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October 1986

Hair Abnormalities and a Rash With a Double-Edged Scale

Author Affiliations

University of Michigan Medical School, Ann Arbor

Arch Dermatol. 1986;122(10):1203-1204. doi:10.1001/archderm.1986.01660220121027

REPORT OF A CASE  A 3½-year-old girl was first seen in the dermatology clinic with a generalized, erythematous, scaly rash that had been diagnosed and treated elsewhere as eczema. She also had sparse scalp hair, which broke easily on combing.The patient was born three months prematurely, following an uncomplicated pregnancy and vaginal delivery. There was no consanguinity. She had normal milestones, with no evidence of delayed growth or deficient intelligence.The patient is a healthy child, who has no recurrent infections, seizures, neurologic disorders, asthma, or hayfever. There is no family history of skin disease other than her mother having eczema as a child. She has no siblings.On examination, the patient's primary lesions were 2- to 3-mm erythematous papules that coalesced to form generalized, migratory, erythematous, annular, and serpiginous lesions with a distinctive double-edged scale (Figs 1 and 2). These lesions had been present since birth. The palms,

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