Abstract
Prolonged mask use during the COVID-19 pandemic has been associated with an increase in dermatologic conditions, particularly irritant and allergic contact dermatitis. Mechanical friction, occlusion, and humidity contribute to skin barrier disruption and inflammation. Although most cases are self-limiting, a subset may evolve into chronic or steroid-dependent dermatoses. We report a case of a 23-year-old male healthcare professional who developed erythematous plaques behind the ear following continuous mask use. The lesions initially responded to topical betamethasone 0.05% cream but relapsed after tapering, evolving into chronic seborrheic inflammation with pruritus and scaling extending into the scalp and external auditory canal. Application of tacrolimus 0.1% ointment and fusidic acid cream aggravated the condition, reflecting persistent inflammation and barrier dysfunction. Clinical findings indicated steroid dependence and chronic seborrheic-type inflammation. Barrier-restoring measures and cautious corticosteroid withdrawal led to gradual improvement. This case highlights the multifactorial pathogenesis of chronic mask-related dermatitis and underscores the importance of barrier repair, prudent corticosteroid use, and interdisciplinary collaboration in managing persistent cases.