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JAMA Dermatology Clinicopathological Challenge
February 2015

A 2-Year-Old Girl With Skin Fragility

Author Affiliations
  • 1Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain
  • 2Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
  • 3Department of Molecular Medicine, Hospital Universitario de Salamanca, Salamanca, Spain
JAMA Dermatol. 2015;151(2):225-226. doi:10.1001/jamadermatol.2014.2772

A 2-year-old girl was referred to our department for skin fragility since early infancy. She had 2 older brothers, and the family had no medical history of note. Physical examination revealed mild xerosis with superficial skin erosions and erythematous residual macules from previous erosions. Some of the lesions had an unusual linear geographic contour and were predominantly located at areas of friction (Figure, A and B). Hair, nails, and mucous membranes were normal. There was no history of blistering. The mother explained that she often found the child peeling off skin with marked facility. Symptoms improved in winter and worsened in summer. Physical and mental developments were normal. Serological markers for celiac disease were negative. A skin biopsy was performed (Figure, C).

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