Hyperpigmented and superficially eroded rash

Case presentation

An 8-year-old Asian boy with a history of atopic dermatitis presents with a hyperpigmented and superficially eroded eruption involving the cubital fossae (Figure 1a), popliteal fossae and neck (Figure 1b). It is irritable but not itchy. The rash has been present for two weeks and has not improved with oral cephalexin and topical betamethasone dipropionate 0.05%. Skin swabs reveal no pathogens.

The patient’s current treatments for atopic dermatitis include his usual moisturiser, topical corticosteroids for flares and a bath oil containing liquid paraffin and triclosan.