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REPORT OF A CASE A 6.5-year-old Arabic boy was referred to the genetics clinic at age 24 months for evaluation of dysmorphic facial features and recurrent upper respiratory tract infections. The patient had reached all developmental milestones without delay. He was currently in the first grade and exhibited no gross or fine motor handicaps. The patient's 4.5-year-old brother had the same syndrome. For age, the patient's height was less than the fifth percentile, his weight in the 75th percentile, and his head circumference in the 95th percentile. Multiple, ivory-colored papules (

REPORT OF A CASE An 11-month-old white girl presented with a firm lobulated yellow-white nodule within an atrophic patch on the upper aspect of the outside left thigh. At age 1 week, a ''pea-sized'' depression became noticeable over her left thigh that became progressively larger with development of a central nodule as time progressed. Her perinatal history was remarkable for fetal seizures at 7.5-months' gestation and subsequent development of polyhydramnios. Her delivery was remarkable for respiratory depression, seizures, and Apgar scores of 4, 7, and 8 at 1, 5, and 10 minutes, respectively. No record in her hospital chart or recollection by her mother of any intramuscular (IM) or subcutaneous injections could be discovered during or after the resuscitation period. Ultrasound of the head at 1 week and magnetic resonance imaging at 2 months revealed a midline left shift with an asymmetrically enlarged left ventricle and hypertrophy of left gyri.