Consultant for Pediatricians Vol 9 No 11

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.

The American Academy ofChild and Adolescent Psychiatry recommendsroutine screening for anxiety inchildhood, querying various sources (child,parent, teacher) about anxiety symptoms,assessing for comorbid disorders,and evaluating severity and functionalimpairment. Transient and developmentallyappropriate worries and fears need tobe distinguished from anxiety disorders.Somatic symptoms, such as headache orstomachache, often accompany anxiety.A child’s anxiety may manifest as crying,irritability, or other behaviors that maybe misunderstood by adults as disobedience.Self-report measures can helpscreen for anxiety symptoms and monitortreatment response. Psychotherapy isthe initial treatment of children withanxiety. Pharmacotherapy with selectiveserotonin reuptake inhibitors may benecessary for those with moderate tosevere anxiety. In these children, theaddition of cognitive-behavioral therapymay improve functioning better thaneither intervention alone.

We congratulate Consultant For Pediatricians Editorial Board member Deepak M. Kamat, MD, PhD, who was presented with the 2010 American Academy of Pediatrics (AAP) Education Award at the National Conference & Exhibition in San Francisco last month.

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.

The mother of a 5-week-old boy was concerned about a swelling under her infant’s right nipple. A 2-cm, movable subareolar mass was palpated on examination.

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 newborn girl was noted to have talipes calcaneovalgus, excessive dorsiflexion of the foot that allows its dorsum to come into contact with the anterior aspect of the lower leg- the toes point upward, the arch is flat. The right foot was normal. The infant had no other abnormalities.