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April 2011

Sandpaper Dermatitis on a 17-Month-Old Girl—Diagnosis

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Arch Dermatol. 2011;147(4):499-504. doi:10.1001/archdermatol.2011.62-b

The biopsy specimen showed suppurative lobular panniculitis with lobular inflammation of lymphocytes, neutrophils, and giant cells within the subcutaneous adipose tissue (Figure 2). Fat necrosis and mild papillary dermal hemorrhage were also seen. The dermis contained perivascular and periadnexal inflammation with lymphocytes and neutrophils, and mild parakeratotic scaling was present. A subsequent Gram stain showed gram-positive cocci involving subcutaneous fat (Figure 3). Punch biopsy cultures were negative for bacteria, viruses, and fungi. Microscopic examination of potassium hydroxide preparations revealed that the skin surface was negative for fungi. Blood and urine cultures, a rapid strep test, and a nasal staphylococcal swab were also negative for organisms.

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