Contemporary Pediatrics Dermcase

Boy’s progressing rash could delay surgeryA preoperative evaluation is requested for a 15-year-old boy who is a renal transplant patient maintained on oral mycophenolate mofetil and tacrolimus. His parents are worried that an itchy rash on his hands and feet, which has been progressing over the last 4 months, will result in postponement of his surgery.
Pruritic vesicles erupt on a boy’s legsA healthy 12-year-old boy with eczema shows up at the office with an incredibly itchy rash on his legs that has exploded over the last 48 hours. He has a history of dry skin to which his mother regularly applies various moisturizers, including calendula oil.
Itchy blisters bother a 12-year-old girlThe mother of a 12-year-old girl brings her daughter to the office for evaluation of recurrent, itchy red bumps and blisters on her legs. The mother gets the same rash recurrently as well.
Recurrent brown spots in an infant girlA mother brings her healthy 6-month-old girl to the outpatient clinic with disseminated, asymptomatic, golden-brown bumps that occasionally become red and swollen.
Infant’s disseminated rash is twice misdiagnosedA frustrated mother carries her 2-month-old son into the office for evaluation of a diffuse bright red rash with dramatic hypopigmentation. Scalp, neck, axillary, and diaper areas are involved.
Adolescent with enlarging asymptomatic birthmarkAn 11-year-old girl asks her pediatrician about an asymptomatic birthmark on her right thigh that drains clear to slightly bloody-tinged fluid occasionally when scratched. It has increased in size proportionally as she has grown.
Girl with rash and muscle weaknessThe mother of a healthy 10-year-old girl brings her child to the office for evaluation of new onset “eczema.” The rash is asymptomatic and began on the patient's upper eyelids, later spreading to her chest and extremities over several weeks. The child complains of difficulty riding her bicycle.
Linear papular eruption grows on boy’s neckA father brings his 12-year-old son to the clinic for evaluation of a skin eruption that has been on the back of the boy’s neck for a year, but which just began to extend behind his ear. The rash is asymptomatic, and the otherwise healthy patient is annoyed that he has to spend a beautiful morning in a physician’s office.
Boy’s fever and rash after insect biteThe parents of a 4-year-old boy who lives in eastern Maryland near the Pennsylvania line are worried about an expanding rash on his back, which started as a small red bump a week ago following a summer picnic. The boy has had a low-grade fever and has not been acting like himself for a few days.
Hyperpigmentation around a teen’s eyeAn adolescent girl is referred by her pediatrician to dermatology for evaluation of a birthmark on her face.