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Special Feature
June 2006

Picture of the Month—Quiz Case

Author Affiliations
 

ALBERT C.YANMD SAMIR S.SHAHMD

Arch Pediatr Adolesc Med. 2006;160(6):645. doi:10.1001/archpedi.160.6.645-a

A 4-year-old black girl presented to the pediatric dermatology clinic for evaluation of a growth on the right foot, first noted in “early childhood.” Examination of the right heel revealed a well-circumscribed 3 × 5–mm white keratotic papule surrounded by a collarette of firm tissue with interruption of skin lines (Figure 1).

The lesion was assumed by the parents to be a wart and was treated with a topical salicylic acid preparation with complete resolution and subsequent recurrence within 1 month. The patient reported focal tenderness to pressure and discomfort while wearing shoes.

The child was born weighing 2090 g at 34 weeks’ gestation by an otherwise uncomplicated vaginal delivery. Apgar scores were 8 and 9, and although the initial physical examination results were normal, the child was taken to the nursery for observation. The postnatal course was complicated by poor feeding, temperature instability, and hyperbilirubinemia, resulting in a prolonged hospital course of 11 days. At the time of discharge, the patient was healthy, and subsequent medical history is otherwise unremarkable.

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