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June 1988

Generalized Pinhead-Sized Papules in a Child

Author Affiliations

Indiana University Medical Center, Indianapolis

Arch Dermatol. 1988;124(6):935-936. doi:10.1001/archderm.1988.01670060081022

REPORT OF A CASE  A 10-year-old girl presented for evaluation of a mildly pruritic eruption of one year's duration. The eruption was initially noted near the elbows but it slowly progressed to involve the entire body. The patient noted no ameliorating or aggravating factors. Her general health was excellent and she was receiving no medication.Physical examination revealed numerous 1-mm uniform, smooth, flesh-colored papules over the entire body (Fig 1). The elbows, buttocks, thighs, and knees showed grouping of the lesions without coalescence. Koebnerization was observed in an abrasion of the right anterior tibia. The palms, soles, and oral mucosa were spared. No nail changes were present.A skin biopsy specimen from the right anterior thigh exhibited a well-circumscribed lymphohistiocytic infiltrate adjacent to the epidermis (Fig 2). The infiltrate was surrounded by the rete ridges in a "ball in claw" configuration. Vacuolar change and incontinence of pigment were present

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