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Special Feature
July 07, 2008

Picture of the Month—Quiz Case

Author Affiliations

Author Affiliations:Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

 

SAMIR S.SHAHMDALBERT C.YANMD

Arch Pediatr Adolesc Med. 2008;162(7):689. doi:10.1001/archpedi.162.7.689

A 1420-g female infant was born prematurely at 33 weeks 4 days' gestation to an otherwise healthy 39-year-old mother. The pregnancy was complicated by maternal hypertension and oligohydramnios. The baby presented with physiologic jaundice and was treated with visible light phototherapy. While unconjugated hyperbilirubinemia improved, extensive areas of confluent, nonpalpable purpura developed (Figure 1and Figure 2).

Figure 1.
A premature infant with areas of extensive, confluent, nonpalpable purpura.

A premature infant with areas of extensive, confluent, nonpalpable purpura.

Figure 2.
Dorsal elbow of premature infant exhibits a similar erythematous pattern as on her chest and abdomen.

Dorsal elbow of premature infant exhibits a similar erythematous pattern as on her chest and abdomen.

A detailed review of the family history revealed idiopathic maternal photosensitivity since the age of 2 years characterized by swelling, blisters, and susceptibility to burns on sun-exposed areas. The mother was otherwise healthy and had successfully managed her condition through strict sun avoidance.

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