Pruritic papular eruption and blisters in a 5-year-old girl

Abstract

A 5-year-old white girl presented with a pruritic papu-lar eruption that had begun 3 weeks previously on herlegs, and gradually progressed to the arms, trunk, palmsand soles (Fig. 1). The child had a history of atopicdermatitis, and of sensitization to peach, plum and egg.One week later, the patient returned to us, present-ing with tense bullae that had appeared on previouslyuninvolved areas on her toes, and on the pre-existinglichenoid papules on the left leg (Fig. 2). On physicalexamination, multiple flat-topped papules were seenon the patient’s trunk, arms, legs, palms and soles, inaddition to tense blisters at the locations mentionedabove. Nikolsky sign was negative.