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Images in Dermatology
August 14, 2019


Author Affiliations
  • 1Department of Dermatology and Radiotherapy, Unesp Medical School, S/N, Botucatu-SP, Brazil
  • 2Department of Morphology, IBB-Unesp, S/N, Botucatu-SP, Brazil
JAMA Dermatol. 2019;155(10):1181. doi:10.1001/jamadermatol.2019.1813

A school-aged child was brought to the dermatology department with a 1-month history of lesions on the hands and feet that were not responsive to oral ivermectin. The family lived in a poor, rural region in Brazil, and the mother reported similar lesions in his siblings, all of whom regularly walked barefoot.

On examination, there were multiple yellow-brown papules with dark central dots on several fingers, toes, and interdigital folds, with development of bullae (Figure 1).

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