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November 1988

A Striking, Papular Rash

Author Affiliations

The Johns Hopkins Medical Institutions, Baltimore

Arch Dermatol. 1988;124(11):1709-1710. doi:10.1001/archderm.1988.01670110069016

REPORT OF A CASE  One week prior to referral, a previously healthy 9-month-old girl developed an erythematous, papular rash on her arms, legs, and face. The papules increased in number at these sites and a few appeared on her trunk as well. She became febrile a few days after the rash developed. The rash was slightly pruritic.The patient's fraternal twin had a high fever a few days before this infant's papular rash appeared. He did not develop a rash, but, according to his parents, developed skin peeling after his fever resolved.On examination, the patient was striking in appearance, with discrete, deeply erythematous, firm papules most prominent over the malar areas, the arms, and the legs (Figs 1 through 3). The buttocks were involved, particularly at the gluteal cleft margins. There were scattered papules on her trunk. The lesions blanched on pressure and were not purpuric. Some were excoriated,

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