An Unexplained Lesion on the Leg of a 2-Year-Old Girl

A 2-year-old girl, who was otherwise healthy, was examined for a lesion on her right lower leg that first appeared after a trip to Mexico 15 months prior. The lesion, initially described as a "tan", evolved into a scaly round plaque that would intermittently appear and disappear, and later developed into red-to-purple nodules. Despite treatments with mometasone furoate ointment, a combined fusidic acid and hydrocortisone 1% ointment, a 1-week course of oral cephalexin, and betamethasone valerate 0.05% ointment, there was no improvement. The patient had no contact with animals and there were no changes in clothing or detergents that could have caused the lesion.