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Allergy

Allergy

I enjoyed Dr Kirk Barber’s interesting Dermclinic quiz featuring a 5-year-old boy with a dramatic resentation of tinea corporis (CONSULTANT FOR PEDIATRICIANS, February 2009, page 43). I am curious to know why Dr Barber prescribed oral terbinafine for this patient.

A 4-year-old boy presented for further evaluation of persistent right hip pain
of 2 months’ duration. Before the onset of the pain, he had been limping,
favoring his right side. For several days before he was brought in for
evaluation, he had had fevers and sweating in addition to the right hip
pain.

A 7-year-old boy with annular, asymptomatic, flesh-colored lesion on
the wrist that had developed slowly over the past month. The parents had
removed the child from school because they were told that the lesion was
ringworm. The lesion had failed to resolve after application of an antifungal
cream for 10 days.

An 18-month-old white boy is brought to his well-care visit by his parents, who are concerned that for the past month he has been less social and active. He has appeared weak and has refused to walk or play with his siblings. He has also had a decreased appetite and has lost about 2 kg. He has vomited several times but with no bile or blood.

The most common chronic medical problem that we pediatricians treat is asthma. We do our best to manage our patients’ asthma by prescribing controller medications, providing asthma action plans, and guiding families through acute exacerbations. We often ask about possible environmental triggers, such as tobacco smoke and cockroaches, and we advise patients to reduce their exposure to those triggers.

The most common chronic medical problem that we pediatricians treat is asthma. We do our best to manage our patients' asthma by prescribing controller medications, providing asthma action plans, and guiding families through acute exacerbations. We often ask about possible environmental triggers, such as tobacco smoke and cockroaches, and we advise patients to reduce their exposure to those triggers.

For the past few weeks, a 10-year-old boy had a pruritic abdominal rash that had not responded to over-the-counter topical medications. The rash had appeared around the time he started wearing a new belt (shown). The child was otherwise healthy. There was a family history of asthma.

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