REPORT OF A CASE
A 5-week-old boy was brought to the emergency room with a 1-day history of vomiting and increased irritability. Three days earlier, his mother had noted multiple firm nodules over his shoulders, back, thighs, and left cheek.He had a complicated vaginal delivery with asphyxia and meconium aspiration. The Apgar scores were 0/0/0/4 during the first 20 minutes of life. He had been postterm and was large for his gestational age. A 22-day hospital stay in the neonatal intensive care unit was necessary, complicated by a need for mechanical ventilation for 8 days, hypoxic ischemie encephalopathy, transient cardiac dysfunction, and acute tubular necrosis. The patient had been doing well since his discharge at 22 days, until the nodules, vomiting, and increased crying developed.Examination revealed multiple firm, well-defined nodules and plaques ranging from 1 to 4 cm in diameter. They were slightly erythematous and were distributed over the left cheek, shoulders, upper aspect of the back, buttocks, and thighs (Figs 1 and 2). The remainder of the examination was unremarkable.
Liu F, Dobry MM, Shames BS, Goltz RW. Subcutaneous Nodules and Hypercalcemia in an Infant. Arch Dermatol. 1993;129(7):901-902. doi:10.1001/archderm.1993.01680280089018