What caused this pruritic eruption on a woman’s arms, thighs, and buttocks?

Case 3:
This pruritic eruption appeared on the arms, thighs, and buttocks of a 28-year-old woman after the uneventful delivery of her second child.

What is your clinical impression?

A. Keratosis pilaris.
B. Staphylococcal folliculitis.
C.Pityrosporum folliculitis.
D.Candida folliculitis.
E. Scabies.
F. Follicular eczema.

(Answer on next page)

Keratosis pilaris, A, can be exacerbated following pregnancy.¹ Pruritus is not a common feature but has been reported.

A staphylococcal infection would be painful, and the distribution on the arms, legs, and buttocks is not typical of a fungal folliculitis. Scabies is a possibility, but one would expect lesions on the trunk, hands, finger webs, and wrists. Follicular eczema is also possible, although this rash usually is preceded by itching; in patients with keratosis pilaris, the papules precede the itching.

References:

1. Jackson JB, Touma SC, Norton AB. Keratosis pilaris in pregnancy: an unrecognized dermatosis of pregnancy? W V Med J. 2004;100:26-28.