A 17-year-old female presents with a pruritic rash around the wrist. Seen in
High-Yield Explanation
Contact dermatitis causes pruritic plaques or vesicles localized to an area of contact. In this case, a bracelet or wristband would be the inciting agent. Dermatitis may have vesicles with weeping lesions. The process is related to direct irritation of the skin from a chemical or physical irritant. It may also be immune-mediated Zoster would be painful and occur in a dermatomal distribution. Herpes simplex produces grouped vesicles, but they are painful and also unlikely to occur around the wrist. Seborrheic dermatitis presents as red, scaly lesions over a circular area with lesions developing in the nasolabial folds, scalp, and retroauricular areas. Ref Harrison 20th edition pg 1245