SHM Converge Scientific Abstract ePoster Gallery-Taking a Closer Look at the Surface: A Toddler Who Would Not Bear Weight on His Foot

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This case describes a 2-year-old child with a history of atopic dermatitis who presented with an erythematous foot and refusal to bear weight. He was initially treated for presumed cellulitis with antibiotics, but there was no improvement. Because of persistent symptoms, he was admitted to rule out osteomyelitis. MRI showed soft tissue swelling without bone infection.<br /><br />Dermatology was consulted after the child’s atopic dermatitis improved with topical steroids, but the foot erythema and pain persisted. A skin biopsy was performed and showed spongiotic dermatitis. The patient was treated with oral steroids, which led to improvement in the redness and return of normal weight-bearing.<br /><br />The poster highlights that spongiotic dermatitis is a skin condition characterized by intercellular epidermal edema and can present with erythema and induration. It may closely resemble cellulitis, contact dermatitis, or eczema, creating diagnostic uncertainty and delaying appropriate treatment. Unlike cellulitis, which should begin improving within about 3 days of antibiotics, spongiotic dermatitis responds better to steroid therapy.<br /><br />The main conclusion is that in patients with a history of atopy who are diagnosed with cellulitis but do not respond to antibiotics, clinicians should broaden the differential diagnosis to include spongiotic dermatitis and consider dermatology evaluation and biopsy.

Asset Subtitle

Anika Kumar

Meta Tag

Author List Anika Kumar, Jasmin Abdallah, Jessica A. Boerner, Moath Azmi

Category Clinical Vignettes

Concept Spongiotic Dermatitis

Concept Cellulitis

Concept Corticosteroids

Concept Erythema

Concept Induration

Distinguished Non-Finalist

Presenter Organization Cleveland Clinic Children's

Presenting Author Anika Kumar

Track Pediatric

Keywords

spongiotic dermatitis

atopic dermatitis

cellulitis mimic

pediatric case

erythematous foot

refusal to bear weight

skin biopsy

oral steroids

dermatology consultation

MRI soft tissue swelling

Spongiotic Dermatitis

Cellulitis

Corticosteroids

Erythema

Induration