A 30-YEAR-OLD WOMAN came into our clinic for treatment of a facial rash. She said that she first noticed the rash (FIGURE) about 2 months earlier. Over the previous month, the eruption had worsened. Interestingly, the patient noted that she had started Bikram yoga (an intensive form of yoga performed in a room heated, in this case, to 105°F) 5 weeks prior to the onset of symptoms. She was taking the yoga classes 2 to 4 times a week and said that she experienced an exacerbation of her symptoms after each 1-hour session.
FIGURE
Yoga as a trigger
Shortly after she started taking Bikram yoga classes, this 30-year-old patient developed inflammatory papules and pustules. Her symptoms worsened after each 1-hour session. On physical exam, there were erythematous, inflammatory papules and pustules concentrated on her forehead. No comedones were present.
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HOW WOULD YOU TREAT THIS PATIENT?