Consultant for Pediatricians Vol 9 No 7

A 10-month-old boy with an asymptomatic rash is brought to your office by his mother. The rash, which began on the legs and spread to the arms, face, and buttocks, has been present for 3 days. Other than rhinorrhea and nasal congestion for the past 3 to 5 days, the infant has been well, although fussier than usual, especially at night. His appetite is normal. The rash has persisted despite the application of bacitracin, petroleum jelly, and cortisone. He has had no sick contacts with a similar rash or illness. His immunizations are up-to-date.

An otherwise healthy 5-year-old girl presented with 2 papillary lesions just below the left lower outer lip. Five months earlier, she had had a common wart on the dorsal side of the web space between her left thumb and index finger. This wart was treated with electrocautery desiccation and curettage. The pictured lesions appeared after the wart on the left hand had been removed.

I’ve weaned my 2-year-old off the bottle. Now how can I get her to break the thumb-sucking habit?

During hospitalization of a 6-month-old boy for respiratory syncytial virus infection, spiking fevers led to a bacteremia workup.

A 16-year-old girl with internal jugular phlebectasia presented for followup ultrasound evaluation. At age 15 months, she was noted to have a right-sided neck mass that appeared when crying or straining. Her weight, height, and head circumference were normal. She had no cardiac anomalies and was otherwise healthy.

At his first well-child visit after a family move, an 8-year-old boy was noted to have bilateral erythematous plaques on the surfaces of his hands and feet. Mother reported that the condition had been present since he was 2 or 3 months old. Patient’s father and other male relatives on the paternal side (uncles, grandfather, great-grandfather) were similarly affected. No other associated symptoms, such as hyperhidrosis, reported. The child did not have a history of eczema, asthma, or food allergies; however, he did have a history of allergic rhinitis and occasional pruritus.

The mother of this 11-month-old Somalian girl expressed concern about a light-colored patch over her daughter’s right brow. She was worried that the infant had vitiligo.

I read with interest Drs Ha and Wilson’s “What’s Your Diagnosis?” case of an infant with a history of wheezing and dry cough ("History of Cough in an Infant and a Toddler"). In a setting such as this, one should also consider the possibility of foreign-body aspiration, which can result in recurring wheezing and pneumonia.