
Early signs of bilirubin-induced neurologic damage in healthy term and near-term newborns are often vague. A comprehensive approach to management helps prevent rapid progression and irreversible consequence.

Early signs of bilirubin-induced neurologic damage in healthy term and near-term newborns are often vague. A comprehensive approach to management helps prevent rapid progression and irreversible consequence.

This lesion has developed over the past 6 months on a 6-year-old's nose. It measures 3 mm and is reddish brown with a regular border.

A 13-year-old boy presented with an explosive eruption of numerous, small, round, erythematous, itchy plaques on his lower back and lower limbs of 2 weeks' duration (A). Some of the lesions were scaly. His nails were normal. There was no evidence of arthritis or joint deformity. He had a sore throat a month before the onset of the rash but did not seek medical attention. He was not taking any medication and had no history of joint pain or family history of skin problems.

The mother of this 3-month-old girl was concerned about her baby's diffuse, gradual loss of scalp hair. The infant was otherwise healthy and was feeding normally.

A 12-year-old boy was brought by ambulance to the emergency department (ED) with fever and shaking of 3 days' duration. He was accompanied by his mother. The boy had spent the weekend at his father's home when he began to feel sick. Since returning to his mother's house, he has been lethargic and has had one episode of vomiting.


Staving off cuts to Medicaid, controlling emissions of mercury

THE CASE: A 3-year-old boy is brought to the office by his mother. The previous evening, she had noticed a single large red spot on the back of his thigh. This morning, his whole body was covered with a similar rash, and he had a temperature of 38.8°C (102°F). The mother administered 1 dose of acetaminophen at home for the fever; the rash was asymptomatic.

"Headaches" is the chief complaint. Acne was the problem last year for 17-year-old Michelle. Otherwise her history is unremarkable. What's causing these daily headaches?

A 9-week-old Caucasian infant is brought to the primary care physician for evaluation of purpura and petechiae. His parents noted the bruising the previous night, which grew progressively worse throughout the next day. The lesions seemed to appear "out of the blue" without apparent cause, including trauma.

Photo Essay: Factitious Dermatitis Lip Licker's Dermatitis Ecchymoses From Spoon Scratching Ecchymosis From Cupping

This 3-year-old girl presented with red tender skin, irritability, and fever. Her mother says that the rash began in her axilla and rapidly spread to involve all of her skin.

For the past 10 days, a 3-week-old infant had a rash on the face. He was born at term to a healthy, 22-year-old primigravida, following an uncomplicated pregnancy and normal spontaneous vaginal delivery (birth weight, 3.1 kg; length, 49.5 cm). Numerous comedones and papules were noted on the infant's cheeks.

An 8-year-old boy seen at a gastroenterology clinic after "accidentally" swallowing 2 coins 4 days earlier. Had difficulty in breathing shortly after swallowing the coins and was taken to emergency department. X-ray films at that time demonstrated coins in his esophagus. Patient was immediately transferred to a tertiary care facility. Repeated x-rays showed the coins in his stomach. Patient was sent home with instructions to follow up with his pediatrician in 1 to 2 days.

The bad news: No easy or standardized treatment exists to prevent complications of asthma in very young children. The good news? Research is pointing the way to improved therapy.

Wheezing is common in children younger than 5 years, but asthma is hard to diagnose in this age group. Research holds promise for earlier identification, before uncontrolled symptoms lead to complications.

What you see on the outside can provide valuable clues that all is not well on the inside. Here are some important signs to watch for.


An 11-year-old girl reports that she has experienced genital itching and pain for several months. The pain is especially intense when she wipes herself after urinating.

This has been an exciting year for medical office technology. Improvements in otoscopy, hemoglobin analyzers, tissue adhesives, and topical skin preps top the list of innovations.

The news this week from the floor of the commercial Exhibit Hall of AAP 2004 National Conference and Exhibition is that the most common allergic reaction has a cure. More than 55 million Americans develop allergic contact dermatitis from exposure to poison oak, poison ivy, or poison sumac (Toxicodendron species) every year. According to a report by researchers at St. Luke's Hospital & Health Network in Bethlehem, Pa., relief with the new soap product of alcohol solubles and anionic surfactants is just 30 seconds away.

Food can keep infants free of allergic disease. The right nutritional choices during the first four to six months of life can mean the difference between a healthy childhood and a progression of atopic disease that can lead to asthma.

With dietary vitamins having potent immunomodulating effects in vitro and in animal models, investigators were led to examine whether vitamin supplementation during infancy affects the risk of asthma and allergic disease in early childhood.

In this installment, the author helps you distinguish among vascular malformations, hemangiomas, and less common vascular tumors of infancy and identify the lesions associated with congenital syphilis. The first part of this article appeared in the July 2004 issue.

In this installment, the author helps you distinguish among vascular malformations, hemangiomas, and less common vascular tumors of infancy and identify the lesions associated with congenital syphilis. The first part of this article appeared in the July 2004 issue.