A 15-year-old Hispanic boy with a medical history of seborrheic dermatitis and mild facial acne was referred to the pediatric dermatology department for evaluation of “red-purple streaks” on his lumbosacral region. His pediatrician had referred him owing to concern of physical abuse by his parents; his case had been reported to the Department of Children and Families. The patient and his family denied trauma or physical abuse. On further questioning, it came out that he had a history of rapid vertical growth despite a negligible change in weight. Specifically, before his growth spurt, he was approximately 60% for height and 40% for weight; after his growth spurt, he was 85% for height and 50% for weight.
On physical examination, the patient appeared thin with violaceous, atrophic, horizontal plaques of the lumbosacral region (Figure). All other physical examination findings were unremarkable.