Case study for Allergy Clinic

CASE HISTORY

Ten-year-old Dermot was referred to the Allergy Clinic because he had an intensely itchy rash. It first appeared in infancy, when he was just four months old. At the time only his face was affected, and he was successfully treated with medicated creams prescribed by his doctor. As he got older the rash reappeared, and spread to other parts of his body, including his neck, arms, legs and ankles. The rest of his skin, although not directly affected by rash, was dry and flaky. In recent months his rash had worsened considerably, and his ferocious scratching had left him with large areas of broken and weeping skin. He was in pain. He was also miserable because the itch had disrupted his sleep for weeks, and because his peers at school were now teasing him about his appearance. Dermot has eczema.

Roisin was a 35-year-old nurse and she had developed a peculiar rash. It was odd only because of where it was: one big patch on the right side of her neck just below the ear, and another on the outer aspect of her left arm. Nowhere else was affected. The rash had been present for many months, and she had tried several creams with varying degrees of success. She was puzzled by its persistence. ‘Do you always sit like that?’ I asked. ‘Like what?’ She said. ‘With your right hand tucked in under your chin one minute, and stroking the side of your left arm the next!' She did always sit like that, and when I advised her to stop wearing nail varnish, the rash disappeared. Roisin had contact allergic dermatitis. In her case it was an allergy to something in the nail varnish.



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