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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">An 8-month-old infant girl with no significant personal or obstetric history was taken to the emergency department for evaluation of lesions on the face and scalp that had appeared 2 weeks earlier&#46; The patient had had no fever at any time and no other associated symptoms&#46; The only history of interest was an upper airway cough the week before the lesions appeared&#44; which did not require treatment&#46; The mother and other close relatives mentioned no previous skin disorders or medical conditions of interest&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed several asymptomatic&#44; erythematous&#44; edematous&#44; nonscaly annular plaques in a symmetrical distribution &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#41;&#46; The physical examination was otherwise normal&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Additional Tests</span><p id="par0015" class="elsevierStylePara elsevierViewall">The results of the blood workup&#8212;including tests for antinuclear antibodies&#44; anti-Ro antibodies&#44; anti-La antibodies&#44; and anti-ribonucleoprotein antibodies&#59; serologies&#59; and hormonal profile&#8212;were negative or normal in the mother and the patient&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Clinical Course and Treatment</span><p id="par0020" class="elsevierStylePara elsevierViewall">As there were no signs of severity or specific disease&#44; the condition was managed with observation&#46; The lesions remitted spontaneously 2 weeks later&#44; leaving no sequelae&#44; and did not recur in the following 6 months&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">What Is Your Diagnosis&#63;</span></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Diagnosis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Given the characteristic clinical presentation&#44; the favorable clinical course&#44; and the spontaneous resolution of the lesions&#44; we established a clinical diagnosis of annular erythema of infancy&#44; probably a reactive process in the context of the earlier upper airway infection&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Comment</span><p id="par0035" class="elsevierStylePara elsevierViewall">The figurate erythemas are a group of dermatoses in which the primary lesion has an annular&#44; arciform&#44; polycyclic&#44; or concentric morphology&#46; Many dermatologic diseases can adopt annular forms &#40;urticaria&#44; erythema multiforme&#44; tinea corporis&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> granuloma annulare&#44; pityriasis rosea&#44; sarcoidosis&#44; lupus erythematosus&#44; etc&#46;&#41;&#46; However&#44; there are also entities characterized by circinate or annular lesions that can be fixed or migratory and whose appearance is related to drug hypersensitivity&#44; infections&#44; neoplastic disease&#44; insect bites&#44; or autologous hypersensitivity&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Many classifications of figurate erythemas have been published in the medical literature&#46; These eruptions can be classified according to the predominant cellular component identified by histologic study &#40;lymphocytes&#44; neutrophils&#44; eosinophils&#44; granulomas&#44; or plasma cells&#41;&#44; by the clinical characteristics of the primary lesion &#40;macular&#44; urticarial&#44; desquamative&#44; or raised&#41;&#44; or by whether the etiology is known or unknown&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Annular erythema of infancy is a rare&#44; benign form of figurate erythema of unknown etiology&#46; It typically appears in the first months of life in the form of erythematous&#44; annular&#44; slow-growing papules with raised borders and a central clearing&#46; The lesions can appear on the face and trunk and usually resolve after a few days without sequelae&#46; New lesions may appear and follow the same course&#46; Histology shows both superficial and deep perivascular lymphohistiocytic infiltrates with abundant eosinophils&#46; In a variant called neutrophilic figurate erythema of infancy&#44; histology also shows leukocytoclasia&#46; In this variant&#44; similar lesions initially manifest on the face and resolve spontaneously after 2 to 4 weeks&#46; The condition tends to be chronic and the lesions can reappear on the limbs&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In conclusion&#44; figurate erythemas are not specific entities but rather reaction patterns that can vary from person to person&#46; Because of the similarities in clinical presentation&#44; these conditions are difficult to diagnose and in some cases can only be distinguished by subtle differences in clinical or histologic features&#46; In managing these conditions&#44; it is important to rule out diseases that require specific treatment or endanger the health of the patient&#46; In cases highly suggestive of annular erythema of infancy&#44; given the benign nature of the lesions&#44; immediate biopsy is not necessary&#44; and watchful waiting with periodic follow-up is appropriate&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4&#44;6</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of Interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
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