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JAMA Pediatrics Clinical Challenge
September 2013

Spiny Follicular Hyperkeratotic Papules on the Face

Author Affiliations
  • 1American University of Beirut Medical Center, Beirut, Lebanon

Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Pediatr. 2013;167(9):867-868. doi:10.1001/jamapediatrics.2013.2246

A 5-year-old boy, known to have acute lymphoblastic leukemia since the age of 3 years, presented with a 3-week history of asymptomatic skin lesions primarily affecting the face and to a lesser extent the trunk and extremities (Figure, A and B). He had been undergoing a maintenance chemotherapy regimen consisting of vincristine sulfate, 6-mercaptopurine, methotrexate, and high-dose prednisone. He did not undergo bone marrow or stem cell transplant as part of his treatment. Multiple topical medications including keratolytics were applied to the affected areas without effect.

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