Dermatology

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I was asked to see this child by her physician who was concerned that these lesions were a neoplastic event. The physician wanted a dermatologist's opinion and a biopsy to guide treatment decisions. Needless to say, the child's parents were distraught. The child was happy, playful, and not at all disturbed by the rash.

Seven-year-old girl with generalized rash that started as a single isolated oval lesion on the lower abdomen. Six days later, diffuse papulosquamous lesions appeared mainly on the trunk, sparing the scalp, face, and extremities. Intense itching despite 3 days of diphenhydramine therapy.

The American Academy of Dermatology (AAD) and the National Jewish Medical and Research Center (NJMRC) have issued statements protesting new black box cancer warnings that the US Food and Drug Administration (FDA) has ordered on Elidel Cream (pimecrolimus; Novartis) and Protopic ointment (tacrolimus; Astellas Pharma US, Inc.), both use to treat atopic dermatitis (eczema).

A 7-week-old white boy presented to the emergency department (ED) with vomiting and weight loss. His parents brought him to the ED 3 weeks earlier after he had vomited for several days. Possible milk protein allergy was diagnosed at that visit, and a change from cow milk formula to an elemental formula was recommended. Vomiting subsequently increased in frequency. Nonbilious but forceful vomiting occurred with each feeding. The patient lost nearly 2 lb during the 3 weeks that followed the first ED visit.

An otherwise healthy 11-month-old infant hadhad an intermittent, nonpruritic rash for mostof his life. The lesions recurred mainly onthe extremities and trunk without a particulartrigger. Applications of 1% hydrocortisonecream were only partially beneficial. The joints and nailswere not affected. The patient’s maternal grandfather hadsevere psoriasis.

A white ring recently developed around this lesion on the upper back of a 15-year-old boy. Is there any reason for concern--and what clues would you use to suggest the need for a biopsy?

A 5-year-old boy, who lives on a farm and routinely plays with his pet dogs, presented with these scaly, inflamed macules with a central clearingon the abdomen (A) and forehead.

he parents of a 16-year-old girl report that during the past several months, she has exhibited behavioral changes, irritability, increased anger, depression, and anxiety. The girl had previously been healthy, and there has been no recent illness or trauma.

A 9-year-old girl presented with these lesions on her face and extremities. The lesions, which had developed within the past 24 hours, were warm to the touch and only mildly pruritic. The child feels unwell with nonspecific complaints of malaise and lack of energy. Before this eruption, she had been healthy and had not been taking any medications.

New products for 2005

This year's roundup looks at innovations in wound care, hand sanitizers, otoscopy, and vision screening. It also considers helpful online resources?and takes a peek into a virtual time capsule of technology.

The mother of a 3-year-old boy has brought him to the clinic for you to evaluate thinning of his scalp hair over the past month. She reports that the hair loss is occurring "all over" his scalp and that she has not noticed him scratching his scalp or pulling his hair. He was hospitalized four months ago for a rotavirus infection.