What Is Causing This Soccer Player’s Rash?

shin guard dermatitis

A 9-year-old boy presented with persistently moderate pruritic and reddened skin on the superior parts of the anterior shins. This occurred during the spring and summer seasons over the last 2 years. He had become an active soccer player during the past 2 years and played organized soccer in the spring and summer. He usually wore shin guards and protective cloth liners between the shin guard and his shin. However, the liner was short and did not cover the entire shin. 

The rash was found on the skin below the knee and above the top edge of the protective liner, in an area where the shin guard still made direct contact with the skin. Occasionally, when he forgot to wear the liner for several days, the whole shin displayed similar symptomatology. There were no other associated symptoms, such as joint pain or nail findings, and no history of exposure to any individuals with a similar skin rash. His parents found that using a low-potency corticosteroid cream and a moisturizer provided moderate relief.

Physical examination revealed thickened erythematous patches with areas of excoriation along the shin bilaterally and especially just below the knee cap area. The rest of the physical examination was unremarkable. 

What is Your Diagnosis?

a. Contact dermatitis
b. Psoriasis
c. Tinea corporis
d. Cellulitis

Answer on page 2

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