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October 1986

Multiple Areas of Localized Tissue Loss in a Child

Author Affiliations

University of Michigan Medical School, Ann Arbor

Arch Dermatol. 1986;122(10):1199-1200. doi:10.1001/archderm.1986.01660220117025

REPORT OF A CASE  An 11½-year-old boy was well until the age of 4 years, when he developed erythema and pruritus of the lower extremities. Shortly afterward, a low-grade fever and multiple erythematous, slightly tender nodules, approximately 2×2 cm in size, over the lower extremities were noted. The patient complained of generalized arthralgias at this time. The pruritus, fever, and arthralgias improved, but not the nodules, which eventually resolved with areas of localized lipodystrophy.There were no further episodes until the patient was first seen by us at the age of 9 years, 9 months with a two-week history of progressive erythema and pruritus of the lower extremities that began at his ankles and extended upward to include the upper part of his thighs and his buttocks. There was no family history of lipodystrophy or autoimmune disease.On examination, his temperature was 38°C (100.4°F). Multiple slightly erythematous subcutaneous nodules were