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JAMA Pediatrics Clinical Challenge
Pediatric Quality Measures
July 2016

Red Scaly Eruption in an Otherwise Healthy 2-Month-Old Boy

Author Affiliations
  • 1Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
  • 2Section of Dermatology, Division of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
JAMA Pediatr. 2016;170(7):705-706. doi:10.1001/jamapediatrics.2015.3746

An otherwise healthy 2-month-old boy was brought to the dermatologist by his parents for a severe but apparently asymptomatic rash characterized by redness and scaling. This condition had been present for 4 weeks and included areas of the scalp, face, chest, abdomen, back, axillae, arms, legs, perineum, and buttocks. There were no aggravating factors, and no family member in contact with the patient had a rash with similar characteristics. The parents tried moisturizers and topical antiyeast medications with no change in the rash. The physical examination findings were notable for a well-appearing infant with pink to brown nummular patches and plaques with thick white scale on the scalp, cheeks, trunk, back, axillae, inguinal crease, scrotum, and umbilicus and posterior to the ears (Figure 1). The patient had no lymphadenopathy or hepatosplenomegaly. He was up to date on all immunizations and was full term.

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