Dermatology Online Journal

A firm plaque on the back of a newborn
Wenhong Zhou MD PhD¹, Alison Wiesenthal², Vicki Carr MD³, Ashley Allison MD³, Brent Kelly MD³, Bernard Gibson MD³
Dermatology Online Journal 16 (2): 11

1. Dept. of Dermatology, University of Texas Health Science Center San Antonio, Texas
2. School of Medicine, University of Texas Medical Branch, Galveston, Texas. acwiesen@utmb.edu
3. Dept. of Dermatology, University of Texas Medical Branch, Galveston, Texas

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Figure 1	Figure 2
Figure 1. Back of the newborn at 5 days of life Figures 2 - 4. Biopsy of the right back

Figure 3	Figure 4

A full term infant girl was born via spontaneous vaginal delivery to a 19-year-old mother. The pregnancy was complicated by Group B strep colonization with treatment at time of delivery. The mother had spontaneous rupture of membranes two hours before delivery with terminal meconium fluid noted. Apgar scores were 6 and 8 at 1 and 5 minutes respectively. The patient's exam at birth was unremarkable. The patient developed jaundice on day 2 of life with a bilirubin of 12.6 mg/dL, which resolved without treatment. On day 5 of life, the parents noticed a small firm erythematous plaque on her left back and some hard nodules over her shoulders (Figure 1). The parents reported that the plaque continued to enlarge over the next 4 weeks to involve most of the back. A 0.3 cm punch biopsy was obtained (Figures 2 - 4).

What is the diagnosis?

Answer

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