Case: A 5 year-old boy presents with scaly plaques affecting both ears. They are itchy with crusty vesicular lesions. He is not responding to mupirocin. This happened last spring as well.
Discussion: These lesions are Juvenile Spring Eruptions (JSE). They are caused by an immune response to UV radiation often in the spring, after the first significant sun exposure, more commonly in boys and young men who are more likely to have their ears exposed to sunlight. They can be treated with mineral-based SPF 30 sunscreens and nonsteroid anti-inflammatories i.e. protopic 0.1% oint BID until improved.