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JAMA Pediatrics Clinical Challenge
June 2014

Pink-Violaceous Patches on the Lower Back, Buttocks, and Thighs of a 13-Year-Old Girl

Author Affiliations
  • 1Pediatric Residency Program, St Christopher’s Hospital for Children, Philadelphia, Pennsylvania
  • 2Division of Pediatrics, Section of Dermatology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
JAMA Pediatr. 2014;168(6):575-576. doi:10.1001/jamapediatrics.2013.3993

A 13-year-old girl with a history of Crohn disease presented to the pediatric dermatology clinic for evaluation of a rash on her buttocks and back. The patient noticed the rash 1 day prior to presentation. The rash was asymptomatic with no pain or pruritus. Fourteen days prior to presentation, the patient was seen in the emergency department for a temperature greater than 102°F. Since that time, the patient reported low-grade fever and 1 week of headache for which she had been taking ibuprofen. She also reported fatigue. She denied any preceding upper respiratory tract symptoms.