Race for the Case

Race for the Case is a clinical quiz feature published quarterly in Dermatology World Directions in Residency — and right here!

Review the case and photos, and submit your answers to the questions below. If you answer correctly, you'll be entered to win a $25 Starbucks gift card. Free coffee and pastries are on the line — what are you waiting for?


      Race for the Case Summer 2018 A Race for the Case Summer 2018 B

A 6-year-old male presents with a two-week history of “dark spots on his feet.” Dark spots were first noticed after the patient had spent the day hiking in Ohio in the fall. The patient began taking amoxicillin for strep throat two days prior to the appearance of the lesions and this is the fourth time he has been treated for step throat this year. Lesions are asymptomatic. Punch biopsy revealed “subtle and non-diagnostic changes” including sparse perivascular lymphocytic inflammation. PAS staining for fungal elements was negative.

This case was submitted by Kylee N. Sacksteder, DO, PGY-4, dermatology resident at OhioHealth O'Bleness Hospital in Athens, Ohio, and Katya Harfmann, MD, attending pediatric dermatologist at Nationwide Children’s Hospital in Columbus, Ohio. 


What is the diagnosis?
What feature of his history is most associated with this disease?
What demographic is most commonly affected with this disease?
What is the treatment?
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