Dermatology

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This erythematous, blanching papular rash developed on the trunk of a 20-month-old boy 3 days after he became ill with a low-grade fever (temperature of 38.3ºC [101ºF]) and mild upper respiratory tract infection symptoms.

A 4-year-old boy who is new to your practice presents for a well-child visit. His parents report that he has had brownish patches on his torso and back since early infancy. The lesions have decreased in size and number as he has aged. The rash is intermittently pruritic, especially when anyone touches the individual lesions.

For 2 weeks, this 13-year-old girl felt tired and achy. She had persistent fevers (temperature up to 38.8°C [102°F]) and an erythematous facial rash above her eyebrows that extended to her cheeks and nasal bridge and spared the nasolabial folds.

Navel battles!

The mother of a 7-month old boy was worried about a nontender, firm, irreducible lump that appeared on his navel 2 months ago.

Nail-Patella Syndrome

This 16-year-old boy with nailpatella syndrome (NPS) presented for routine follow-up. As an infant, he had surgical correction for clubfeet. For the past month, he had had intermittent bilateral foot and ankle pain and some knee and hip discomfort.

You are asked to evalute a fussy 6-week-old infant with a rash that started on her left axilla 3 weeks ago and spread to the left arm, chest, and abdomen.

This 14-year-old boy is brought for assessment and treatment of acne by his mother who is noted to have superficial acne scars. His 17-year-old brother has required systemic isotretinoin to control his acne, and the mother wishes to avoid any systemic therapy for her other son.

This 9–month–old boy was initially evaluated at age 6 weeks for an extensive eczematous rash on the head and antecubital and diaper areas and blood and mucus in the stool with each diaper change over a 2– to 3–week period. The symptoms were attributed to milk allergy, and the infant’s formula was changed. At 8 weeks of age, a petechial rash developed on the boy’s trunk and legs. His symptoms persisted despite multiple formula changes, and he was referred to the emergency department.

A 13-year-old boy from inner city Philadelphia presented with an infected “tattoo” on his right forearm. On examination, he had multiple hypopigmented scars on his extremities. When asked about the scars, the patient appeared embarrassed and stated that they were tattoos, which he created with an eraser from a pencil.