A 10-Year-Old Boy with Multiple Lesions on His Ear

The Resolution

 

Differential Diagnosis

• Juvenile spring eruption
• Solar urticaria
• Hydroa vacciniforme
• Allergic contact dermatitis

 

Figure 2.

Diagnosis

This patient was diagnosed with juvenile spring eruption (JSE), also known as juvenile spring eruption of the ears. JSE is considered to be an unusual, localized variant of polymorphous light eruption. It occurs most commonly in male children 5 to 12 years of age, but has been reported in young adult males.

 

Learnings

• Both light sensitivity and cold weather are thought to have a role in induction of JSE. Lesions arise several hours after exposure to sunlight and cold conditions
• Grouped small papules, papulovesicles, or true vesicles occurring on the helices of the ears characterize the lesions of JSE. Vesicles may rupture and crust

 

Pearls for Urgent Care Management and Considerations for Transfer

• Lesions resolve spontaneously, usually within 2 weeks, with minimal to no scarring, but may be treated with topical steroids and emollients
• Antihistamines may be prescribed to relieve itching
• Patients should be advised to avoid sun exposure

 

Acknowledgment: Images and presentation courtesy of VisualDx.