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Unknown: A firm plaque on the back of a newborn

  • Author(s): Zhou, Wenhong;
  • Wiesenthal, Alison;
  • Carr, Vicki;
  • Allison, Ashley;
  • Kelly, Brent;
  • Gibson, Bernard
  • et al.
Main Content

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.
3. Dept. of Dermatology, University of Texas Medical Branch, Galveston, Texas

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?


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