Ichthyosiform Rash and Fever in a Child

A 4-year-old black girl presented with a 9-day history of fever and a fine, papular, pruritic rash that initially appeared on her face and scalp, resembling "heat rash," and later became thick and scaly, spreading to her trunk and arms. Upon admission, she was febrile, with diffuse thick scaling on the scalp but no alopecia, and extensive scaly and crusted papules on her face, ears, neck, trunk, and extremities. Laboratory tests showed normal blood cell counts and serum chemistry, with sterile blood and urine cultures, and negative KOH preparations for hyphae. Skin lesion biopsies were performed for further analysis.