Elias Milgram, MD

A 3-year-old boy with high fever, malaise, anorexia, and drooling of 3 days' duration was brought to the emergency department (ED). A bacterial throat infection was diagnosed, and oral antibiotic therapy was started.

The mother of a young child was concerned about these hyperpigmented streaks that had appeared on her son's upper chest during the previous 2 weeks. Initially, the streaks were erythematous. They were completely asymptomatic, and the child was otherwise healthy and taking no medications.

A 16-year-old girl with type 1 diabetes mellitus had had asymptomatic, sharply demarcated, waxy plaques, with atrophic, shiny centers, in both pretibial areas for several years.