PLEVA
I think this little girl had the inflammatory variant of Pityriasis lichenoides (PLEVA).The necrotic papules were suggestive.She was not ill.Chickenpox and an inflammatory reaction to molluscum contagiosum were also considered in the differential diagnosis.Lymphomatoid papulosis would not be so extensive.Her bloods were all normal.She responded to erythromycin after about a week's therapy.A viral exanthem would also be in the differential.She had a past history of Atopic eczema
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posted by Dr Ian McColl at 10:29 PM
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Inflammatory papular dermatitis in children Gianoti Crosti syndrome,Papular acral located syndrome,papular urticaria,frictional dermatitis,Bindii dermatitis,caterpillar hairs,mite bites,benign cephalic histiocytosis.These are some of the other inflammatory papular conditions in childhood.I really felt this girl had molluscum but I just could not identify a delled lesion.I think a viral exanthem is most likely.
10:40 PM
I have had two such cases this spring. I could not label them as a viral exanthems or eczema herpeticum (no history of underlying atopic dermatitis). I was not sure about the diagnosis but I had a strong suspicion of PLEVA considering acute onset and morphology of the eruption in both the cases. I am still waiting for their follow up visits.
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