Spot Diagnosis

You can answer the question shown below with a picture. Immediately after answering the question the correct answer is displayed to you. And you can see previous questions with its correct answers.

A recalcitrant chin dermatosis

Andreia Sofia Jacinto Fernandes¹, Sara Adriana de Brito Correia Laranja¹, Mafalda João Cerqueira da Costa Pereira¹, Maria Margarida de Carvalho Vilarinho², Cristina Isabel Correia dos Santos Amaro Sordo^3
1Pediatrics Department, Unidade Local de Saúde Algarve - Hospital de Faro, Faro, Portugal, ²General Practitioner, Unidade Local de Saúde São José - Unidade Saúde Familiar Vasco da Gama, Lisboa, Portugal, ³Dermatology Department, Unidade Local de Saúde Lisboa Ocidental - Hospital Egas Moniz, Lisboa, Portugal

Address for Correspondence: Andreia Sofia Jacinto Fernandes, Unidade Local de Saúde Algarve – Unidade de Faro, Rua Leão Penedo, 8000-386, Faro, Portugal.
Email: andreiasjf@gmail.com
Keywords : tinea incognita, corticosteroids, imunosupressants, dermatophytosis, diagnosis.
Question:
A 5-year-old girl, with no relevant past history, presented to Pediatrics Dermatology consultation due to a cutaneous rash on her chin for the last 3 months. Corticosteroid and antifungal topical therapy, both separately and combined, as well as oral and topical antibiotics have been previously prescribed. There was transient improvement with corticosteroids, but the rash recurred after treatment was stopped. There was no history of pruritus, pain, contact with animals or similar lesions in the family. Physical examination revealed a mentonian plaque with multiple erythematous papules and pustules, with some showing a very subtle scaling border (Figure 1 and 2).

Figure 1. Mentonian plaque with multiple erythematous papules and pustules, with some showing a very subtle scaling border (anterior view).


Figure 2. Mentonian plaque with multiple erythematous papules and pustules, with some showing a very subtle scaling border (anteroinferior view).

What is the diagnosis?