Dermatology

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A 4-year-old, previously healthy girl presented to a tertiary care children’s hospital emergency department (ED) with large, tense bullae involving up to 40% of her body surface area. The patient’s parents described a 12-day history of itchy, papulovesicular lesions that had progressed into large blisters.

A 14-year-old boy presented to the abuse clinic at the request of child protective services. The boy’s gym teacher had noticed multiple large bruises on his back, arms, and legs. School officials had previous experience with the child’s “volatile” stepfather and thought him “capable of abuse.” There were also unofficial concerns of past domestic abuse. A 14-year-old boy presented to the abuse clinic at the request of child protective services. The boy’s gym teacher had noticed multiple large bruises on his back, arms, and legs. School officials had previous experience with the child’s “volatile” stepfather and thought him “capable of abuse.” There were also unofficial concerns of past domestic abuse.

This 1-year-old African-American boy is being followed for developmental delays. His 35-year-old mother has no known health problems, and this was her third pregnancy.Premature delivery at 27 weeks was uncomplicated, yielding appropriate birth weight and Dubowitz scores for gestational age.

A hypoxemic, 2-month-old boy has respiratory synctial virus bronchiolitis. As you're listening to his wheezing chest during the emergency department visit, his mother asks about the "big freckles" on his scalp and forehead that have been present since birth.

This 7-year-old boy was brought in for a routine well-child visit. His history included profound sensorineural hearing loss, (for which he had received cochlear implants) and congenital heart disease (a small ventricular septal defect, subaortic ridge, right ventricular conduction delay, and mild left ventricular dilatation).

A 2-day history of fever and sore throat and an erupting rash prompted the mother of a 5-year-old boy to bring her son into the office for evaluation.

A healthy 9-month-old boy is brought to the clinic by his mother, who is concerned about multiple golden-brown "bumps" on his trunk, head, arms and legs that developed soon after birth.