Dermatology

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stock image of a hemangioma

Contemporary Pediatrics sits down exclusively with Sheila Fallon Friedlander, MD, a professor dermatology and pediatrics, to discuss the one key condition for which she believes community pediatricians should be especially aware-hemangiomas.

An 8-year-old boy is brought to the office for evaluation of a persistent itchy rash on his extremities, trunk, and face. Although the rash has been present for longer than 3 months, individual skin lesions change from hour to hour and occasionally the rash clears completely only to recur several hours later. He is otherwise healthy with no known allergies, changes in diet, medication use, or recent illness.

A previously healthy 8-year-old boy presents to the dermatology clinic with a progressively worsening elbow rash over the course of the last week. The rash does not itch. He spent the previous weekend sailing on the Chesapeake Bay. His pediatrician prescribed a course of cephalexin as well as a trial of topical antiviral ointment, neither of which improved the rash. The patient denies any other new exposures. 

image of eye

The mother of a healthy 4-week-old boy brings him to the office for evaluation of a small pit on the medial canthus of the left eye, noted since birth. There is constant drainage of tears onto the left side of his face and exudate on the bottom of the left medial canthus.

An anxious mother brings her healthy 4-month-old daughter for evaluation of itchy pustules on both hands and feet. The eruption has persisted despite 2 courses of permethrin for scabies. The infant also was diagnosed with hand-foot-and-mouth syndrome and dyshidrotic eczema, but neither of these diseases fit clinically.

The worried mother of an 11-year-old boy arrives at the office for evaluation of an asymptomatic bumpy rash that appeared suddenly in his right groin a month ago, and that has now extended all the way down to his right ankle. What's the diagnosis?

A 16-year-old boy develops a diffuse, rapidly progressive eruption on his trunk, face, and extremities 4 days after starting oral amoxicillin for presumed strep throat. He presents to the emergency department (ED) where Stevens-Johnson syndrome is considered. The ED physician notes no mucous membrane involvement.

A 9-year-old boy presents for evaluation of white spots on his hands, elbows, knees, and legs. There is also a ring around a mole on his back. The patient’s parents first noted areas of depigmentation on his trunk and extremities, and his lesions have spread particularly in areas of trauma. The lesions were most noticeable in the summer when tanning increased the contrast between the involved and uninvolved areas of his body.

An 11-month-old boy was brought to the doctor by anxious parents for the evaluation of persistent diaper dermatitis. Despite trying multiple barrier creams and over-the-counter antifungal products, the rash did not resolve.