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Adolescent with rash on face and scalp

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A 13-year-old African American male presented with a 2-year history of a mildly pruritic central facial rash (FIGURE) and dandruff. Recent treatment with hydrocortisone 1% cream and nystatin cream (100,000 U/gm) for 1 week resulted in no improvement.

The patient had no history to suggest an allergic contact dermatitis or drug allergy. He had confluent scaling and erythema with hypopigmentation in the nasomesial folds and eyebrows, and diffuse scaling and erythema throughout his scalp.

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