Photo Quiz

A Vietnamese Child with a Rash on the Back


Am Fam Physician. 2016 Jan 15;93(2):131-132.

A nine-year-old Vietnamese girl presented with an erythematous rash on her back that appeared suddenly one day prior. She also had upper respiratory tract symptoms, including nasal congestion, sore throat, nonproductive cough, and a fever of 102°F (38.9°C) for three days. Her history was otherwise unremarkable.

On physical examination, the patient appeared acutely ill. She had erythematous nasal turbinates and bilateral anterior cervical lymphadenopathy. The lungs were clear to auscultation. There were linear erythematous lesions located on her posterior thorax (Figure 1). The lesions included petechiae and were nontender to palpation. She had no other skin lesions.

Figure 1.


Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?

A. Atopic dermatitis.

B. Child abuse.

C. Coining therapy.

D. Contact dermatitis.

E. Viral exanthem.


Address correspondence to Nguyetcam V. Lam, MD, at Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.


show all references

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2. Wolff K, Johnson R, Saavedra A, Fitzpatrick TB, eds. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 7th ed. New York, NY: McGraw-Hill; 2013.

3. Shukla R. Dermatology's changing face…and body. Practices adapt to demographic and racial shifts. American Adademy of Dermatology. Young Physician Focus. Fall 2012. Accessed October 22, 2015.

4. Greenberg M. Greenberg's Text-Atlas of Emergency Medicine. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2005:938.

5. McDonald KC. Child abuse: approach and management. Am Fam Physician. 2007;75(2):221–228.

This series is coordinated by John E. Delzell, Jr., MD, MSPH, Assistant Medical Editor.

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