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JAMA Pediatrics Clinical Challenge
May 2017

Multiple Skin Changes on the Lower Back of a Neonate

Author Affiliations
  • 1University of Louisville, School of Medicine, Louisville, Kentucky
  • 2Division of Pediatrics, Section of Dermatology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
JAMA Pediatr. 2017;171(5):487-488. doi:10.1001/jamapediatrics.2016.4125

An 11-day-old, full-term girl presented for evaluation of multiple skin changes that were noted at birth (Figure). These skin changes included a red patch on the central lower back with a soft nodule located on top of the patch. Additionally, she had a pedunculated red papule positioned on top of the red stain and soft nodule. She was asymptomatic, moving all limbs, urinating, and defecating normally. Her prenatal screens, including 20-week ultrasonography, were normal. Pregnancy was uncomplicated and there was no history of teratogenic exposure or family history of congenital defects. Ultrasonography of the spine obtained prior to the visit showed no abnormalities.

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