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- Ajay Rana, MBBS*
- Stephen de Waal Malefyt, MD, FAAP*
- *Department of Pediatrics, Albany Medical Center, Albany, NY.
Author Disclosure
Drs Rana and de Waal Malefyt have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Presentation
A 6-month-old African American girl presents for a well-child visit and is found to have multiple yellow-brown, dome-shaped papules over her face, neck, and trunk. The lesions were first noticed at her 4-month visit as three similar 5- to 7-mm papules on her forehead and were diagnosed as congenital nevi. Over the past 2 months, the lesions have increased in size and number and now extend all over her forehead, cheeks, eyelids, ears, neck, and trunk. The infant seems to be unaffected by these lesions. There have been no complaints of increased fussiness, disturbed sleep, itching, or poor feeding.
The patient's perinatal history is unremarkable. The past medical and surgical history is noncontributory. Her only medication is sodium fluoride 0.25 mg daily. She is following her growth curves and has achieved age-appropriate milestones. There have been no similar skin lesions in her parents or grandparents.
On physical examination, the infant has multiple raised, well-demarcated, 5- to 15-mm, yellow-brown, firm, rubbery papules (Figs 1–3) located over her forehead, upper eyelids, cheeks, ear pinna, neck, axillary folds, chest, and back. No oral lesions are noted. The lesions are nontender and there is no excoriation, ulceration, or bleeding. Because of the multiplicity and rapidly progressing nature of the lesions, the patient is referred to a dermatologist.
Forehead lesions. Note lesion on right superior eyelid.
Facial lesions.
Axillary lesions.
A shave biopsy is performed and the diagnosis is made on the basis of the histologic findings.
Diagnosis: Juvenile Xanthogranuloma
On …
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