Dermatology

This 10-year-old girl presents with a 2-week history of a persistent rash around the lips.

14-Year-old boy who presents to emergency department with nonpainful swelling under his chin that began about a week earlier. Swelling has been gradually growing; patient now has some difficulty in flexing his neck.

The Food and Drug Administration (FDA) last week approved a topical acne gel developed and manufactured by the Canadian drug company QLT Inc. for use for patients between 12 and 17 years old.

Children and adolescents who have had a malignancy are at risk of medical, psychological, and social late effects of their disease and its treatment. If you're aware of potential problems and how to screen for them, you can help ensure the good health and proper development of these vulnerable youngsters.

A 2-year-old girl has a pimple-like swelling on her right middle finger that has expressed green fluid and developed erythema.

Each of the 21 photographs on the following 4 pages was featured in Dermclinic during the past year. How many of these disorders do you recall?

This 13-year-old boy has a Becker nevus--also called Becker melanosis, because the lesions do not contain nevus cells. This common lesion is characterized by the abrupt onset of hyperpigmentation that gradually expands; it appears at or before adolescence.

The parents of this 2-year-old boy brought their son for evaluation of swelling of the right leg and excoriation and serosanguineous discharge from the ankle region of 3 days' duration.The child had had a hemangioma of the right ankle since birth. Subsequently, there was gradual spread of the lesion along the leg to the buttocks.

ABSTRACT: Children are at greater risk than adults for many travel-related problems, such as barotitis and barotrauma associated with flying, cold and heat injury, drowning, and infection with geohelminths. Most of these problems can be avoided with appropriate measures. To prevent insect-borne diseases, advise parents to apply permethrin to their children's clothing before the trip and apply slow-release DEET (30% to 35% concentration) to their skin every 24 hours. Infection with ground-dwelling parasites can be avoided by wearing protective footwear. At high altitudes, infants and children may experience acute mountain sickness. Acetozolamide (5 mg/kg/d, divided bid or tid) is an effective prophylactic; however, it is contraindicated in patients with sulfa allergy. Some preventive measures that are effective in adults may not be appropriate for children; for example, several medications used to control motion sickness are ineffective and associated with significant side effects in children.

After spending a day at the beach, a 12-year-old boy presented with a second-degree sunburn and blisters on his shoulders (A). According to his mother, he had used sunscreen. The child was not taking any medications. Except for a significant number of moles, his skin was normal.

Consultations & Comments: Do You Recognize This Lesion?

This 14-year-old girl had first noticed the well-circumscribed, roughened, irregular growth on her right middle finger 6 months earlier. The lesion had progressively enlarged. The girl's mother had a similar, but smaller, lesion on the left elbow. Alexander K. C. Leung, MD, and Justine H. S. Fong, MD, of Calgary, Alberta, diagnosed verruca vulgaris. This proliferative, hyperkeratotic, exophytic lesion is most commonly caused by human papillomavirus types 2 and 4.

A 3-year-old boy who presents with blue sclerae and a history of tibial fracture following a minor trau- ma (jump from a height of less than 18 inches). Has a long-standing complaint of back pain. Mother remarks that the boy bruises easily. Medical history otherwise unremarkable.

There's but limited advice you can dispense to parents of your patients who have a potentially life-threatening food allergy: Avoid, avoid, avoid! Yet there's cause for optimism today among stymied clinicians and the four percent of Americans who have a food allergy—often to nuts or shellfish: a new Food Allergy Research Consortium convened at the end of June by the federal government, and led by a prominent pediatrician and food allergy expert, has been charged with, first, conducting basic, clinical, and epidemiologic studies aimed at developing therapies to treat and prevent food allergy and, second, developing educational programs aimed at parents, children, and healthcare providers.

The incidence of community-based methicillin-resistant Staphylococcus aureus (MRSA) infection in healthy children is increasing. This review discusses possible reasons for that rise, reviews antibiotic susceptibility patterns, and presents management guidelines.

The numerous superficial, rounded, red-based ulcerations on the left buttock of a 3-year-old girl are characteristic of bullous impetigo.

Pediatricians need a keen understanding of the variables that influence how phototherapy lowers the bilirubin level and of how to deliver an optimal dose of light.

An otherwise healthy 22-month-old was referred for evaluation of a pruritic rash on her buttocks and right leg of 5 days' duration. Her mother reported that the rash had begun as red bumps and blisters on the buttocks that subsequently spread to the right leg.

Genetic Disorders: Newborn With Multiple Anomalies

A 14-year-old African American boy presented during the winter months with a painless, nonpruritic, periumbilical rash that had been present for approximately 1 month. Initially bluish, the rash had become dark brown.

Over the past 5 years, methicillin-resistant Staphylococcus aureus (MRSA) isolates have become widespread throughout the United States as well as the world.1 In some regions, including our own Gulf Coast, MRSA accounts for the majority of S aureus isolates recovered from patients with community-acquired infections.

During a routine annual checkup, a 5-ft 8-in, 94.5-kg (210-lb) 13-year-old girl was noted to have a hyperpigmented "dirty" lesion on the back of her neck. The girl's parents were also obese. Her mother had type 2 diabetes mellitus.

This neonate was born at 34 weeks' gestational age via elective cesarean section because of breech presentation. He weighed 1950 g, and his Apgar scores were 7 and 8, at 1 minute and 5 minutes, respectively.

This 12-month-old infant comes to your office with an asymptomatic eruption of sudden onset that involves the arms and legs. The child has a mild fever.

Developmentally healthy 9-month-old boy brought for evaluation of congenital pale pink 2-cm plaque on left parietal scalp. Lesion relatively unchanged since birth. No history of birth trauma or scalp electrode monitoring in the intrapartum period. Mother denied varicella infection during pregnancy.

Extreme hyperbilirubinemia must be treated swiftly to prevent neurologic damage. Here are methods for determining a newborn's likelihood of developing severe jaundice and guidelines for treating those judged at greatest risk.

Early signs of bilirubin-induced neurologic damage in healthy term and near-term newborns are often vague. A comprehensive approach to management helps prevent rapid progression and irreversible consequence.

This lesion has developed over the past 6 months on a 6-year-old's nose. It measures 3 mm and is reddish brown with a regular border.