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May 1992

Dermal Plaques on the Face of a Child

Author Affiliations

New York (NY) Medical College and Bayley Seton Hospital, Staten Island, NY

Arch Dermatol. 1992;128(5):681-682. doi:10.1001/archderm.1992.01680150111017

REPORT OF A CASE  A 6-year-old boy from Afghanistan was referred to the dermatology clinic for evaluation of two enlarging asymptomatic plaques on the forehead and nose. These plaques were of 9 months' duration. A history of an insect bite to the nose a few months before the development of the lesions was elicited. He had no history of fever, weight loss, cough, or neuropathy. The child's health was excellent, with no family history of cutaneous disease. On physical examination, two erythematous-to-tan, crusted dermal plaques measuring 2 to 3 cm were present on his forehead and nose (Fig 1). A skin biopsy specimen was obtained (Figs 2 and 3). Results of laboratory studies at the time of the initial examination revealed a normal hemogram and urinalysis. Bacterial cultures from the plaque on the child's nose revealed growth of coagulase-positive Staphylo-coccus aureus.What is your diagnosis?

DIAGNOSIS:  Cutaneous leishmaniasis (Leishmania tropica complex).

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