Purple‐Grey Indurations with Linear and Arcuate Scarring on a Neonate

Abstract

An 11-month-old baby presented with a month-long history of purple-grey areas in a semicircular shape that had become erythematous and indurated with raised borders, in multiple areas on the proximal extremities and trunk. There was no crusting or purulence and the lesions did not appear to be tender. The mother reported that the infant had been febrile with upper respiratory congestion slightly more than 1 month before, followed by the onset of the first lesion on the left posterolateral thigh 3 days later. In the following month, more lesions, varying in size from 3 to 10 cm, appeared on the upper extremities and back; some lesions spontaneously resolved within 2 to 4 days, leaving behind residual scabs and hypopigmented linear scars. The child is otherwise in good health according to history and examination, with length in the 94th percentile and weight in the 95th percentile, but had not kept up with vaccinations because of "unexpected reactions" to earlier vaccinations. A 4-mm punch biopsy was performed on the right shoulder.