Two shiny, flat eruptions
An 18-year-old female complained of a rash around her umbilicus for the past several months. Recently she had developed a papular eruption on her body. Both eruptions were pruritic. During history-taking, she noted that her daily attire consisted of jeans with metal clasps and a belt with a large metal buckle. She had no other medical problems. According to her mother, an eruption similar to the one close to the young woman’s umbilicus had once appeared on her earlobes. However, that resolved, and the patient had been wearing earrings, with no ill effect.
The patient was a 25-year-old black woman who presented with flat-topped skin papules on her legs and dorsal foot for the previous four months. The eruption did not itch, burn, or hurt. The woman had no medical problems and reported no history of atopic dermatitis, inflammatory bowel disease, or sarcoid. Patch testing for allergic contact dermatitis was negative. Purified protein derivative testing was nonreactive. Biopsy showed perivascular and interstitial lymphocytes in the area surrounded by projection of the papillary dermis.