Presenter: Krina Chavda, D.O., Suzanne Sirota Rozenberg, D.O.
Dermatology Program: St. Johns Episcopal Hospital, Far Rockaway, NY
Program Director: Marvin Watsky, D.O.
Submitted on: October 18, 2008
CHIEF COMPLAINT: Itchy brown patch on left axilla
CLINICAL HISTORY: A 6 year old African American male presented to our clinic with the above chief complaint. As per his father, the patient developed this patch approximately 4 to 5 months prior to his visit to us. He states that it recently started increasing in size. No prior treatment. The patient was on Trileptal for seizure disorder. He also had recently developed flaccid paraparesis for which he had an appointment scheduled for a Pediatric neurologist.
PHYSICAL EXAM:
A 6 years old African American male with verrucous hyperpigmented pruritic linear plaques distributed over left axilla and left upper chest along the lines of Blaschko.
LABORATORY TESTS: N/A
DERMATOHISTOPATHOLOGY:
Hyperkeratosis, papillomatosis, and acanthosis with rete ridge elongation in a psoriasiform pattern.
DIFFERENTIAL DIAGNOSIS:
1. Lichen Striatus
2. Inflammatory linear verrucous epidermal nevus
3. Epidermal Nevi
4. Epidermal Nevus Syndrome
5. Incontinentia pigmenti
