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JAMA Dermatology Clinicopathological Challenge
September 2018

Necrotizing Anogenital Ulcer in a Healthy 8-Month-Old Male

Author Affiliations
  • 1Department of Dermatology, University of Minnesota, Minneapolis
  • 2Department of Pediatrics, University of Minnesota, Minneapolis
JAMA Dermatol. 2018;154(9):1080-1081. doi:10.1001/jamadermatol.2018.0287

A healthy 8-month-old male infant was admitted for management of a rapidly progressive, painful anogenital ulcer. The lesion had developed acutely over 48 hours, starting as symmetric pink patches leading to pustules, erosions, and ulceration. Associated symptoms included generalized fatigue, but no fevers, chills, or other systemic symptoms. The child’s parents denied any new topical exposures or medications. The child was born via vaginal delivery at full term. Pregnancy was complicated by gestational diabetes. The child had no major medical issues and met all developmental milestones. There was no relevant family medical history. Broad-spectrum intravenous antibiotics were initiated on admission. Dermatology was consulted prior to scheduled debridement and skin grafting.

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