procedure
Counseling
The patient was reassured that epidermal inclusion cysts are benign sacs containing keratin and do not require treatment unless inflamed, painful, or cosmetically concerning. He elected for removal. Risks, benefits, and alternatives were reviewed, including possible infection, recurrence, or scarring.
Punch Excision
Location: Superior thoracic spine
Size: 1.6 x 1.2 cm
Anesthesia: Local infiltration with 1% lidocaine with epinephrine
Procedure:
Skin prepped with Betadine and draped
A 4 mm punch tool was used to excise the cyst opening
Blunt dissection performed to remove cyst contents and capsule
Hemostasis achieved with electrocautery
Simple interrupted closure with 4-0 nylon sutures
Petrolatum and sterile dressing applied
Estimated blood loss: Minimal
Complications: None
Post-Procedure Care
The patient was instructed to:
Avoid heavy lifting, exercise, or swimming for 14 days
Keep the wound clean and apply petrolatum as directed
Return for suture removal in 14 days
Contact the office for fever, bleeding, severe pain, or signs of infection
Conclusion
This case demonstrates the successful punch excision of a benign epidermal inclusion cyst in an adult male patient. At Village Dermatology in Katy and Houston, TX, our dermatologists specialize in safe removal of cysts, moles, and skin growths, ensuring optimal cosmetic outcomes and patient peace of mind.
Case Study: Enlarging Growth on the Back – Lipoma in a 43-Year-Old Female
A 43-year-old female presented to Village Dermatology in Katy and Houston, TX, with an enlarging growth on her back. Diagnosis: lipoma, a benign fatty tumor. Learn how surgical excision provides a definitive solution.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, patients often present with new or enlarging growths that raise concern about skin cancer or other serious conditions. This case highlights a 43-year-old female with a darkening, enlarging growth on her upper back, ultimately diagnosed as a lipoma.
Patient Presentation
A 43-year-old female presented as a new patient for evaluation of growths on the right upper back. The lesions had been darkening, enlarging, and irregular in appearance for several months. They were moderate in severity and had not been treated in the past.
Her main concern was whether these growths represented something malignant, and she sought evaluation and management.
Dermatologic Examination
A full-body exam was performed, including the scalp, face, trunk, and extremities, with the assistance of a dermatoscope.
Findings included:
Lipoma: A soft, subcutaneous, slow-growing mass measuring approximately 1.8 cm on the upper back.
No other suspicious lesions were noted.
Impression and Plan
Lipoma
The growth was determined to be a lipoma, a benign tumor made of fatty tissue.
Counseling and Education:
Lipomas are noncancerous and slow-growing.
They often remain stable but can gradually enlarge over time.
No treatment is strictly necessary unless the lesion is bothersome, enlarging, or cosmetically concerning.
Treatment Recommendation:
Surgical excision was recommended for definitive treatment and removal.
The patient was offered referral to Dr. Vaughn or Dr. Armenta for the procedure.
The patient elected to proceed with surgical removal.
Key Takeaway
Not all enlarging or darkening skin growths are dangerous. Lipomas are benign fatty tumors, but professional evaluation is essential to rule out other possibilities. In this case, the patient was reassured, counseled, and scheduled for surgical removal.
At Village Dermatology in Katy and Houston, TX, we provide expert evaluation of growths, lumps, and skin lesions, offering both reassurance and treatment options tailored to each patient.
Case Report: Isotretinoin (Accutane) Initiation for Severe Acne in a 24-Year-Old Female | Village Dermatology Katy & Houston, TX
Village Dermatology in Katy & Houston, TX presents a case of a 24-year-old female with hormonally influenced acne starting isotretinoin (Accutane) therapy. Learn about her treatment plan, birth control counseling, and lab monitoring for safe and effective acne care.
by: Caroline Vaughn
Introduction
Acne vulgaris is one of the most common dermatologic conditions affecting young adults. At Village Dermatology in Katy and Houston, Texas, we see many patients with acne that is persistent, hormonally influenced, and resistant to standard therapies. This case highlights a 24-year-old female whose acne worsened around her menstrual cycle and was inadequately controlled with prior treatments, leading to the initiation of isotretinoin (Accutane).
Patient Presentation
The patient is a 24-year-old female who presented for evaluation of acne on her face and back. She reported both comedonal papules and inflammatory papules/pustules, with flares around her menstrual cycle.
Examination
A focused skin examination of the face revealed:
Comedonal papules
Inflammatory papules and pustules
Acne of moderate-to-severe nature with potential for scarring
The patient was otherwise well developed, oriented, and in no acute distress.
Diagnosis
Acne vulgaris (L70.0), inadequately controlled
Pattern consistent with hormonally influenced acne
Risk of scarring identified
Management Plan
Counseling
The patient received detailed education about:
Skin care: Use of gentle cleansers, non-comedogenic moisturizers, and cosmetics
Treatment expectations: Improvement may take 2–3 months with a 60–80% reduction in acne lesions
Warning signs: Return to clinic if acne worsens, new scars form, or cysts appear
Treatment Initiation: Isotretinoin (Accutane)
Planned dose: 40 mg daily
Indication: Severe acne with scarring, resistant to prior treatments
iPledge program: Patient registered and counseled regarding strict pregnancy prevention requirements
Contraception: Patient started Aviane oral contraceptive pill (OCP) in addition to condoms
High-Risk Medication Monitoring
Patient counseled on potential side effects: dryness, headaches, blurry vision, muscle aches, mood changes, liver effects, lipid changes
Monitoring: Monthly visits with blood work (hepatic function panel, triglycerides)
Urine pregnancy test: Negative in clinic prior to starting therapy
Follow-Up
The patient will return in 31 days for repeat testing, counseling, and isotretinoin monitoring.
Conclusion
This case demonstrates a structured, safety-focused approach to Accutane initiation in young female patients. At Village Dermatology in Katy and Houston, TX, our dermatologists emphasize patient education, regular monitoring, and comprehensive acne treatment to achieve long-term skin health and reduce scarring risk.
Painful Neck Growth in a 41-Year-Old Male: Furuncle and Skin Tag Removal
A 41-year-old male presented to Village Dermatology in Katy and Houston, TX, with a painful neck growth diagnosed as a furuncle and multiple underarm skin tags. Learn how antibiotics and minor procedures provided relief.
by: Ashley Baldree
At Village Dermatology in Katy and Houston, Texas, we frequently evaluate patients with new or concerning skin growths. This case highlights a 41-year-old male who presented with a painful lesion on the back of his neck, as well as skin tags in the underarm area.
Patient Presentation
A 41-year-old male presented as a new patient with a growth on the posterior neck. The lesion had been present for 3 days and was initially painful. The patient had not tried any treatment prior to his visit.
He also noted multiple skin tags in the left axilla, which he wished to have removed.
Dermatologic Examination
A focused exam of the neck and left axilla was performed with the assistance of a dermatoscope. Findings included:
Furuncle (Boil): Inflamed, tender lesion on the posterior neck.
Skin Tags (Acrochordons): Multiple soft, pedunculated papules in the left axillary vault.
Impression and Plan
Furuncle
The lesion on the posterior neck was most consistent with a furuncle, a bacterial skin infection forming a small abscess.
Treatment Plan:
Doxycycline 100 mg taken orally twice daily for 10 days.
Mupirocin 2% ointment applied to the affected area three times daily for 10 days.
Supportive care: warm compresses with diluted vinegar solution, gentle cleansing with Hibiclens wash, and use of benzoyl peroxide.
Counseling:
Furuncles typically resolve with antibiotics but may occasionally require drainage.
If the lesion worsens or fails to heal, culture may be needed to rule out MRSA (methicillin-resistant Staphylococcus aureus).
Skin Tags
Ten skin tags in the left axilla were removed for cosmetic reasons.
Procedure:
Local anesthesia with lidocaine and epinephrine.
Removal performed using gradle excision.
Hemostasis achieved with Drysol.
Counseling:
Skin tags are benign but can be irritating when caught on clothing or jewelry.
Risks of removal, including bleeding, pigment changes, infection, or scarring, were reviewed with the patient.
Key Takeaway
This case demonstrates the value of dermatology evaluation for both infectious lesions (furuncles) and benign growths (skin tags). Early intervention with antibiotics and minor procedures can provide rapid relief and peace of mind.
At Village Dermatology in Katy and Houston, TX, we provide expert diagnosis and treatment of painful skin growths, infections, and cosmetic concerns.
Case Report: Evaluation of Skin Lesions in a 23-Year-Old Female with Dysplastic Nevus and Benign Moles | Village Dermatology Katy & Houston, TX
A 23-year-old female with a history of dysplastic nevi presented to Village Dermatology in Katy & Houston, TX for a full-body skin exam. Learn about her diagnosis of atypical nevus, benign moles, and lentigines, plus counseling on sun protection.
by: Caroline Vaughn
Introduction
Skin cancer prevention and mole monitoring are an important part of dermatology care, especially for patients with a history of dysplastic nevi. At Village Dermatology in Katy and Houston, Texas, we provide comprehensive skin exams, patient education, and treatment when concerning lesions are identified. This case highlights a 23-year-old female who presented for evaluation of multiple skin lesions and counseling regarding sun protection and mole monitoring.
Patient Presentation
The patient is a 23-year-old female who presented with multiple skin lesions on the body, present for several years. The lesions were asymptomatic and had not been previously treated. She also requested education regarding sun exposure, mole checks, and surveillance for suspicious growths. Her history is significant for dysplastic nevi biopsied at an outside dermatologist in Louisiana. She has no family history of melanoma.
Examination
A full-body skin examination was performed, including:
Scalp, head, face, and neck
Chest, abdomen, back
Upper and lower extremities
Digits and nails
Groin and buttocks (underwear not removed at patient’s request)
A dermatoscope was used for detailed mole evaluation.
Findings included:
Dysplastic Nevus with Severe Atypia (left upper back, previously biopsied)
Benign Nevi: regular, symmetric, evenly-colored macules and papules on the back, left 5th toe, and left dorsal great toe
Lentigines: pigmented sun-induced lesions
Impression & Plan
1. Dysplastic Nevus with Severe Atypia (D22.5)
Previously biopsied, severe atypia confirmed
Excision recommended for complete removal
Patient counseled on self-skin checks and importance of monitoring for new or changing lesions
2. Benign Nevi (D22.5, D22.72)
Multiple stable, non-concerning moles identified
No treatment necessary
Patient counseled to perform monthly self-skin checks and return if changes occur
3. Lentigines (L81.4)
Related to sun exposure and sun damage
Benign, but can be treated with sunscreen, bleaching creams, retinoids, chemical peels, or laser therapy
Patient counseled on strict sun protection
Sun Protection Counseling
The patient received detailed sunscreen and sun safety education:
Broad Spectrum SPF 30+ sunscreen recommended, applied 15 minutes before sun exposure
Reapply every 2 hours, or every 45–60 minutes if swimming/sweating
Use of sun protective clothing and hats encouraged
Lip balm with SPF for lip protection
Conclusion
This case underscores the importance of regular dermatology skin checks for patients with a history of atypical moles. At Village Dermatology in Katy and Houston, TX, our team provides comprehensive care, including mole mapping, biopsy, excision, and ongoing patient education to prevent skin cancer and maintain healthy skin.
Eyelid Dermatitis in a Teenager: Case Study and Management Approach
An 18-year-old female with eyelid dermatitis was evaluated at Village Dermatology in Katy and Houston, TX. Learn about her treatment plan with tacrolimus ointment and ketoconazole cream, plus why follow-up and patch testing may be needed.
by: Ashlee Baldree
At Village Dermatology in Katy and Houston, Texas, we care for patients of all ages presenting with rashes, skin lesions, and facial irritation. This case highlights an 18-year-old female with a persistent rash on the face, emphasizing the importance of accurate diagnosis and tailored treatment for eyelid dermatitis.
Patient Presentation
An 18-year-old female presented as a new patient with enlarging skin lesions on the left cheek, nose, and right cheek. The lesions had been present for several months, were moderate in severity, and had not been treated previously. She reported that the rash frequently recurred around her eyes.
Dermatologic Examination
A full exam of the scalp, face, ears, lips, and forearms was performed using a dermatoscope. Findings included:
Facial Dermatitis (Unspecified): Patches of lighter, irritated skin around the eyes.
The clinical appearance raised consideration of atopic dermatitis, seborrheic dermatitis, allergic contact dermatitis (ACD), or lupus.
No systemic symptoms were reported.
Assessment and Plan
The differential diagnosis included several causes of eyelid dermatitis. Since no definitive diagnosis could be made during the initial visit, treatment was focused on symptomatic relief and careful follow-up.
Treatment Initiated
Tacrolimus 0.1% ointment: Apply twice daily to affected areas.
Ketoconazole 2% cream: Apply twice daily for two weeks.
Emollients were recommended to maintain hydration and support skin barrier function.
Counseling and Education
The patient was counseled regarding:
The chronic and sometimes unclear nature of eyelid dermatitis.
Avoiding potential irritants and allergens around the eyes (makeup, harsh cleansers, fragranced products).
Monitoring for warning signs such as fever, worsening rash, or new systemic symptoms.
Follow-Up
The patient was scheduled for follow-up in 4 weeks. If symptoms persist, patch testing will be considered to identify possible allergens. Blood work for ANA (antinuclear antibodies) was also ordered to rule out autoimmune causes such as lupus.
Key Takeaway
Eyelid dermatitis in young patients can have multiple potential causes. Early dermatology evaluation, gentle treatment, and close follow-up are essential to achieve relief and prevent long-term complications.
At Village Dermatology in Katy and Houston, TX, we provide expert evaluation and customized treatment plans for patients with rashes, dermatitis, and facial skin conditions.