13th February 2025

A 22-year-old student presents with a painful area of her face.

A 22-year-old student presents with a painful area of her face. She is normally fit and well but does suffer from eczema, which can be particularly troublesome when it affects her eyelids. It has been flaring recently as she has been juggling studying for exams with a placement in a primary school. This has made her feel generally run down, and she is worried that it is infected at the moment as a few spots have appeared near her eye. She uses only topical treatments for her eczema, as prescribed by her GP, and takes no other medications.

Observations are as follows: HR 72, BP 109/58, RR 13, temperature 36.4℃.

She has five small vesicular lesions above her right eyebrow and medial to the medial canthus of that eye. There is a scaly, erythematous patch on both of her eyelids. There are no deficits on cranial nerve examination, although on testing the sensation of her forehead she feels a burning pain.

What is the most likely diagnosis?

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