[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.159.202.12. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Citations 0
Off-Center Fold
Oct 2011

Keratotic “Spiny ” Papules in an Immunosuppressed Child —Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2011;147(10):1215-1220. doi:10.1001/archdermatol.2011.286-a

A 9-year-old girl developed a mildly pruritic follicular eruption near the completion of chemotherapy (mercaptopurine, methotrexate, vincristine, and dexamethasone) for pre –B-cell acute lymphoblastic leukemia. When she first presented to the dermatology clinic, her leukemia was in remission and she was systemically well. Her only regular medication was a course of prophylactic trimethoprim-sulfamethoxazole, which was completed shortly thereafter.

Skin examination revealed an eruption of follicular crusted papules with keratotic spines on the patient's face, including prominent eyebrow involvement. Her shoulders, arms, and legs were also affected (Figure 1). Her eyebrow hair was thinned, but scalp alopecia was not present. Palmoplantar surfaces and nails were uninvolved. The results of her physical examination were otherwise unremarkable. A punch biopsy specimen was obtained from a papule (Figure 2 and Figure 3).

First Page Preview View Large
First page PDF preview
First page PDF preview
×