Dermatology

Pediatricians need a keen understanding of the variables that influence how phototherapy lowers the bilirubin level and of how to deliver an optimal dose of light.

An otherwise healthy 22-month-old was referred for evaluation of a pruritic rash on her buttocks and right leg of 5 days' duration. Her mother reported that the rash had begun as red bumps and blisters on the buttocks that subsequently spread to the right leg.

Genetic Disorders: Newborn With Multiple Anomalies

A 14-year-old African American boy presented during the winter months with a painless, nonpruritic, periumbilical rash that had been present for approximately 1 month. Initially bluish, the rash had become dark brown.

Over the past 5 years, methicillin-resistant Staphylococcus aureus (MRSA) isolates have become widespread throughout the United States as well as the world.1 In some regions, including our own Gulf Coast, MRSA accounts for the majority of S aureus isolates recovered from patients with community-acquired infections.

During a routine annual checkup, a 5-ft 8-in, 94.5-kg (210-lb) 13-year-old girl was noted to have a hyperpigmented "dirty" lesion on the back of her neck. The girl's parents were also obese. Her mother had type 2 diabetes mellitus.

This neonate was born at 34 weeks' gestational age via elective cesarean section because of breech presentation. He weighed 1950 g, and his Apgar scores were 7 and 8, at 1 minute and 5 minutes, respectively.

This 12-month-old infant comes to your office with an asymptomatic eruption of sudden onset that involves the arms and legs. The child has a mild fever.

Developmentally healthy 9-month-old boy brought for evaluation of congenital pale pink 2-cm plaque on left parietal scalp. Lesion relatively unchanged since birth. No history of birth trauma or scalp electrode monitoring in the intrapartum period. Mother denied varicella infection during pregnancy.

Extreme hyperbilirubinemia must be treated swiftly to prevent neurologic damage. Here are methods for determining a newborn's likelihood of developing severe jaundice and guidelines for treating those judged at greatest risk.

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.