An unusual presentation of incontinentia pigmenti in a 4-month-old girl.

A four month old girl initially presented with a crusted nodule on her right index finger. Evaluation was unremarkable for infectious causes or malignancy. She ultimately developed similar hyperkeratotic plaques and papules of the right hand and ultimately linear hyperpigmented patches of her arms and legs. The diagnosis of Incontinentia Pigmenti (IP) was then made. The diagnosis of IP and the differential diagnosis of IP-like lesions is presented.