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Special Feature
September 01, 2008

Picture of the Month—Quiz Case

Author Affiliations

Author Affiliations:Penn State College of Medicine (Ms Wasong), and Departments of Dermatology (Drs Klepeiss and Zaenglein) and Pediatrics (Zaenglein), Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.




Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2008

Arch Pediatr Adolesc Med. 2008;162(9):893. doi:10.1001/archpedi.162.9.893

A two-month-old, previously healthy Hispanic boy was transferred from a local hospital. He had a 2-week history of increased redness of his scrotum and penis. Two days prior to admission, the patient's mother noticed an ulcerative lesion on his scrotum. She had been treating the lesion with clotrimazole cream but took him to the local hospital when the lesion did not improve. Prior to transfer to our hospital, he was started on ceftriaxone sodium and vancomycin hydrochloride owing to the presumed infectious nature of the lesion. There was no associated fever, lethargy, or bleeding from the lesion, but significant pain was noted with diaper changes.

Physical examination revealed 2 tender ulcers on the scrotum measuring approximately 2 × 2 cm surrounded by a pink-red, erythematous, slightly elevated plaque that extended from the scrotum to the perianal region (Figure 1). Results of the remainder of the examination were normal.

Figure 1.
Image not available

Two tender ulcerative lesions surrounded by a pink-red, erythematous plaque on the scrotum of a 2-month-old boy.