Consultant for Pediatricians Vol 10 No 1

A 4-year-old boy who is new to your practice presents for a well-child visit. His parents report that he has had brownish patches on his torso and back since early infancy. The lesions have decreased in size and number as he has aged. The rash is intermittently pruritic, especially when anyone touches the individual lesions.

For 2 weeks, this 13-year-old girl felt tired and achy. She had persistent fevers (temperature up to 38.8°C [102°F]) and an erythematous facial rash above her eyebrows that extended to her cheeks and nasal bridge and spared the nasolabial folds.