Dermatology

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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 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.

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 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.

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 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.

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