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October 1989

Widespread Crusted Plaques and a History of Blisters

Author Affiliations

Harrogate (England) General Hospital; University of Leeds, (England)

Arch Dermatol. 1989;125(10):1420a-1420b. doi:10.1001/archderm.1989.01670220117022

REPORT OF A CASE  A 10-year-old boy was referred to the dermatology department with a widespread skin eruption consisting of crusted lesions with dirty scales and an offensive odor. He had suffered from a skin disorder since early infancy with an offensive-smelling rash that blistered. Because of his skin disease he had been transferred to foster care at age 2 years, and no family history was available. Blistering had lessened as he grew older, but many of the affected areas had produced heaped scaling.On examination, he was a highly intelligent boy of normal height and weight. Physical examination of the skin revealed areas of whorled, arciform, and linear, thickened, scaly areas over the trunk (Fig 1) and limbs, with normal skin intervening. Particularly in the flexures (Fig 2) and on the hands and feet (Fig 3), the scaly areas were raised in thick, crusted, cracked, and malodorous plaques. The

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