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An 8-year-old child with intense itching, worst about the thumbs, adjacent dorsum of the hand, and navel. No prior medical problems. Not exposed to poison ivy recently. Other family members have not had the same symptom. Not clear if the pruritus is worse at night.
Generally healthy. Developmentally appropriate for age. Normal vital signs. Abnormal findings confined to the skin and consist of linear and round areas of reddish brown discoloration, sometimes confluent. Lesions are most prominent in and about the navel.
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