Dermatology

The diagnosis is epidermolysis bullosa.

Most pediatricians are ill-prepared to address the growing concern of parents about children's exposures to environmental toxins such as pesticides and polychlorinated biphenyls (PCBs). This environmental health expert reviews the evidence about the potentially harmful effects of these chemicals and explains what makes children particularly vulnerable.

With an array of asthma medications from which to choose, pediatricians must understand the pharmacology of the different drugs in order to make appropriate choices for each child. The author reviews the medications used for long-term asthma management and quick relief, delivery systems for these agents, and promising new drug therapies that lie on the horizon.

A 4-month-old girl is referred to you to evaluate a large pigmented birthmark covering her left flank and abdomen.

This troublesome group of diseases—from juvenile rheumatoid arthritis to lupus to fibromyalgia—presents problems for pediatricians and patients alike. A guided tour will help you make an accurate diagnosis and initiate effective management.

This year's innovations include a hearing screener, a glucose monitor, new rapid optical immunoassays, and a CD-ROM version of the Red Book. Meanwhile, technologies that could revolutionize your practice are getting more sophisticated and affordable all the time.

Parents often believe that their child's hives or GI upsets are caused by a sensitivity to a particular food. Confirming their suspicions relies on knowledge of common symptoms of food allergy and a diagnostic process that may or may not include skin prick or blood tests.

Acne remains an unavoidable part of growing up for many adolescents, who must cope with both the cosmetic and psychosocial effects of the disorder. Here's a look at the latest topical and systemic treatment options for mild to moderate acne.

Artificial fingernails are all the rage among adolescents, but those who wear them may be playing with fire?literally. Educating yourself and your patients about the health and safety risks of acrylic nails, including the previously undocumented danger reported here, could prevent potentially disfiguring complications.

Skin lesions are signposts to an array of systemic conditions. This review covers some of the most distinctive associations.

Asthma management has come a long way in recent years, but many dilemmas remain: When is the right time to make the diagnosis and start anti-inflammatory therapy? What about growth suppression from steroids? Is an inhaler or nebulizer best for acute attacks?

Hyperandrogenism, most notably polycystic ovary syndrome, is a common cause of acne and menstrual difficulties in teenage girls, yet many pediatricians fail to recognize the condition. Prompt diagnosis and treatment can relieve a significant source of distress for patients, while helping to prevent serious complications later in life.

Boy with dark brown streak in fingernail.

The request for a neurologic consultation sounded a bit out of the ordinary: "Please evaluate a 22-month-old with odd, shaking movements of the legs."

The request for a neurologic consultation sounded a bit out of the ordinary: "Please evaluate a 22-month-old with odd, shaking movements of the legs."

Minimizing the risk that your patients and employees will acquire a contagious disease in your office demands diligent infection control. This review summarizes guidelines and offers recommendations that can reduce the spread of infection?from what soap and lotion to use for handwashing to what immunizations your office staff need.

Though not as deadly as it once was, HUS remains a serious threat to young children, with a real risk of dangerous complications. Continuing outbreaks caused by E coli O157:H7 highlight the need for accurate diagnosis, intensive supportive care, and effective prevention.

Despite some formidable obstacles, lung transplantation has become an accepted treatment for children with end-stage lung disease caused by conditions such as cystic fibrosis. Do you have a patient who could benefit?

Parents look to pediatricians for advice on bathing their newborn and avoiding diaper rash. Discolorations and lesions (usually benign) are another concern. This review also updates the best way to care for the umbilical cord and addresses special skin-care considerations in premature infants.

A 3-year-old boy has had a rash on his face for at least six months, and no family history of skin disease.

The eosinophil can either enhance or suppress immune function, and it's associated with a wide variety of diseases. Little wonder a finding of eosinophilia often leaves pediatricians scratching their heads.

Arthritis can be caused by a range of viruses or other infectious agents, or develop in the wake of an enteric, genitourinary, or respiratory tract infection. Knowing the possible causes and typical signs and symptoms of infection-related arthritides helps make the diagnosis.

New products of interest to pediatricians

A 7-year-old boy is brought to your office for evaluation of an asymptomatic birthmark on his left buttock. Except for proportional growth, there have been no changes in the lesions.

Children who exceed their expected share of infections conjure up a host of differential diagnoses, from allergies to a primary immune defect. The authors walk you through the workup you need to do to get at the source of the problem.

You have been asked to see a 17-year-old young woman with recurrent life-threatening episodes of asthma. She was admitted to the pediatric intensive care unit two days earlier with profound dyspnea, her seventh ICU admission and tenth hospitalization since her asthma symptoms began when she was 9 years old.

The mother of a 16-month-old boy brings him to your office for evaluation of a painful blistering rash on the tip of his right thumb. The rash began two days ago as a single blister.