Dermatology

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The parents of this 2-year-old boy brought their son for evaluation of swelling of the right leg and excoriation and serosanguineous discharge from the ankle region of 3 days' duration.The child had had a hemangioma of the right ankle since birth. Subsequently, there was gradual spread of the lesion along the leg to the buttocks.

ABSTRACT: Children are at greater risk than adults for many travel-related problems, such as barotitis and barotrauma associated with flying, cold and heat injury, drowning, and infection with geohelminths. Most of these problems can be avoided with appropriate measures. To prevent insect-borne diseases, advise parents to apply permethrin to their children's clothing before the trip and apply slow-release DEET (30% to 35% concentration) to their skin every 24 hours. Infection with ground-dwelling parasites can be avoided by wearing protective footwear. At high altitudes, infants and children may experience acute mountain sickness. Acetozolamide (5 mg/kg/d, divided bid or tid) is an effective prophylactic; however, it is contraindicated in patients with sulfa allergy. Some preventive measures that are effective in adults may not be appropriate for children; for example, several medications used to control motion sickness are ineffective and associated with significant side effects in children.

After spending a day at the beach, a 12-year-old boy presented with a second-degree sunburn and blisters on his shoulders (A). According to his mother, he had used sunscreen. The child was not taking any medications. Except for a significant number of moles, his skin was normal.

This 14-year-old girl had first noticed the well-circumscribed, roughened, irregular growth on her right middle finger 6 months earlier. The lesion had progressively enlarged. The girl's mother had a similar, but smaller, lesion on the left elbow. Alexander K. C. Leung, MD, and Justine H. S. Fong, MD, of Calgary, Alberta, diagnosed verruca vulgaris. This proliferative, hyperkeratotic, exophytic lesion is most commonly caused by human papillomavirus types 2 and 4.

There's but limited advice you can dispense to parents of your patients who have a potentially life-threatening food allergy: Avoid, avoid, avoid! Yet there's cause for optimism today among stymied clinicians and the four percent of Americans who have a food allergy—often to nuts or shellfish: a new Food Allergy Research Consortium convened at the end of June by the federal government, and led by a prominent pediatrician and food allergy expert, has been charged with, first, conducting basic, clinical, and epidemiologic studies aimed at developing therapies to treat and prevent food allergy and, second, developing educational programs aimed at parents, children, and healthcare providers.

The incidence of community-based methicillin-resistant Staphylococcus aureus (MRSA) infection in healthy children is increasing. This review discusses possible reasons for that rise, reviews antibiotic susceptibility patterns, and presents management guidelines.

The numerous superficial, rounded, red-based ulcerations on the left buttock of a 3-year-old girl are characteristic of bullous impetigo.

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.

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.