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January 2008

Recurrent Pustular Eruption in an Infant—Quiz Case

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Arch Dermatol. 2008;144(1):105-110. doi:10.1001/archdermatol.2007.13-a

An 8-month-old white girl presented with a 3-month history of recurrent pustular eruption. The lesions lasted 10 to 15 days, with intermittent remission, leaving residual hyperpigmentation. The patient appeared to have intense pruritus that did not respond to treatment with oral antihistamines. She had no personal or family history of allergic disease, scabies, or any prolonged infection that would indicate immunosuppression.

Dermatologic examination revealed hyperpigmented patches and numerous tiny, scattered and grouped papules and pustules on an erythematous base located mainly on the scalp, trunk (Figure 1), and extremities. A 3-mm punch biopsy specimen was obtained from a pustule on the back and sent for microscopic examination (Figure 2 and Figure 3).