Contemporary Pediatrics Cases

Toddler with blistering acrodermal rashThe anxious parents of a previously healthy 19-month-old boy bring the child to the emergency department for evaluation of progressive rash that began 4 months ago. The skin eruption began as small blisters on his knees, which became tense and ruptured, eventually evolving to red-pink scaly plaques. Over the next few months, the boy developed similar lesions on his hands, elbows, neck, perineal area, and face, with sparing of the mucous membranes.
Baby girl with right labia majora massA 26-day-old female neonate, born at 36 weeks of gestation, presents to the clinic with a visible swelling in the right labia majora.
Boy’s papule develops lymphangitic streakA baffled mother brings her 14-year-old son for evaluation of an asymptomatic bump that appeared on the side of his right third finger 1 week ago.
Unusual abdominal pain in an 8-year-old boyA previously healthy 8-year-old Hispanic boy presented to the emergency department (ED) with a 2-day history of abdominal pain and 2 episodes of nonprojectile vomiting in the last 24 hours.
Bald area on back of a girl’s scalpThe parents of a 4-year-old girl are worried about a bald area on the back of her scalp that has been present since birth.
Mucositis and rash in a 9-year-old boyThe anxious parents of a 9-year-old boy bring him to clinic for the evaluation of progressive sores in his mouth for 2 days and a rash that erupted last night. Nine days earlier, he had felt warm and had a cough with wheezing and abdominal pain.
Young violinist notes persistent red patchA healthy 14-year-old girl who is an avid violin player is brought to the office for evaluation of facial acne. The examination notes a rash on her left neck that has been present for a few years. The patch is mildly tender and itchy but otherwise asymptomatic.
Rash on boy’s trunk and extremities after upper respiratory infectionParents of a 6-year-old boy bring him to your office for urgent consultation for a rash that blossomed on his trunk and extremities 2 weeks ago following an upper respiratory infection and that shows no sign of improving. What’s the diagnosis?
Fever, rash, and pain in the extremities of returning pediatric travelersTwo siblings, 5-year-old Emmanuel and 3-year-old Cassandra, are brought to your emergency department (ED) in July 2014 by their parents. Both children are up to date on their immunizations and have not had significant medical problems in the past. They were referred to you by their pediatrician for 1 day of high fevers, rash, and pain in the extremities. Emmanuel had 1 episode of gum bleeding last night. His sister has been unwilling to walk since this morning.
Growing asymptomatic birthmark on boy’s left ankleA healthy 10-year-old boy is brought to your office by his worried father for evaluation of an asymptomatic birthmark on his left ankle. It has grown proportionately and does not cause pain or interfere with normal function. What’s the diagnosis?