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JAMA Dermatology Clinicopathological Challenge |

Multiple Polycyclic Brownish to Reddish Macules on the Skin in an Infant QUIZ

Despoina Papathemeli, MD1; Klaus Mohnike, MD2; Andreas Ambach, MD1
[+] Author Affiliations
1Department of Dermatology and Venereology, Otto-von-Guericke University, Magdeburg, Germany
2Department of Pediatrics, Otto-von-Guericke University, Magdeburg, Germany
JAMA Dermatol. 2015;151(11):1249-1250. doi:10.1001/jamadermatol.2015.2469.
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A 6-month-old daughter of nonconsanguineous parents was seen with multiple polycyclic dark to less dark brown, partly livid shimmering macules, which covered large areas of the back, neck, buttocks, and lower extremities. New lesions had appeared during the past weeks on the shoulders. What Is Your Diagnosis?

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A, Polycyclic, brown, partly livid shimmering macules covered large areas of the back, neck, buttocks, and lower extremities. B, Fusiform and dendritic cells were found scattered in the dermis (hematoxylin-eosin, original magnification ×100). C, Immunohistological staining of the same specimen (original magnification ×200). S-100 protein positivity identified these cells as melanocytes. D, A triangle-shaped first lumbar vertebral body is shown.

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