Case presentation
An 18-month-old girl presented to our clinic with a one-month history of non-pruritic red-orange papules that started on the scalp and spread to the face, trunk, and extremities. She was a healthy full-term newborn with a normal birth weight. She had no systemic manifestation, no history of allergies, and she had received all vaccinations. Her family history and review of systems were unremarkable. The physical examination showed multiple discrete hyperkeratotic papules on the forehead, and bilateral cheeks with fine and powdery scales, extending to the scalp. There were also multiple reddish to orange scaly papules affecting the chest and arms resembling nutmeg grater appearance. Subsequently, the same papules were prominent with the tendency to coalesce into orange-red plaques on both knees (Figure 1). Developmental and neurological evaluations of the patient were both normal.