April 2011






History: A 3 year old healthy white female presents to outpatient clinic with an itchy rash that started 4 to 5 days prior.  The rash started on the right neck and chest and then spread to face and to legs.  The patient was seen by pediatrician 3 days prior, who at that time thought the rash looked consistent with pityriasis rosea.  She was started on 10 Days of Keflex for possible impetigo. The rash did not improve.  The patient had recently been around kittens.  She denied fevers or other recent illnesses or any contacts with rash or illness.

Past Medical History:  History of Acute Bronchitis

Medications:  Keflex and benadryl

Family History: Unremarkable

Physical Exam:  The patient ‘s exam was notable for multiple, sharply circumscribed, erythematous, scaly papules and plaques on face including eyebrows, chest, abdomen, bilateral legs, and bilateral extensor arms.  These lesions had raised leading edges and central clearing (Figures 1-3).


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