The tiny papules are follicular eczema, an atopic dermatitis variant that is common in Black children. The patient's itching improved with the application of triamcinolone 0.1% ointment to the affected skin, including the flared follicular eczema areas. Follicular eczema is often missed on skin inspection. If the skin is touched by the physician or provider, the lesions feel like "goose bumps" or monomorphic follicular papules.
In patients with skin of color, atopic dermatitis may appear in various morphologies, including follicular prominence, papules, nummular plaques, lichenoid papules/plaques, lichenification, hypopigmented plaques, and/or hyperpigmented plaques that often result in postinflammatory hyperpigmentation or postinflammatory hypopigmentation.
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Cite this: Candrice R. Heath. Fast Five Quiz: Keys to Atopic Dermatitis in Skin of Color - Medscape - Mar 18, 2021.