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February 1, 2008

Multiple Nodules in a Child—Quiz Case

Author Affiliations


Arch Dermatol. 2008;144(2):255-260. doi:10.1001/archdermatol.2007.41-a

A previously healthy 23-month-old white child presented with 7 firm, nonmobile, and nontender nodules located on the forehead, abdomen, hands, and knees (Figure 1). The lesions arose abruptly within 1 month, and the child's mother denied any trauma to the affected areas. The lesions had been treated by the primary care pediatrician with oral amoxicillin trihydrate, 1 g daily, without resolution. No superficial lymph nodes were palpable. The following laboratory test results were within reference range: complete blood cell count; blood chemistry studies; nuclear antibody; anti-Ro, anti-La, and anti-Sm antibodies; anti–double-stranded DNA antibodies; erythrocyte sedimentation rate; and serum amyloid A protein.