A 5-year-old male child was reported with multiple (four to five) episodes of abnormal movements per day since 1 year of age and weakness of both lower limbs for the last 15 days. Physical examination revealed a giant, "cape-like" hairy nevus, with multiple satellite nevi. In total, the estimated surface area of the nevi was 60% of the total body surface (-Fig. 1). On neurological examination, there was paraplegia; power in both lower limbs was 3/5. Deep tendon reflexes in both lower limbs were exaggerated and Babinski sign was positive. There was also bowel bladder involvement in the form of urinary retention with urinary catheter in situ. Laboratory testing revealed normal parameters.
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