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JAMA Pediatrics Clinical Challenge
September 2014

A 6-Day-Old Male Infant With Linear Band of Skin-Colored Papules

Author Affiliations
  • 1Comer Children’s Hospital, Pritzker School of Medicine, University of Chicago, Chicago, Illinois
  • 2Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla
  • 3Division of Pediatric and Adolescent Dermatology, Rady Children’s Hospital, San Diego, California

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JAMA Pediatr. 2014;168(9):859-860. doi:10.1001/jamapediatrics.2014.74

A 6-day-old male infant presented to the emergency department with a linear band of skin-colored papules on his left upper extremity. These papules had been present at birth and were persistent at the time of the patient’s initial hospital discharge. Because no resolution had been noted over the next few days, the patient was taken to his primary care physician for evaluation and then sent to the emergency department for further workup. The patient was afebrile. The patient’s mother noted that both the pregnancy and the delivery were uncomplicated. She denied ever having a miscarriage and had another healthy male child at home without any similar lesions. The mother had a history of varicella as a child; she did not have a history of herpes simplex virus and had no oral or genital lesions at the time of delivery. On examination, the patient was noted to have 2- to 3-mm vesicles on the left upper extremity in a linear, bandlike distribution (Figure, A), and similar 2- to 3-mm deep-seated vesicles on his left medial thigh in a whorled configuration, approximately 4 × 3 cm in total size (Figure, B). In addition, the patient had a 1-mm vesicle on his abdomen.

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