An infant girl presented for her 2-month well-child checkup. Her mother reported that the infant had recendy developed new skin lesions, the first of which had been a red nodular lesion in her right axilla. Subsequently, the girl had developed other red lesions, some raised and some flat, on her trunk, neck, scalp, and proximal extremities. The lesions did not seem to bother her. History. The patient had been born at term via uncomplicated vaginal delivery, and she had had no neonatal complications. She was growing well, eating well, and meeting developmental milestones, and she had not been ill. The family had a dog that recently had been treated for fleas, but no one else in the household had any skin lesions. Physical examination. Examination revealed several heterogeneous lesions. The axillary lesion (Figure 1) was nodular, and multiple maculopapular lesions were present on her neck and trunk (Figure 2). A few of the lesions appeared to have crusting. The patient was prescribed an antibiotic ointment for the lesions that appeared to be impetigo. At a 1-month follow-up visit, the patients mother reported that the antibiotic ointment had not helped, and that the infant had developed more lesions. The original lesions appeared to be unchanged. The girl was otherwise well and was still developing normally.
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