Authors


Joshua J. Sacha, DO

Latest:

Pityriasis Lichenoides Et Varioliformis Acuta in a 10-Year-Old Boy

A 10-year-old boy presented with a persistent rash that began several months earlier as recurrent crops of papules and a few vesicles with crusting. Varicella was initially diagnosed, and the patient was treated unsuccessfully with over-the-counter drying lotions. The patient denied systemic symptoms and pruritus and was in his usual state of health otherwise. Review of systems, family history, and social history were unremarkable. There was no history of travel or new exposures during this period.


Joshua S. Coren, DO, MBA

Latest:

What'sYour Diagnosis?

Ten-month-old girl with swelling of the left knee of 7 weeks' duration. Unable to bear weight on the left leg for the past 2 weeks. No fever or history of trauma to the area. Infant has good appetite for breast milk and formula, but possible malaise.


Jualecia Malone, PA-C

Latest:

Vaccine-Associated Herpes Zoster

A 23-month-old girl presented with an erythematous papular rash on her torso that extended in a linear pattern around to the back. The mother first noticed the rash while bathing the child 3 days earlier. The child had no associated itching, irritability, or fever, but she had mild rhinorrhea preceding the rash that resolved without treatment. The patient and her older sibling were cared for at home by their mother.


Juan C. Roig, MD

Latest:

Aplasia Cutis Congenita With Associated Fetus Papyraceus

A baby boy born after normal vaginal delivery at 36 weeks’ gestation was noted to have a distinct abdominal wall lesion. Apgar scores were 8 and 9 at 1 and 5 minutes, respectively.


Jugpal S. Arneja, MD

Latest:

Otoplasty: What You Need to Know About Prominent Ear Deformity

Prominent ear deformity is relatively common; this defect- inherited as an autosomal dominant trait-affects approximately 5% of white children.1 As such, surgical correction is a common operation performed by plastic surgeons.


Julia Cronin, MD

Latest:

Child With Difficulty in Walking

A 4-year-old boy with a history of autism presents to his pediatrician’s office with a complaint of right leg pain. He is presumed to have pulled a muscle; an elastic bandage is applied and he is given ibuprofen. Over the next few days, he begins falling and tripping and is unable to maintain his balance. At a return visit, the patient’s mother says her son’s right leg is “like Jell-O” and that he appears to be dragging the leg.


Julie L. Cantatore-francis, MD

Latest:

Photoclinic: Vaccine-Induced Herpes Zoster

In the Photoclinic item titled "Vaccine-Induced Herpes Zoster," by Julie L. Cantatore-Francis, MD, and Yelva Lynfield, MD (Consultant For Pediatricians, June 2005, pages 290 and 291), the dosage of acyclovir was incorrectly printed as 80 mg/d divided into 4 doses. The correct dosage is 80 mg/kg/d divided into 4 doses. We apologize for the error.


Julie Sherman, PhD

Latest:

What Are Common Comorbidities in ADHD?

In this expert Q&A, Julie Sherman, PhD and Jay Tarnow, MD briefly discuss the latest research findings on ADHD.


Justine H. S. Fong, MD

Latest:

Tinea Faciei

A 7-year-old boy was brought for evaluation of a rash on the chin that had appeared 2 weeks earlier. It was slightly itchy. The mother had applied a topical corticosteroid for a few days but then stopped because of worsening of the lesion.


K. Scott Whitlow, DO

Latest:

Acute Poisoning: Keys to Zeroing In on the Cause

Poisons have been a threat to the health and well-being of humankind for millennia. Given the ubiquitous nature of potential poisons, exposure to a toxin should be included in the differential diagnosis of patients with unexplained illnesses or unusual presentations.


Karen A. Stanford, MD

Latest:

Cystic Hygroma in an 11-Year-Old Girl

An 11-year-old girl presented with a swelling on the left side of the chin of 1 month's duration; in the past 24 hours, following a bite by an unidentified insect, the swelling had rapidly enlarged and become painful (A). She was otherwise healthy and had no significant medical or family history.


Karen K. Hansen, MD

Latest:

6-Month-Old Girl With Genital Mass

Child Protective Services (CPS) has asked you to evaluate a 6-month-old girl with a genital mass. The goal is to determine whether the "weird lump in the baby's private area"--noted while the child's diapers were being changed in day care--was the result of sexual abuse.


Kartikeya Makker, MD

Latest:

Wiskott-Aldrich Syndrome

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.


Katherine A. Siamas, MD

Latest:

Two-Year-Old Boy With Recalcitrant “Diaper Rash”

A 2-year-old boy brought for pediatric dermatology consultation because of the "worst diaper rash in the world." Mother reported that the rash had been present for a year and was asymptomatic. She had been using topical barrier creams, corticosteroids, and antifungals to treat the area. Child had also received a course of oral antibiotics. Occasional improvement of rash noted but never complete resolution. Patient had no other medical problems. Family history noncontributory.



Kathleen Ryan, MD

Latest:

Ganglion cyst

The bump on this 5-year-old girl's left wrist had been gradually enlarging. The child could not remember how long it had been present.


Kathryn Moffett, MD

Latest:

Case in Point: Night Terrors

The patient is a healthy 5-year-old boy who typically awakens 90 minutes after falling asleep. His parents find him screaming, sweaty, and standing up wide-eyed in bed (Figure A). These episodes occur 3 or 4 times a week. He is otherwise a happy, well-adjusted child who attends kindergarten. He has an older sibling with whom he gets along well. There have been no changes in the family.


Katy E. Tresco, PhD

Latest:

The Uncontrollable Child: Family and Educational Interventions

It is estimated that about 20% of children and adolescents meet criteria for a mental health disorder, and a high percentage of these youths are impaired by disruptive behavior problems.


Kavita Parikh, MD

Latest:

A Young Girl With Unexplained Cervical Lymphadenopathy: Infection? Lymphoma--or Something Else?

An 11-year-old African American girl was hospitalized with new fever in the context of unexplained cervical chain lymphadenopathy. WBC and ANC were low, ESR and LDH levels were elevated. Does the image here offer a clue to the ultimate diagnosis?


Keith Linas, MD

Latest:

Supracondylar Process

A 10-year-old boy injured his left elbow during football practice. He subsequently had pain with normal range of motion of the elbow.


Kellie J. Nazemi, MD

Latest:

A Brain Tumor Presenting as Chronic Intermittent Stridor

A 2-year-old previously healthy girl was brought to her pediatrician with the chief complaint of persistent noisy breathing. Two months earlier, the child had an upper respiratory tract infection (URI) with rhinorrhea, cough, noisy breathing, and wheezing. All symptoms had resolved except the abnormal breathing. Physical examination findings were unremarkable. A lateral neck x-ray film demonstrated subglottic narrowing, thought to be consistent with croup. Laryngoscopic examination by an otolaryngologist did not reveal any pathology.


Kelly Hicks, MD

Latest:

Intussusception With a Pathological Lead Point

A 4-month-old girl was admitted to a rural hospital with nonbilious vomiting and bloody stools that began the prior evening. The parents reported that the infant had periods of excessive irritability mixed with periods of calm. She had no fever, exposure to illness, or surgical history.


Kelly M. Cordoro, MD

Latest:

Tinea Capitis and Tinea Corporis

A 16-year-old boy complains of an itchy scalp and areas of hair loss. Physical examination reveals a 2- to 3-cm patch of alopecia studded with black dots, as well as posterior cervical and occipital lymphadenopathy.


Kevin E. Klingele, MD

Latest:

Hip Pain in a Teenaged Girl

A 17-year-old girl presented for evaluation of right hip pain. Several months earlier she had incurred a twisting injury to her hip when she landed from a jump while dancing.


Kevin R. Murphy, MD

Latest:

A Guide to Monitoring and AchievingAsthma Control in ChildrenYounger Than 5 Years

Asthma is the most prevalent chronic disease in children. In the United States, asthma affects approximately 1.4 million children younger than 5 years and causes frequent activity limitations and hospitalizations.


Khalid H. Safi, MD

Latest:

To Tie or Not to Tie: The Dilemma of the Supernumerary Digit

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



Kimball Silverton, DO

Latest:

A 3-Year Old Girl with a Rash on Left Arm, Flank, and Thigh

A 3-year old girl presents with a 4-week history of rash on her left arm, flank, and thigh. The rash is non-pruritic and non-painful. The patient is taking no medications and is up-to-date on all immunizations.


Kirk Barber, MD, FRCPC

Latest:

Resistant "Diaper Rashes"

The photos presented this month reveal disease entities I have seen that did not respond to conventional therapy and that became resistant "diaper rashes." You may have seen some of these "bottoms" in previous issues of Consultant For Pediatricians. Next to each photograph, I have given several clues to the diagnosis. See if you can match these clues with the diagnostic choices listed below. You can check to see whether your diagnostic choices are correct on page 61.


Kirk H. Waibel, MD

Latest:

Atypical Tuberculin Skin Test Responses

Twenty-four hours after receiving a standard 5-unit purified protein derivative of tuberculin (PPD) skin test, a young African American presented with a slightly pink, raised, firm plaque at the site of the injection (A). His previous PPD test results were negative. He denied any constitutional symptoms and rashes. He was otherwise healthy, was not taking any medication, and was HIV-negative.

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