Seven year old male with full body eruption

Presenter: Trent Gay, DO

Dermatology Program: Lewis Gale Hospital Montgomery

Program Director: Daniel Hurd, DO

Submitted on: December 5, 2015

CHIEF COMPLAINT: Full body eruption

CLINICAL HISTORY: A 70-year-old male presented with a 4-month history of an asymptomatic, scaly, persistent full-body rash. He reported no preceding infections or recent travel and is otherwise in good health. His past medical history was unremarkable, with no current medications, significant family history, or surgical history. The patient lives at home with his parents, denies alcohol or tobacco use, and attends elementary school. He has no known drug allergies.

At the time of presentation, two punch biopsies were performed, and the patient was prescribed desonide ointment and Sarna lotion. The biopsy results revealed non-specific spongiotic dermatitis. One month later, the patient returned for a follow-up and was placed on an oral steroid taper. Although the rash resolved during the steroid treatment, it reappeared upon tapering and remained unresponsive to the previous topical medications. Consequently, two additional punch biopsies were performed. Following the results, the patient was started on oral erythromycin.

PHYSICAL EXAM:
Well-nourished, otherwise healthy-appearing male with a full-body distribution of scaly macules and patches with post-inflammatory hyperpigmentation changes at sites of old lesions. Palms and soles are spared and there is no oral involvement noted.