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JAMA Clinical Challenge |

Sudden Onset of Generalized Pustules in a Newborn QUIZ

Ge Qian, MD1; Jiang Ji, MD2; Jianbo Wu, MD3
[+] Author Affiliations
1Department of Dermatology, Children’s Hospital of Zhengzhou, Zhengzhou, China
2Department of Dermatology, The Second Affiliated Hospital of Soochow University, Suzhou, China
3Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan, China
JAMA. 2016;315(9):934-935. doi:10.1001/jama.2016.0006.
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On day 3 after birth, a full-term neonate developed a pustular rash over the face and trunk that progressed to a “flea-bitten” pattern on the limbs. Wright staining showed eosinophils, Tzanck smear and bacterial and fungal cultures were negative, and WBC count and ESR were normal. What would you do next?

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Figure 1.

Left, Multiple, firm, 1- to 3-mm, discrete, thick-walled, yellow pustules on a red and swollen base over the trunk at presentation. Inset shows enlarged view of pustules. Right, Scattered erythematous macules and papules on the right leg.

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