THE CASE: A 4-year-old boy who is new to your practice presents for a well-child visit. His parents report that he has had brownish patches on his torso and back since early infancy. The lesions have decreased in size and number as he has aged. The rash is intermittently pruritic, especially when anyone touches the individual lesions. The child has no systemic complaints. The parents deny any vomiting, failure to thrive, developmental concerns, or wheezing.
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