Dermatology

You are asked to evalute a fussy 6-week-old infant with a rash that started on her left axilla 3 weeks ago and spread to the left arm, chest, and abdomen.

My 18-month-old son has had a diaper rash, with no other symptoms, within a few days of eating a poached egg on 3 separate occasions.

Vaccination against infectious diseases has saved millions of lives. The recurrent threat of influenza pandemics and the prevalence of global HIV infections underscore the need for better-designed, more effective vaccines.

This 14-year-old boy is brought for assessment and treatment of acne by his mother who is noted to have superficial acne scars. His 17-year-old brother has required systemic isotretinoin to control his acne, and the mother wishes to avoid any systemic therapy for her other son.

This 9–month–old boy was initially evaluated at age 6 weeks for an extensive eczematous rash on the head and antecubital and diaper areas and blood and mucus in the stool with each diaper change over a 2– to 3–week period. The symptoms were attributed to milk allergy, and the infant’s formula was changed. At 8 weeks of age, a petechial rash developed on the boy’s trunk and legs. His symptoms persisted despite multiple formula changes, and he was referred to the emergency department.

A 6-month-old boy with different colored eyes since birth. The parents are concerned that the eye anomaly may be associated with an underlying condition after reading about eye disorders online.

A 13-year-old boy from inner city Philadelphia presented with an infected “tattoo” on his right forearm. On examination, he had multiple hypopigmented scars on his extremities. When asked about the scars, the patient appeared embarrassed and stated that they were tattoos, which he created with an eraser from a pencil.

The mother of a healthy 21-month-old girl says that her daughter's unruly hair never lies flat on the scalp and cannot be tamed by combing or brushing.

This 8-year-old girl has had swollen, red eyelids for the past 24 hours. She denies pain or pruritus. She has had no eye drainage, fever, or other systemic signs of illness. She reports some mild fatigue for the past few months but denies myalgias or decreased muscle strength.

A 10-year-old boy had increasing irritation and itching of the lower legs for the past 5 weeks. The boy was an avid soccer player. Examination revealed an acutely inflamed, exudative dermatitis on the anterior aspect of both legs.

For 3 days, a 10-year-old boy had an itchy, tense, vesicular rash on the fingers of both hands (A). He was otherwise healthy.

This 14-month-old girl was brought for evaluation of marked swelling and erythema of the left eyelids (A) The mother had noticed a green discharge and mild swelling of the eye 2 nights earlier.

An 11-day-old African American boy was brought in for a well-baby visit. Pregnancy, labor, and delivery had been uncomplicated.

I read with interest Drs Kumar, Noronha, and Leung's recent "What's Your Diagnosis?" case highlighting the common skin problem, keratosis pilaris. In my suburban pediatric practice, patients frequently ask me how to eradicate this benign but annoying condition.

This pigmented lesion has developed over the past 12 months on the posterior aspect of a 3-year-old boy's thigh. The lesion measures 5 mm and exhibits a dark black nodular center with a light brown pigmented periphery. The lesion is asymptomatic, and the child is well.

Identification of this disorder can be difficult because of the wide range of effects of prenatal alcohol exposure. Here: tips on how to recognize its clinical manifestations and neurodevelopmental features and behaviors.

A baby boy, aged 14 days, presented with a temperature of 38.2°C (100.8°F), a generalized maculopapular rash, and purulent otorrhea. He was treated with oral amoxicillin for 10 days. At age 25 days, he again presented-this time with erythema and edema of the umbilicus, thrush, and fever of 24 hours’ duration.

A discussion of three types of Genital Lesions: Sebaceous Gland Hyperplasia of the Penis, Varicocele, and Penile Dog Bite.

A 4-month-old girl is brought to your office by nervous parents who point out swelling of all the fingers of her right hand associated with tender, deep nodules on the proximal and middle phalanges.

The areas of hypopigmentation on this 4-month-old girl are sequelae of eczema. The rash had developed on the infant’s upper extremities in the bilateral antecubital and popliteal fossae at 1 month of age. Her cheeks were also affected, although only slightly. Her initial diet consisted of regular infant formula. This was switched to soy formula, which she vomited. She was then given a lactose-free formula, which she tolerated well.

A17-month-old girl was hospitalized 3 weeks earlier because of gagging and retching emesis that contained blood-streaked mucus. Her symptoms persisted and she was transferred to a tertiary care center for further workup.

Three-month-old boy with multiple birthmarks and hypertrophic left arm. Infant was born at 38 weeks’ gestation to a 33-year-old gravida 2, para 1 after an uncomplicated pregnancy and normal spontaneous vaginal delivery. Birth weight, 3.45 kg; length, 53 cm. Both parents healthy, nonconsanguineous. No family history of growth abnormalities. Father had port-wine stains on nape and chest.

A 7-month-old boy with a history of severe atopic dermatitis and asthma was brought for evaluation of a generalized rash, fever, and irritability of 2 days’ duration. He had no respiratory symptoms. His medical history was significant for anorexia, without vomiting or diarrhea. He had a strong family history of allergy.

The lesions on this 10-year-old boy had developed during the past year. They were asymptomatic and appeared only on the anterior chest. The child's older brother had had similar lesions, also on the chest, for more than 10 years. The boys' mother was concerned that her younger son might experience the same "disfigurement" as her older son and wanted to prevent that from happening.

The mother of an 8-year-old boy sought medical care for her son, who had complained of a sore throat for 3 days. No fever, drooling, rash, rhinorrhea, cough, congestion, ear pain, neck stiffness, or dyspnea was reported. The boy had not been in contact with any ill persons, although his complaints coincided with a local outbreak of streptococcal pharyngitis.

During a newborn examination, you note a yellow streak on the foot of a healthy newborn.

The rash on this 4-week-old girl had appeared 5 days earlier on her face as thickened scales on an erythematous base and subsequently spread to the scalp, shoulder, chest, abdomen, and extremities. A few bullae were noted on the neck and hands. Initial treatment with cephalexin failed to control the rash, and the infant was admitted to the hospital for further evaluation.

For 3 days, a 7-year-old girl had severe, generalized abdominal pain. The patient described the pain as sharp and achy without radiation; she denied any relieving or aggravating factors. She also reported decreased appetite and energy for the past week.

A15-year-old girl was referred to a pediatric endocrinologist for evaluation of hyperthyroidism. Her primary concerns were intermittent increases in heart rate and appetite (with a weight gain of 7 kg within the past year), feeling hot at night even in winter, persistent lower extremity edema that had been present since age 4 years, and difficulty in concentrating. She denied having diarrhea, sweating, fatigue, breathing difficulties, hair loss, or changes in hair texture.

The mother of a 4-year-old boy noticed a rash on her son's left shoulder the day before. The otherwise healthy, asymptomatic boy plays outdoors daily in his hometown of West Virginia. Earlier in the week, he told his mother that he had felt a "scab" on his shoulder and had picked it off.