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chronic cases, ultraviolet light phototherapy can be an effective adjunct to
therapy.
Seborrheic Dermatitis
For more information about seborrheic dermatitis, see Chapter 69 Rash: Neonatal
. This is a red eruption with greasy scale that is seen in neonates and then in
adolescence and adulthood.
Psoriasis
Psoriasis occurs in three forms during childhood: guttate, erythrodermic, and
pustular. Any or all of these types may develop with silvery scales into the
chronic, plaque-type psoriasis. For a more detailed discussion please see Chapter
70 Rash: Papulosquamous Eruptions and Viral Exanthems .

VASCULAR LESIONS
Pyogenic Granulomas
Pyogenic granulomas ( Fig. 88.8 ) are vascular nodules that develop rapidly at the
site of an injury, such as a cut, scratch, insect bite, or burn. Clinically, the lesions
are bright red to reddish-brown or blue-black. The vascular nodules are
pedunculated, ranging from 0.5 to 2 cm in size. Their surfaces are glistening, or
raspberry-like, often becoming eroded and crusted. They bleed easily. Removal
by curettage, excision, or laser is advisable because few spontaneous resolve.
Acute bleeding may be managed by cautery, by constriction with a suture, or by
excision.

Hemangioma
Hemangiomas, including PHACE and LUMBAR syndromes, are detailed in
Chapter 69 Rash: Neonatal .

URTICARIA/WHEALS
Urticaria is often encountered in the pediatric population, occurring in 2% to 3%
of all children. In most cases, no cause is identified. A small number of cases are
caused by allergic reactions from the ingestion of drugs or foods (e.g., nuts, eggs,

shellfish). Urticaria also follows viral (e.g., Epstein–Barr virus, hepatitis),
bacterial (streptococcal), or parasitic infections. Physical factors, including
dermographism, cholinergic stimulation (induced by heat, exercise, and
emotional tension), cold (acquired and familial), and solar exposure, can induce
urticaria. Finally, urticaria may be caused by factors producing a vasculitis or
other autoimmune phenomena (particularly thyroid diseases) and substances