Rare Lesion On a 9-Month-Old Infant

Presenter: Jeffrey Harbold, DO, Carlos A. Rivera MD, Rick Lin, DO
Dermatology Program:  South Texas Dermatology Residency Program, Bay Area Corpus Christi Medical Center
Program Director: Rick Lin, DO MPH

Submitted on: April 5, 2019

CHIEF COMPLAINT:  ¨My son has a rare lesion on his left arm”

CLINICAL HISTORY:

Signs and symptoms: A 9-month-old Hispanic male with an evolving asymptomatic linear atrophic plaque on the flexor surface of the left wrist extending to the left upper arm. The patient’s Mother reports the presence of lesion at birth. She also reports that the lesions have progressed in a linear pattern towards the proximal arm. The patient has a history of pyloric stenosis s/p pylorectomy, macrocephaly, and patent foramen ovale/peripheral pulmonic stenosis(PFO/PPS). No significant dermatological family history was reported, including history of skin cancer. At 5 months of age, the patient underwent a MRI Brian for the history of macrocephaly which demonstrated enlargement of the subarachnoid spaces. Echocardiogram was performed during infancy for the history of PFO/PPS that was otherwise normal. 

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Pink papules on both arms

Presenter: Jeffrey Harbold, DO, Carlos A. Rivera MD, Rick Lin, DO, Michael Hohnadel, DO, Thomas L Davis, MD
Dermatology Program:  South Texas Dermatology Residency Program, Bay Area Corpus Christi Medical Center
Program Director: Rick Lin, DO MPH

Submitted on: October 7, 2019

CHIEF COMPLAINT:  ¨I have skin lesions on both arms”

CLINICAL HISTORY:

Signs and symptoms: A 45-year-old Hispanic male with a past medical history of Down syndrome was referred to our clinic with an 8-year history of numerous crops of hyperpigmented confluent smooth papules. Lesions originated on the flexural surfaces of both arms with subsequent spread to the lower torso and legs, with facial sparing. The patient reported occasional mild pruritus but denied any associated pain. Other dermatologic history include biopsy-confirmed scabies in 2015 successfully treated with topical permethrin and a history of rosacea controlled with metronidazole gel and an occasional oral minocycline. There was no significant dermatologic family history reported.

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