Consultant for Pediatricians Vol 9 No 8

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.

This young girl’s lesions have persisted for several months despite therapy with a multitude of over-the-counter products. The patient’s younger sister is affected as well.

A 9-year-old previously healthy boy presents to his pediatrician with acute onset of a nonproductive cough, left eye swelling without loss of visual acuity, persistent fever of 3 days’ duration, chills, headache, chest pain, vomiting, and left knee pain with inability to bear weight.

A discussion of three types of Genital Lesions: Concealed Penis, Balanoposthitis, and Scrotal Abscess.

Otherwise healthy 9-year-old African American boy seen for first time for complaints of frequent exhaustion, particularly when climbing stairs or walking for long periods. He could no longer participate in sports because of inability to keep up with his peers. He had been toe walking and had become clumsier over the past year, tripping and falling more frequently. Besides a mild delay in walking (around 16 months), his mother had reported no outstanding gross motor delays in infancy. He was in a regular class in school, although he did receive extra help in math and reading.

Dr Robson reports on his time in 2 Haitian cities severely damaged by the January earthquake. He describes the significant challenges he faced and stresses the need for ongoing volunteer efforts.