May 2000

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History: The patient is a 23 month old African American male who presented to pediatric dermatology with a history of facial papules and pustules sine six months of age. His past medical history and review of systems was unremarkable.


Physical Exam: Multiple closed comedones and pustules were present on the face(Fig. A note forehead and chin), chest and back. He was thought to have childhood acne and was prescribed topical Cleocin and Differin. On a subsequent visit, he was noted to have an accelerated growth rate an increased bone age to that of a 4 year old. He had sparse axillary and pubic hair, and an enlarged phallus. He was referred to endocrinology  

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