Contemporary Pediatrics Dermcase

New violaceous nodules in a neonateFollowing an uncomplicated pregnancy, labor, and delivery, a healthy 13-day-old girl presents for evaluation with a 2-day history of firm, violaceous nodules on her mid-upper back and right arm just above the axilla.
Protuberant blister over newborn’s lumbar spineA healthy full-term newborn presented with a prominent sacral dimple within an oval patch. Ultrasound showed no evidence of spinal anomalies, and the child was discharged home. Three days later, the patch became elevated, red, and moist appearing, and she was brought to the emergency department (ED) for further evaluation of the “growing blister.”
Can you solve these 6 puzzling cases?We know you love a diagnostic challenge. Can you crack these 6 puzzling cases?
Rapidly growing nodule on infant’s posterior thighThe parents of a healthy 5-month-old boy bring him to the office for evaluation of an enlarging yellowish nodule on the back of his right thigh. It started as a pink macule several months ago and became yellow and lumpy over the last month. The infant was born at term and has grown and developed normally. His parents deny any trauma, but report occasional bleeding from the surface of the nodule. They deny any new medications or outdoor exposures. There is no history of new topical skin products.
Teenaged girl distressed by persistent rashA 16-year-old girl presents for evaluation of an asymptomatic brown rash over her central chest and back that developed over the preceding 6 months. She is embarrassed by the appearance.
Stubborn ring of rash around a boy's mouthThe mother of a healthy 11-year-old boy brings him to the office for help to clear a rash that has persisted around his mouth for 3 months. Although the boy rarely licks his lips, he does not use lip products and has not changed his dental products.
Girl’s papular rash will not respond to treatmentThe mother of a healthy 5-year-old girl brings her to the office for evaluation of 2 itchy plaques on her right ankle that have worsened over the last 10 days despite treatment for possible tinea corporis with topical clotrimazole 1% ointment and hydrocortisone 2.5% ointment. A fungal culture is pending.
Girl’s blistering rash spreads to eyes and faceA healthy 9-year-old female presents with a 1-day history of fever, progressive rash, conjunctivitis, and superficial oral ulcers.
Father, son share similar blue bumpsA father brings his 8-year-old son to the office for evaluation of new, asymptomatic blue bumps that have appeared on the boy’s chest over the last several months (Figure). The dad notes that he has had similar lesions as well.
Acute pruritic eruption on a child’s face and handsYou are asked to evaluate a healthy 9-year-old girl with an itchy rash on her face, neck, and hands for a week. She had a similar eruption 1 month ago that resolved over several days. Although she has a history of poison ivy, her parents knew of no exposure. There was no history of new topical skin products. However, she had begun to eat more seasonal fruits recently, including strawberries, grapes, and mangos.