Caso para diagnóstico

Abstract

WHICH IS YOUR DIAGNOSIS? HISTORY OF THE DISEASEMale patient, seven-years-old, with a history of discrete pruriginous skin lesions for 18 months. Lesions first appeared on his forearms and rapidly disseminated. The patient denied the use of previous medication, comorbidities or familial history of skin lesions. Physical examination revealed small, nonscaly, smooth and shiny skin-colored papules, with 1-2 mm of diameter, affecting nearly all his skin, sparing only nails, palmoplantar regions, mucous membranes, and part of his hair scalp (Figures 1, 2).Histopathological evaluation showed the presence of dense lymphohistiocytic dermal infiltrate, partially surrounded by interpapillary cones, atrophic superadjacent epidermis, and parakeratosis (Figures 3 and 4). Culture was negative for acid-fast bacilli (BAAR) and fungi.