Ms Levandoski is a fourth-year medical student at Johns Hopkins University School of Medicine, Baltimore, Maryland.
Teenaged girl distressed by persistent rash
A 16-year-old girl presents for evaluation of an asymptomatic brown rash over her central chest and back that developed over the preceding 6 months. She is embarrassed by the appearance.
Adolescent with enlarging asymptomatic birthmark
An 11-year-old girl asks her pediatrician about an asymptomatic birthmark on her right thigh that drains clear to slightly bloody-tinged fluid occasionally when scratched. It has increased in size proportionally as she has grown.