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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 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