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October 1992

Erythematous, Vesicular Lesions in a Newborn

Author Affiliations

USA; USA; USA Dwight David Eisenhower Army Medical Center, Fort Gordon, Ga

Arch Dermatol. 1992;128(10):1397-1398. doi:10.1001/archderm.1992.01680200107019

REPORT OF A CASE  An 11-day-old girl was referred to our dermatology clinic for evaluation of widespread swirling, linear, vesicular lesions on her skin. These lesions had been present since birth but had increased in severity over the past few days. Papulovesicular lesions overlying areas of macular erythema in a whirling, linear pattern (Figs 1 and 2) were noted on physical examination. The physical examination was otherwise within normal limits. Laboratory data were remarkable for a complete blood cell count showing a cell differential of 0.15 eosinophils. Skin biopsy specimens were obtained from the right buttock and right axilla and stained with hematoxylin-eosin (Figs 3 through 5). The mother related a history of having similar lesions at birth, which had resolved without leaving any residual.What is your diagnosis?

DIAGNOSIS:  Incontinentia pigmenti.

HISTOPATHOLOGIC FINDINGS  The biopsy specimens revealed intraepidermal vesicles containing, and surrounded by, numerous eosinophils. The epdermis contained whorls of squamous cells with areas of central keratinization and dyskeratotic cells

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