Lesions are warm to the touch; exam is unremarkable. Does mom have the answer? Do you?
You see a 9-month-old male with acute onset of warm, erythematous cheeks. Immunizations are up-to-date. History is unremarkable.
A partial differential diagnosis: Erythema infectiosum/Fifth’s disease; neonatal lupus; child abuse; panniculitis from something cold; chilblains.
Cold panniculitis: Disorder of subcutaneous fat; a lobular panniculitis characterized by intense inflammation at dermosubcutaneous junction.
There are many types of panniculitis; never assume cold is the answer; systemic diseases such as buccal cellulitis (Haemophilus and Pneumococcal sepsis) can have very similar presentation.
Indurated annular lesions appeared on this 9-month-old boy's cheeks overnight. He was previously well. Have a virtual seat in the Acute Care Clinic where Dr Jon Schneider and his resident puzzle over the potential causes of these nontender patches. What do you suspect?Â Â
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