Consultant for Pediatricians Vol 9 No 12

One of the more common conditions pediatricians diagnose is deformity of the skull. Deformational plagiocephaly may be caused by compressive forces in utero (eg, multiple births) or by constant pressure on one portion of the newborn’s malleable skull when the infant is kept in the same supine position for prolonged periods.

Premature Adrenarche: A 7-year-old girl had growth of pubic hair for the past 6months. The hair was initially limited to the labia majoraand then extended gradually into the pubic area. Isolated Scrotal Hair of Infancy: Infant was born at term to a 32-year-old gravida 2 para 3 after a normal vaginal delivery. Scrotal hair developedat age 1 month.

Lessons From Colby

Like many physicians, I find it difficult to care for a patient with a terminal disease-a discomfort heightened when the patient is an ebullient, beautiful child.

This benign but impressive neonatal eruption progresses through several stages, beginning with pustules that quickly rupture and leave flat macules with collarettes of scale. The pustules may rupture in utero, and the neonate may present at birth with the macules, as was the case in this baby boy.

Nail-Patella Syndrome

This 16-year-old boy with nailpatella syndrome (NPS) presented for routine follow-up. As an infant, he had surgical correction for clubfeet. For the past month, he had had intermittent bilateral foot and ankle pain and some knee and hip discomfort.

A 5-year-old boy with a history of allergies and asthma presents with fever (temperature of 40°C [104°F]), headache, cough, vomiting, and diffuse pain in and around the chest area on the right side. The patient has never traveled and has no sick contacts. A chest radiograph is obtained (A).