Painful perioral rash with unpredictable flare-ups

Painful perioral rash with unpredictable flare-ups
Painful perioral rash with unpredictable flare-ups

An 89-year-old Caucasian woman presented with an erythematous perioral rash that had persisted for five weeks and appeared to be spreading. The patient complained that the rash itched and burned. Papules 1-2 mm in size were scattered bilaterally on the chin and nasolabia, but the rash was more pronounced on the right side. No pustules were observed. The lesions did not clear despite treatment with OTC cleansers and twice-daily topical pimecrolimus (Elidel).

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