Dermatology

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As the attending on the community hospital's general pediatric service, you're called in this afternoon to see a 9-year-old girl who was admitted the evening before for chief complaints of a fever (axillary temperature, 102° F to 103° F) and cough of five days' duration. She has been observed to have a dry hacking cough, and broke out in a faint rash after admission. Can you solve this Pediatric Puzzler?

Because nickel allergy, which affects children of all ages, can cause severe contact dermatitis, it is important to identify sources of nickel on clothing and accessories.

This 10-year-old boy presented for evaluation of a rash that developed during a spring vacation on Florida's Atlantic coast.

A 6-year-old girl and an 11-year-old boy each presented for evaluation of an erythematous, pruritic, papular rash that developed after swimming in a Wisconsin lake.

A 10-month-old infant was referred for evaluation of possible Sturge-Weber syndrome. According to his parents, the discoloration on the child’s face was present at birth. Physical examination revealed an otherwise healthy infant with extensive port-wine stains on his face. Ophthalmologic and neurologic examination findings were normal.

A 6-year-old girl, who went on a weekend trip with her family and stayed at a "famous" downtown hotel, awoke in the morning to find an itchy rash on her arms and legs. Several other family members had similar, but more limited, eruptions on exposed areas of skin. Topical steroids and antibiotics offered little relief.

A buildup of cerumen can make it difficult to examine your patient's ears, but the wrong approach to cleaning the wax can cause even bigger problems. What's the right way to get rid of wax?

Eye on Washington

Once Thanksgiving 2003 passed, Congress grew anxious to adjourn; members prefer to spend the Christmas season at home, with family and constituents.

A 22-month-old boy is brought to you with an asymptomatic, linear scaly rash that developed on his right elbow four months ago. Two weeks after onset, the eruption had extended down his right arm to the top of the hand and onto the fourth finger.

The physical examination for a patient seeking clearance to participate in a sport should focus on areas likely to yield significant findings--notably, the cardiovascular and musculoskeletal systems.

Proper measurement of blood pressure is essential both to detect children with hypertension and to avoid over-diagnosis. Once the condition is identified, the pediatrician must decide whether the patient requires lifestyle changes alone or antihypertensive drug treatment as well.