LAUSR

A toddler with a history of neurofibromatosis type 1 (NF1) and juvenile xanthogranulomas presented to the clinic for an eruption on his trunk that began 2 months previously with multiple round red patches that had been slowly increasing in size. Treatment with griseofulvin and clotrimazole had not improved the rash. One day prior to presentation he had developed a fever and was diagnosed with otitis media in the emergency department. Acetaminophen, ibuprofen, and amoxicillin were used for treatment, but the child was receiving no other medications. Physical examination revealed multiple annular, indurated, dusky red plaques with central clearing and trailing scale ranging from 1 to 6 cm in diameter on his trunk (Figure, A and B). A 4-mm punch biopsy of the largest lesion on his back was performed and sent for histopathologic examination (Figure, C). Clinical photograph A Clinical photograph B