Dermatology

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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).

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.

You are called to the emergency room to see an ill-looking, 13-year-old boy with a severe flare of his atopic dermatitis associated with fever, malaise, and chills, which started a week ago.