Severe skin rash

A 14-year-old boy in good health was examined for a severe shin rash (Figure) that had started two weeks earlier and had been treated with oral antibiotics for ten days. Examination revealed that the rash was more severe, beginning on the shins and extending to the trunk, some of the face, and the ears. The knees and ankles were somewhat spared. The boy's protective shin guards were tattered on the inside. An accurate diagnosis of allergic contact dermatitis was made because of the initial location of the eruptions and the lack of improvement after taking antibiotics. Patch tests against common allergens and the patient's soccer shin protectors were scheduled.