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.