Red weepy ears.

Abstract

A Caucasian woman aged 18 years developed a well-defined erythematous vesicular eruption with clear non-purulent exudates on the ear lobules and adjacent inferior neck area (Figure 1). Both of her ears had been pierced two weeks earlier at an accredited piercing salon. This was her first piercing. She had been diligent with her care of the new piercings and had used an antiseptic spray given to her by the salon staff to apply to the area. She was otherwise medically well with no personal or family history of skin disease or atopy, and she was not taking any regular medications. The patient initially self-treated the rash by switching to another brand of antiseptic spray from a local pharmacy, which only exacerbated the eruption. The patient was then prescribed oral cephalexin 250 mg and mupirocin 2% ointment for a diagnosis of a suspected wound infection. The patient was also instructed to continue using the antiseptic spray and leave the earrings in. Both antiseptic sprays contained benzalkonium chloride as the main ingredient. There was no response to antibiotic therapy. Ultimately, the patient stopped using the antiseptic spray because of the stinging sensation when applied. Cessation of the antiseptic sprays brought significant improvement. The vesiculation and erythema drastically improved only three days after stopping the sprays (Figure 2).