A boy aged 11 years was referred to the dermatology clinic for evaluation of a pruritic facial rash. The rash had been present for months despite the application of a number of OTC and prescription creams, including tolnaftate (Absorbine Jr. Antifungal), hydrocortisone 0.5%, clotrimazole (Desenex, Lotrimin), and a prescription cream containing clotrimazole and betamethasone (Lotrisone). All of these medications appeared to help initially, but the patient’s rash always returned and eventually worsened over time.

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A girl aged 7 years visited the dermatology clinic for treatment of a facial rash that had been present for months. The rash was a source of concern to her parents, who had tried at least six different products on it, including tea tree oil, tolnaftate (Absorbine Jr. Antifungal), various OTC moisturizers, and hydrocortisone 0.5% cream, all of which produced no effect. The child’s pediatrician had given the parents a prescription for terbinafine (Lamisil, Terbinex) 250-mg tablets to take once daily, but the parents insisted on seeing a dermatologist instead.

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