A 3-year-old girl presented to the pediatric dermatology clinic with a diffuse, intensely pruritic, scaly rash that had been present since birth. She had previously been diagnosed as having atopic dermatitis and had undergone treatment with both topical and systemic steroids, without success. Her medical history was significant for maternal drug abuse during pregnancy, lack of prenatal care, and failure to thrive.
Physical examination revealed a thin, adequately nourished child who scratched persistently. There were well-demarcated, serpiginous, erythematous, double-edged plaques surmounted with scale on her extremities and trunk (Figure 1). No fissures were observed. Her scalp hair was dull, sparse, short, fragile, and of varying lengths (Figure 2).
Piliang MP, Guenthner S, Treadwell PA. Abnormal Hair Growth in a Child With Atopy. Arch Dermatol. 2001;137(11):1521-1526. doi: