Dermatology

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Fourteen-year-old JT is worried. During health class last week, he learned about the different sexually transmitted infections as well as about testicular self-examination. While practicing his monthly testicular examination in the shower, he noticed that he had a number of small growths on his penis. On further questioning, JT insists that he has never been sexually active with another person.

Medicine is at least as much art as science. Often things are not clear-cut, but rather appear in shades of gray. We offer the following list of terminology for those who don't mind thinking in terms of black or white.

A healthy, 3-year-old African-American girl is brought to your office for evaluation of hair loss. The child does not have a history of recent infection or medication use. She has not had any hair styling treatments and has not been subject to trauma or application of heat to the hair. What's the diagnosis?

Several asymptomatic, erythematous papules and plaques had appeared on the hands of an otherwise healthy 11-year-old girl. The personal and family medical histories were noncontributory. A punch biopsy from the largest lesion on the palm confirmed the clinical diagnosis of localized granuloma annulare, a self-limited inflammation of the dermis

The prevalence and incidence of sinus infection, or sinusitis, is increasing and has been estimated to affect 31 million persons in the United States each year. It is one of the most common reasons why patients seek a physician's care. If left untreated, sinusitis can cause significant physical symptoms and can negatively affect quality of life by substantially impairing the daily functioning of sufferers. For children, this can mean learning difficulties at school and for adults, a loss of efficiency at work.

A healthy 16-year-old girl was bothered by a patch of white hair on her forehead; she also had a few white plaques on her abdomen, which had been present since birth. Her maternal great grandmother and maternal grandfather, as well as her mother, had a similar pattern of white hair.

Early attention to maternal diet and infant nutrition may help prevent allergy and food intolerance in high-risk infants who are unable to be completely breastfed, according to recent data and speakers at a dinner symposium Sunday evening. Speakers Peyton Eggleston, MD, professor of pediatrics at Johns Hopkins University School of Medicine; Mark Boguniewicz, MD, National Jewish Medical and Research Center and University of Colorado School of Medicine; and John A. Kerner, MD, Stanford University School of Medicine, discussed the rising prevalence of allergic disease worldwide and the key factors shaping the trend, the progression of atopic disease in genetically predisposed children, the factors associated with risk of developing allergic disease, and the evidence for a role of diet in preventing allergic disease in young children.

The mother of this 3-year-old boy noticed that his smile was asymmetric when he awoke that morning. He had been seen 3 days previously for left ear discomfort, sore throat, and a low-grade fever. Otitis media was diagnosed, and amoxicillin was prescribed. The child has an unremarkable history and is otherwise healthy. He has been acting normally and tolerating food and liquids without difficulty.

The parents of a 7-year-old girl, who had fallen off her bicycle and hit her left forehead 2 weeks earlier, brought their daughter to the emergency department after she began having increasingly severe headaches. She had been healthy before her fall and had no history of other trauma or meningitis. She had no neurologic deficits on presentation. Examination of the fundus revealed no papilledema.

In a trend that pediatricians should note carefully in their management of children with atopic dermatitis (eczema), dermatologists likely will exercise more caution in prescribing the topical calcineurin inhibitors (TCIs) Elidel cream (pimecrolimus, Novartis) and Protopic ointment (tacrolimus, Astellas Pharma) in response to the Food and Drug Administration's decision to add "black box" warnings to these drugs' labels, an expert pediatric dermatologist told the publication Dermatology Times recently.