A 7-Year-Old Boy with Scaly Red-Brown Papules on His Trunk

A 7-year-old boy is brought to your urgent care center by his mother because she’s concerned about a rash of scaly papules on his trunk, some of which had crusted or healed. A few of the lesions are hemorrhagic. She notes that they appeared a few days ago, accompanied by a mild fever. She dismissed the possibility that the source could be chickenpox because her son had been vaccinated. The boy reports that the papules are “really itchy.” During the exam, you detect generalized lymphadenopathy.

View the photo taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.