Case History/Examination
A 2-month-old female developed three episodes of severe eczematous
dermatitis with impetiginization, herpetic infection, and Staphylococcal
osteomyelitis requiring multiple hospitalizations over a six-month
period. Newborn screening for severe combined immunodeficiency was
negative, no history of abnormal bleeding, chronic diarrhea, failure to
thrive, and no known family history of atopy or immunodeficiency
syndromes. Significant cutaneous erythema and dry excoriation were seen
on the forehead, hairline, cheeks (Figure 1), chest, abdomen, bilateral
forearms, and ankles. No honey-crusting or vesicular lesions were noted.
Neurology and other exams did not reveal significant findings. She had
achieved all development milestones on time.