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Vesicular rash in a newborn girl

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The appearance and pattern of this child’s rash led us to suspect a rare diagnosis. The findings of a cutaneous biopsy confirmed it.


 

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A 3-week-old girl was brought to our pediatric dermatology clinic by her mother for evaluation of a rash on her arms, legs, and trunk that she’d had since birth. The child was otherwise healthy and the mother said she hadn’t experienced any complications during pregnancy or the perinatal period.

On physical exam, we noted erythematous papules, vesicles, and brown verrucous papules distributed on the newborn’s torso and extremities in a Blaschkoid patter (FIGURE 1). A shave biopsy revealed a mild to moderate hyperplastic epidermis with eosinophilic spongiosis and many scattered necrotic keratinocytes (FIGURE 2).

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