Dermatology

The parents of a 4-year-old boy who lives in eastern Maryland near the Pennsylvania line are worried about an expanding rash on his back, which started as a small red bump a week ago following a summer picnic. The boy has had a low-grade fever and has not been acting like himself for a few days.

An adolescent girl is referred by her pediatrician to dermatology for evaluation of a birthmark on her face.

The parents of a healthy 6-month-old boy with eczema bring him to the office for evaluation of a rapidly progressive rash on his arms, legs, face, and back. He had a low-grade fever and loose stools for 2 days last week.

Alarmed parents bring their healthy 14-month-old son to the office for evaluation of a rash that appeared on his face and arms 3 days ago. He had a fever and runny nose at that time, but the fever has since resolved and he is behaving normally.

Anxious parents of a healthy 4-month-old boy come to the office for an urgent consultation for a pink nodule on the baby’s fifth finger that has doubled in size over the last month.

The mother of a healthy 15-year-old boy brings him to the office for evaluation of a darkening hairy patch on his left upper chest and shoulder.

The anxious parents of a previously healthy 19-month-old boy bring the child to the emergency department for evaluation of progressive rash that began 4 months ago. The skin eruption began as small blisters on his knees, which became tense and ruptured, eventually evolving to red-pink scaly plaques. Over the next few months, the boy developed similar lesions on his hands, elbows, neck, perineal area, and face, with sparing of the mucous membranes.

A baffled mother brings her 14-year-old son for evaluation of an asymptomatic bump that appeared on the side of his right third finger 1 week ago.

The parents of a 4-year-old girl are worried about a bald area on the back of her scalp that has been present since birth.

The anxious parents of a 9-year-old boy bring him to clinic for the evaluation of progressive sores in his mouth for 2 days and a rash that erupted last night. Nine days earlier, he had felt warm and had a cough with wheezing and abdominal pain.

A healthy 14-year-old girl who is an avid violin player is brought to the office for evaluation of facial acne. The examination notes a rash on her left neck that has been present for a few years. The patch is mildly tender and itchy but otherwise asymptomatic.

Parents of a 6-year-old boy bring him to your office for urgent consultation for a rash that blossomed on his trunk and extremities 2 weeks ago following an upper respiratory infection and that shows no sign of improving. What’s the diagnosis?

Two siblings, 5-year-old Emmanuel and 3-year-old Cassandra, are brought to your emergency department (ED) in July 2014 by their parents. Both children are up to date on their immunizations and have not had significant medical problems in the past. They were referred to you by their pediatrician for 1 day of high fevers, rash, and pain in the extremities. Emmanuel had 1 episode of gum bleeding last night. His sister has been unwilling to walk since this morning.

A healthy 10-year-old boy is brought to your office by his worried father for evaluation of an asymptomatic birthmark on his left ankle. It has grown proportionately and does not cause pain or interfere with normal function. What’s the diagnosis?

The mother of a 7-year-old girl brings her to the office for evaluation of eczema. On review of symptoms, she mentions concern about a bald spot above her daughter’s right ear, noticeable when she braids her hair.

The parents of a 3-year-old girl with a history of a slowly regressing infantile hemangioma on her right forehead were afraid that she was developing a new hemangioma near her right eye.

The mother of a 16-year-old girl brings her to the office for evaluation of a painful rash on her hands and feet and oral ulcers that make it difficult to eat and drink.

An anxious mother of a 10-year-old boy brings him to the office for evaluation of a new mole that appeared on his back in the last 24 hours. What is causing the rapidly developing pigmented lesion in this patient?

Laws that ban texting while driving have indeed reduced crash-related hospitalizations among all age groups, according to a recent report.

Rashes and fevers are among the most common complaints seen in the pediatrician’s office. The differential diagnosis is often large and ranges from entities the pediatrician sees commonly such as erythema infectiosum to the less common diseases such as Kawasaki syndrome, to more potentially serious conditions such as vaccine preventable illnesses and everything in between.

The parents of a healthy 12-year-old boy bring him for a second opinion. He was diagnosed with pityriasis rosea 6 months ago, and new lesions, which are occasionally a little itchy, keep coming. What is causing these new lesions?

A healthy 2-month-old boy presents with a 4-day history of diaper dermatitis unresponsive to barrier creams. The infant has developed “red spots” that started on his cheeks, then spread to his trunk and diaper area. He is a bit fussy but feeding well.

The parents of a healthy 11-month-old girl eagerly seek a consultation for a recurrent blistering brown bump on the baby’s right cheek, present since birth. Recently, the blistering episodes seem to be decreasing, although the bump continues to become bright red a few times a week.

A healthy 2-month-old girl presents for evaluation with a large pigmented plaque on her left cheek and scalp that her mother says she has had since birth.

You are asked to evaluate a minimally itchy rash that has been present for over a year on the arm of a 10-year-old girl.

Menstrual irregularity, acne, and other characteristics often seen in adolescent girls may be misdiagnosed as polycystic ovarian syndrome (PCOS).

When it comes to isotretinoin, dermatology experts say, pediatricians should advise parents not to believe everything they read online. Furthermore, patients can't always be relied upon to comply with the birth-control requirements for using the drug.

A worried mother brings her 2-year-old boy to your office for evaluation of an asymptomatic skin eruption that has been present for 2 months. The lesion developed 6 months after he sustained an abrasion to the same site when he fell on concrete steps.

A 17-year-old white female is transferred from an outside hospital with the chief complaint being painful oral ulcers. Over the last 72 hours, the pain from her ulcers has progressively worsened, leading to the inability to speak or eat. She also has a diffuse papulopustular rash. There is an extensive family history of autoimmune disease, and she tested positive for mononucleosis 2 months prior to hospitalization.

You are asked to evaluate a healthy 18-year-old girl with a history of “mosquito bites” on her arms and legs that appeared after her first pregnancy 2 years ago. Although not symptomatic, the lesions become redder and more swollen intermittently, particularly when accidentally scratched or rubbed.