What Rash Consists of These Brownish Macules?January 13th 2011
A 4-year-old boy who is new to your practice presents for a well-child visit. His parents report that he has had brownish patches on his torso and back since early infancy. The lesions have decreased in size and number as he has aged. The rash is intermittently pruritic, especially when anyone touches the individual lesions.
What Caused the Facial Rash in These Infants That Resists All Topical Therapies?December 20th 2010
A 9-month-old boy has had a pruritic facial rash that has resisted topical therapy. Another9-month-old boy has had a similar rash, with no response to topical therapy. Both infants have the same condition and a family history of atopy.
Snippets of Vaccine History: Success, Failure, and ControversyNovember 19th 2010
Vaccination against infectious diseases has saved millions of lives. The recurrent threat of influenza pandemics and the prevalence of global HIV infections underscore the need for better-designed, more effective vaccines.
Is topical therapy the best choice for this teenaged boy’s acne?November 17th 2010
This 14-year-old boy is brought for assessment and treatment of acne by his mother who is noted to have superficial acne scars. His 17-year-old brother has required systemic isotretinoin to control his acne, and the mother wishes to avoid any systemic therapy for her other son.
This 9–month–old boy was initially evaluated at age 6 weeks for an extensive eczematous rash on the head and antecubital and diaper areas and blood and mucus in the stool with each diaper change over a 2– to 3–week period. The symptoms were attributed to milk allergy, and the infant’s formula was changed. At 8 weeks of age, a petechial rash developed on the boy’s trunk and legs. His symptoms persisted despite multiple formula changes, and he was referred to the emergency department.
A New Trend in Homemade TattoosNovember 5th 2010
A 13-year-old boy from inner city Philadelphia presented with an infected “tattoo” on his right forearm. On examination, he had multiple hypopigmented scars on his extremities. When asked about the scars, the patient appeared embarrassed and stated that they were tattoos, which he created with an eraser from a pencil.
Juvenile Dermatomyositis Sine MyositisOctober 12th 2010
This 8-year-old girl has had swollen, red eyelids for the past 24 hours. She denies pain or pruritus. She has had no eye drainage, fever, or other systemic signs of illness. She reports some mild fatigue for the past few months but denies myalgias or decreased muscle strength.
Keratosis pilaris: Regimens for rough skinOctober 7th 2010
I read with interest Drs Kumar, Noronha, and Leung's recent "What's Your Diagnosis?" case highlighting the common skin problem, keratosis pilaris. In my suburban pediatric practice, patients frequently ask me how to eradicate this benign but annoying condition.
Would you biopsy the pigmented lesion on this young boy’s thigh?October 7th 2010
This pigmented lesion has developed over the past 12 months on the posterior aspect of a 3-year-old boy's thigh. The lesion measures 5 mm and exhibits a dark black nodular center with a light brown pigmented periphery. The lesion is asymptomatic, and the child is well.
Fetal Alcohol Spectrum Disorder: How to Recognize the Various ManifestationsOctober 7th 2010
Identification of this disorder can be difficult because of the wide range of effects of prenatal alcohol exposure. Here: tips on how to recognize its clinical manifestations and neurodevelopmental features and behaviors.
Infant With Recurrent Omphalitis and OtitisOctober 7th 2010
A baby boy, aged 14 days, presented with a temperature of 38.2°C (100.8°F), a generalized maculopapular rash, and purulent otorrhea. He was treated with oral amoxicillin for 10 days. At age 25 days, he again presented-this time with erythema and edema of the umbilicus, thrush, and fever of 24 hours’ duration.
Hypopigmentation Secondary to EczemaSeptember 13th 2010
The areas of hypopigmentation on this 4-month-old girl are sequelae of eczema. The rash had developed on the infant’s upper extremities in the bilateral antecubital and popliteal fossae at 1 month of age. Her cheeks were also affected, although only slightly. Her initial diet consisted of regular infant formula. This was switched to soy formula, which she vomited. She was then given a lactose-free formula, which she tolerated well.
Hematemesis Caused by Esophageal DuplicationSeptember 13th 2010
A17-month-old girl was hospitalized 3 weeks earlier because of gagging and retching emesis that contained blood-streaked mucus. Her symptoms persisted and she was transferred to a tertiary care center for further workup.
Infant With Multiple Birthmarks and Hypertrophic Left ArmSeptember 13th 2010
Three-month-old boy with multiple birthmarks and hypertrophic left arm. Infant was born at 38 weeks’ gestation to a 33-year-old gravida 2, para 1 after an uncomplicated pregnancy and normal spontaneous vaginal delivery. Birth weight, 3.45 kg; length, 53 cm. Both parents healthy, nonconsanguineous. No family history of growth abnormalities. Father had port-wine stains on nape and chest.