Papules and Vesicles in an 18-Month-Old Boy

REPORT OF A CASE A healthy 16-month-old white boy presented with 5 months of erythematous papules on his left arm and leg, chest, and back. The papules later spread to his scalp and became more tender. He had previously been treated empirically for scabies with lindane, without relief, and was also using mometasone furoate cream, with minimal resolution of the papules. On examination, he had a few scattered papules on the anterior aspect of his chest and left thigh and on his left arm and buttock and 20 to 25 papules on his scalp, primarily the vertex ( Figure 1 ). The erythematous papules, vesicles, and crust ranged from 2 to 5 mm in greatest dimension. A 1.2-cm right postauricular lymph node was palpated. A punch biopsy specimen was obtained from the patient's scalp ( Figure 2 through Figure 4 ). What is your diagnosis? Papules and Vesicles in an 18-Month-Old Boy DIAGNOSIS: Eosinophilic