Dermclinic

This annular configuration is classic for granuloma annulare; very widespread lesions may signal diabetes mellitus. Ultrapotent topical steroids may lead to resolution.

The morphology and distribution of these lesions is characteristic of ectoparasite bites, which occur when a human carries a pet—usually a kitten or puppy—as if the animal were a human newborn baby.

While melanoma is quite uncommon during the prepubertal years, the “jet black” morphology and history of recent lesional growth dictated further investigation.

The black, hard center represents an eschar. This type of morphology is almost always caused by a virulent organism—bacterial or fungal. Biopsy showed non-septate hyphae within the dermis, and a culture grew Mucor species (a saprophytic soil fungus).

The skin lesions of adenoma sebaceum and the history of some mental challenge led to the suspected diagnosis of tuberous sclerosis. Genetic testing confirmed this diagnosis.

The multiple erosions on this teenager's lip are most likely an exaggerated version of herpes labialis related to his underlying lymphoma. A viral culture would be useful to verify the diagnosis.

The “rash” of innumerable asymptomatic flat-topped papules on this teenager’s face is highly likely to be flat warts.

This distribution of an inflammatory disorder in a very young child almost always indicates atopic dermatitis. The family history of asthma suggests the atopic diathesis.

This neonate was seen in consultation when brought to the emergency department because of staff concern about bacterial omphalitis. The baby had been feeding well and sleeping through the night.

A 6-year-old boy was brought for medical evaluation when he broke out with innumerable pea-sized and shaped, asymptomatic red papulonodules on cheeks, buttocks, and upper thighs. The week before onset of the rash, the child had not been feeling well, and had complained of chills, nausea, and a sore throat.

Ear infection is the most common cause of severe ear pain in young children. Here I offer a few home remedies based on cold and warmth that may help a parent soothe a cranky child.

High fevers; more fatigue; rapid onset of illness... more diagnostic pearls here.

Here are some home treatments I have recommended for children with bronchitis.

West Virginia (the state in which I practice) was not one of the 10 best places to live if you have autism, according to this year’s survey from Autism Speaks. Although thanks to a piece of legislation enacted this month, it is now a better place to live if you have autism. Your state can become better too.

In a conference last week, President Obama announced a new Web site http://stopbullying.gov to help raise awareness about the issue. This is part of an effort to encourage cooperation between government agencies and educators to protect children from bullying based on race, ethnicity, disability, or sexuality. Are you an advocate for prevention? Share your antibullying efforts with colleagues.