“It's my right cheek. It burns and oozes,” a twenty-eight-year-old woman told us. It had been that way for months. Cortisone had given some temporary help, but antibiotics were ineffectual.

What we saw was a weeping dermatitis extending downward from her right lower eyelid to the medial right cheek. The left cheek and her skin elsewhere were completely normal. Her past history was unremarkable, except for the loss of her right eye five years ago following an accident. The eye had been surgically enucleated and she wore a prosthesis.

We puzzled over the cause of her dermatitis, so localized to the right cheek. We eliminated the possibility of unilateral rosacea, because the eruption was too eczematous. Could she be allergic to a salve she was applying? We knew that some people even become allergic to the hydrocortisone in healing creams sold over the counter. A trial of complete avoidance of topical measures, soaps, and sprays had no effect. Could it be due to an underlying sinusitis of just that side? It seemed unlikely, because x-rays failed to reveal any sinusitis.

The most likely diagnosis was infectious eczematoid dermatitis, a condition in which chronic purulent drainage produces a band of acute dermatitis in the drainage area. We had seen it in patients with a chronic draining ear infection, in the form of an eczematous band on the face below the infected ear. Yes, our patient did have some drainage from the right eye socket, but it was not purulent.