Dear Editor,We present a case of a 13‐year‐old boy presenting with a pruritic eruption on the ears. This had occurred 2 days following an outdoor sporting event on a cold but sunny day in May. A similar eruption had occurred in previous years but to a lesser extent and severity, and presenting earlier in the spring. Seven days prior to this episode, the patient’s hair had been cut following relaxation of the COVID‐19 lockdown restrictions. His hairstyle had previously been longer on the parietal scalp at the sides, and had covered the helices of the ear.On physical examination, a vesiculopapular eruption was seen on the helical rims bilaterally with associated lymphadenopathy (Fig. 1). The clinical appearances and history were in keeping with juvenile spring eruption (JSE). Treatment with potent topical steroids led to resolution within 1 week.
Figure 1
Vesiculopapular eruption present on the helix with cervical lymphadenopathy.
Vesiculopapular eruption present on the helix with cervical lymphadenopathy.Considered to be a variant of polymorphic light eruption, JSE occurs in early spring with resolution over several weeks, likely due to photohardening of the skin., We propose that as a result of the COVID‐19 pandemic restrictions on barbers, our patient had a relatively longer hairstyle, resulting in relative shielding of the helices to sun exposure. In comparison to the presentation in previous years, this protection from the hair appeared to lead to a later‐onset and more severe presentation of JSE.Reports of clusters of perniosis cases during the COVID‐19 pandemic have been suggested as a result of lifestyle changes rather than direct infectious aetiology. This case represents a novel presentation of a photodermatosis in a more severe form in the same patient related to grooming practice behaviour as a result of the COVID‐19 restrictions.
Acknowledgement
We thank the parents for providing informed consent for use of the case description and photographs.
Figure 1