Consultant for Pediatricians Vol 9 No 3

A 51⁄2 -year-old girl was brought to her pediatrician’s office by her mother, who reported that her daughter had a 1-week history of nasal congestion, intermittent fever, and cough that was worse in the morning and at night. The child was alert and smiling and appeared to be in no apparent distress.

This asymptomatic swelling above a 3-month-old boy's left eyebrow had not changed since birth. The 15 × 13-mm, soft, nontender, freely mobile nodule had no punctum, hair tuft, or other skin anomaly. The infant was born at term and was otherwise healthy. At the parents' request, the nodule was excised without complications by a pediatric surgeon. Pathological findings showed lamellated keratin within the mass and surrounding pilosebaceous units opening into the mass, consistent with a dermoid cyst.

Complete duplication of the left thumb in a baby boy was noted at birth; a radiograph of the thumb showed 2 proximal and distal phalanges with 1 first metacarpal bone. He also had fusion and incomplete bony duplication of the right thumb; a radiograph of this digit showed normal proximal and distal phalanges plus a small tiny bony remnant of the proximal and distal phalanges of an accessory thumb.

The conditions seen in these 3 photographs are easily confused. Can you match each picture with the correct diagnosis?

A 6-month-old boy with dysmorphic facial features, ear anomalies, and hypospadias brought for evaluation of elevated temperature and generalized seizure. Infant born at term to a 37-year-old mother via uncomplicated cesarean delivery.

Allergy testing can aid the diagnosis of allergic disorders; however, it is not diagnostic. With skin testing, in particular, a positive result does not necessarily indicate clinical allergy, and a negative result does not always exclude clinical relevance.