RT Book, Section
A1 Collier, Sigrid M
A1 Krejci-Mannwaring, Jennifer
A1 Usatine, Richard P.
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114877920
T1 Disorders of Hyperpigmentation
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114877920
RD 2024/04/19
AB A  7-year-old  African  American  girl  was  brought  to  her  pediatrician  by  her  mom  who  was  worried  that  she  was  itching  and  that  her  skin  was  getting  darker.  The  pediatrician  knew  the  girl  well  as  a  patient  with  asthma  and  allergic  rhinitis.  In  fact,  the  girl  performed  the  allergic  salute  more  than  once  in  the  office  as  she  rubbed  her  itchy  nose.  Morgan-Dennie  lines  were  seen  under  her  eyes  (Figure  168-1A).  The  mom  undressed  the  girl  to  show  the  dark  patches  of  skin  around  her  knees  (Figure  168-1B).  Atopic  dermatitis  is  common  in  the  popliteal  fossae  and  this  girl  clearly  demonstrated  the  atopic  triad:  atopic  dermatitis,  asthma,  and  allergic  rhinitis.  The  darkening  of  the  skin  around  the  knees  and  also  seen  on  the  neck  is  related  to  the  scratching  and  rubbing  of  the  skin  secondary  to  the  pruritus  of  atopic  dermatitis.  The  pediatrician  explained  to  the  mom  and  child  about  the  need  to  more  aggressively  treat  the  atopic  dermatitis  with  emollients  and  topical  steroids.  No  promises  were  made  about  the  reversibility  of  the  hyperpigmentation  as  each  patient  will  respond  differently  to  treatment.