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Endgames Case Review

Itchy papules and pustules on the forehead

BMJ 2023; 380 doi: (Published 09 February 2023) Cite this as: BMJ 2023;380:e070988
  1. Wu Guo, consultant dermatologist1,
  2. Bin Zhang, consultant dermatologist2
  1. 1Department of Dermatology, Children’s Hospital affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital. Zhengzhou, China
  2. 2Beijing Children’s Hospital of Capital Medical University, Beijing, China
  1. Correspondence to B Zhang dr.binzhang{at}

A teenage girl with no pre-existing medical conditions presented to the dermatology department with a two week history of itchy papules and pustules on her forehead. The lesions first appeared as scattered papules, which gradually increased in number. The patient had been prescribed topical mupirocin and tretinoin cream but with minimal improvement. Her home environment was hot and humid because of poor ventilation and recent changes in the weather.

Physical examination found clustered small papules and pustules of the same shape and size on the forehead with no visible comedones (small papules caused by accumulation of sebum and keratin in the follicles) (fig 1). No …

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