A 2-Year-Old Girl With Intense Itching

Maria Silvana Horenstein, MD; Eduardo Franklin Horenstein, MD


July 17, 2017

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A 2-year-old girl presents to her pediatrician with a 1-week history of a worsening papular rash associated with intense pruritus on the trunk, arms, and hands (see Figure 1 ).


The itching is worse at night. She had not used any oral or topical medications before the onset of pruritus. Her parents deny any history of allergies, concurrent fever, or other illness. Her vaccination schedule is up-to-date. The patient's recent social history includes a summer vacation to the mountains 3 weeks before her parents noticed the skin rash.


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