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A 20 year old female consulted a dermatologist, presenting with a greater than six month history of recurrent, erythematous papules and pustules on her arms with no clinical history of acne or rosacea. In addition, she presented with circumscribed pruritic plaques on the dorsal aspect of her arms. The patient described severe itching, and frustration because many previous physicians had believed that no underlying disease was present. Before her biopsies, ampicillin, Atarax® and mupirocin ointment had been prescribed with no improvement. She then decided to consult the dermatologist. Skin biopsies were obtained for hematoxylin and eosin(H&E) review, for immunohistochemistry (IHC) and for direct immunofluorescence (DIF) studies; these were performed as previously described [2]. No tissue culture was performed from the biopsies. After receiving the diagnosis, prednisone was given by for 3 weeks and did not help; fluocinonide ointment, 0.05% then provided improvement and relief for the patient. ABSTRACT

Lichen simplex chronicus positive for C5b-9/MAC, IgD and C3c as a result of recurrent bacterial hair follicular unit infection