Swelling and Erythema of the Scalp on a Teenager
Am Fam Physician. 2016 Nov 15;94(10):836-842.
A 16-year-old boy presented with swelling and erythema on the scalp that had worsened over the previous four weeks. Three to four months prior to the development of the swelling, he noted a red circular rash on the same area of his scalp. The rash resolved with application of an over-the-counter antifungal cream. After resolution of the rash, the swelling and erythema began, and the area became painful. He did not have a fever or chills, and there was no discharge from the site. The patient was otherwise healthy and active, and was a member of his school's wrestling team.
Examination of the scalp revealed an area of erythema and induration (Figure 1). The scalp was tender to palpation but not fluctuant. There was no cervical or occipital lymphadenopathy. Ultrasonography showed no fluid collection in the lesion.
Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?
A. Id reaction.
C. Pustular psoriasis.
D. Staphylococcal abscess.
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This series is coordinated by John E. Delzell Jr., MD, MSPH, Assistant Medical Editor.
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