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Follicular Rash on the Knees and Hyperkeratotic Palms

Follicular Rash on the Knees and Hyperkeratotic Palms Clinical Review & Education JAMA Pediatrics Clinical Challenge A Difficult Diagnosis Irum Noor, DO; Sara Braswell, BS; Sandy Milgraum, MD A B Figure 1. A, Well-defined follicular, pink, scaly papules coalescing into plaques on the patient’s knees. B, Marked orange-red hyperkeratosis of the patient’s palms. A healthy 7-year-old girl presented with a 2-month history of an itchy WHAT IS YOUR DIAGNOSIS? rash on her elbows, knees, hands, and feet. The patient was otherwise healthy with normal development and growth. She had no other A. Psoriasis medical problems and was not taking any B. Ichthyosis medications. The rash started as small pink Quiz at jamapediatrics.com bumps on her knees and elbows, spread- C. Circumscribed juvenile pityriasis ing to her hands and feet and progressively thickening. The patient’s rubra pilaris history was otherwise unremarkable; she had no pets, had no recent D. Atopic dermatitis travel outside the United States, and her vaccinations were up to date. On physical examination, the patient had well-defined, follicular, pink, scaly papules coalescing into thin plaques on her knees (Figure 1A), elbows, and dorsal hands and feet, as well as diffuse, marked orange-red hyperkeratosis and hyperlinearity of her palms with clear demarcation at the wrists (Figure http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Pediatrics American Medical Association

Follicular Rash on the Knees and Hyperkeratotic Palms

JAMA Pediatrics , Volume 169 (5) – May 1, 2015

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Publisher
American Medical Association
Copyright
Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6203
eISSN
2168-6211
DOI
10.1001/jamapediatrics.2014.3327
pmid
25938647
Publisher site
See Article on Publisher Site

Abstract

Clinical Review & Education JAMA Pediatrics Clinical Challenge A Difficult Diagnosis Irum Noor, DO; Sara Braswell, BS; Sandy Milgraum, MD A B Figure 1. A, Well-defined follicular, pink, scaly papules coalescing into plaques on the patient’s knees. B, Marked orange-red hyperkeratosis of the patient’s palms. A healthy 7-year-old girl presented with a 2-month history of an itchy WHAT IS YOUR DIAGNOSIS? rash on her elbows, knees, hands, and feet. The patient was otherwise healthy with normal development and growth. She had no other A. Psoriasis medical problems and was not taking any B. Ichthyosis medications. The rash started as small pink Quiz at jamapediatrics.com bumps on her knees and elbows, spread- C. Circumscribed juvenile pityriasis ing to her hands and feet and progressively thickening. The patient’s rubra pilaris history was otherwise unremarkable; she had no pets, had no recent D. Atopic dermatitis travel outside the United States, and her vaccinations were up to date. On physical examination, the patient had well-defined, follicular, pink, scaly papules coalescing into thin plaques on her knees (Figure 1A), elbows, and dorsal hands and feet, as well as diffuse, marked orange-red hyperkeratosis and hyperlinearity of her palms with clear demarcation at the wrists (Figure

Journal

JAMA PediatricsAmerican Medical Association

Published: May 1, 2015

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