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Pediatric Dermatology: A Quick Reference Guide
Perioral Vesicles and Erosions in a Toddler with Atypical Hand-Foot-and-Mouth Disease
Table of Contents
Free Topics
About
Acanthosis Nigricans
Acquired Melanocytic Nevi
Approach to the Patient With a Rash
Confluent and Reticulated Papillomatosis (CARP)
Congenital Melanocytic Nevi (CMN)
Dedication
Editors' Note
Figure Credits
Flowchart - Treatment Options for Mild Acne Based on Lesion Type
Flowchart - Treatment Options for Moderate Acne
Folliculitis/Furunculosis/Carbunculosis
Foreword
Psoriasis
Reviewers/Contributors
Tinea Capitis
Tuberous Sclerosis Complex (TSC)
Warts
1. Approach to the Patient With a Rash
1. Approach to the Patient With a Rash
Figure(s)
1.1. Cafe Au Lait Macules (Spots) in a Patient Who Has Neurofibromatosis Type 1
1.10. Erosions, as Seen in This Infant Who Has Acrodermatitis Enteropathica
1.11. An Ulcer Occurs When There Has Been Loss of Epidermal
1.12. A Linear Arrangement of Papules or Vesicles Often Occurs in Contact
1.13. Grouped Vesicles are Characteristic of Herpes Simplex Virus Infection on the Skin
1.14. The Lesions of Herpes Zoster Appear in a Dermatomal Distribution
1.15. An Annular (Ring-Shaped with Central Clearing) Plaque is Typical of Tinea Corporis
1.16. Lichenification
1.2. A Port-Wine Staina Vascular Patch
1.3. Molluscum Contagiosum. There are Erythematous and Skin-Colored Papules
1.4. Nodules Representing Neurofibromas in a Patient Who Has Neurofibromatosis Type 1
1.5. Pink Wheals in a Patient Who Has Urticaria
1.6. Scaling Plaques, Plateau-Like Lesions, are Observed in Psoriasis
1.7. Vesicles, as Seen Here in Varicella, are Filled with Clear or Serous Fluid
1.8. Bullae, Filled with Clear Fluid, are Observed in Chronic Bullous Disease of Childhood
1.9. Pustules are Filled with Purulent Material. This Patient Has Folliculitis
2. Diagnostic Techniques
2. Diagnostic Techniques
Figure(s)
2.1. Potassium Hydroxide Preparation Showing Branching Hyphae (Arrows)
2.2. Potassium Hydroxide Preparation in Tinea Capitis Caused by Trichophyton Tonsurans
2.3. Pseudohyphae (Red Arrow) and Spores (Yellow Arrows) are Characteristic of Infection
2.4. In Tinea Versicolor, the Potassium Hydroxide Preparation Reveals Short Hyphae
2.5. Uninoculated Dermatophyte Test Medium is Yellow (Left)
2.6. Newly Hatched Mite (Red Arrow) and Fecal Material (Yellow Arrows) on a Mineral Oil Preparation
2.7. A Mineral Oil Preparation in a Patient Who Has Scabies Reveals
2.8. Wood Light Examination in Tinea Capitis Caused by Microsporum Canis
3. Therapeutics
I. Selection and Use of Topical Corticosteroids
II. Selection and Use of Moisturizers
III. Cryotherapy
IV. Sun Protection
Table(s)
3.1 Selected Topical Corticosteroids by Potency
3.2 Guidelines for Selecting Corticosteroid Potency
Dermatitis
4. Atopic Dermatitis
5. Contact Dermatitis (Irritant and Allergic)
6. Juvenile Plantar Dermatosis
I. Irritant Contact Dermatitis
II. Allergic Contact Dermatitis
Figure(s)
4.1. Erythematous Patches on the Face of an Infant Who Has Atopic Dermatitis
4.10. Polygonal Scales with a Pasted-on Appearance Located on the Lower Extremities
4.11. Erosions, Weeping, and Crusting are Observed When Lesions of Atopic Dermatitis
4.2. Hypopigmented Patch on the Dorsum of the Wrist in an Infant Who Has Atopic Dermatitis
4.3. Erythematous Lichenified Patch in the Antecubital Fossa in Childhood Atopic Dermatitis
4.4. Chronic Atopic Dermatitis in the Antecubital Fossa
4.5. Oval Crusted Lesion of Nummular Eczema
4.6. Involvement of the Feet in Atopic Dermatitis: Erythema, Lichenification, Scaling,
4.7. Erythematous Patches in the Antecubital Fossae of an Adolescent Who Has Atopic Dermatitis
4.8. Keratosis Pilaris: Follicular Papules that Have a Central Core of Keratin Debris
4.9. Ill-Defined Hypopigmented Macules are Characteristic of Pityriasis Alba
5.1. Irritant Diaper Dermatitis. Erythematous Patches Sparing the Skinfolds
5.2. Asteatotic Eczema is Characterized by Dry, Rough Skin with White Rectangular Scaling
5.3. Multiple Small Vesicles Overlying an Erythematous Plaque in a Boy Exposed to Poison Ivy
5.4. Contact Dermatitis Caused by Nickel in a Clothing Snap or Belt
5.5. Nickel Contact Dermatitis at the Site of an Earring
5.6. In Toilet Seat Dermatitis, Symmetric, Eczematous Lesions are Seen on the Posterior Thighs and Buttocks
5.7. Vesicles and Erythematous Papules in a Linear Arrangement
5.8. Id Reaction
6.1. Erythema, Scaling, and Increased Skin Markings of the Forefoot in Juvenile
6.2. Scaling and Fissuring of the Forefeet in Juvenile Plantar Dermatosis
Acne
7. Acne Vulgaris
8. Neonatal and Infantile Acne
9. Periorificial Dermatitis
Figure(s)
7.1. Open Comedones (Ie, Blackheads) on the Forehead (Arrows)
7.2. Closed Comedones are Small White or Skin-Colored Papules Without Surrounding Erythema
7.3. Inflammatory Lesions are Erythematous Papules, Pustules, or Nodules
7.4. Patient with Moderate Acne
7.5. Treatment Options for Mild Acne Based on Lesion Type
7.6. Treatment Options for Moderate Acne
7.7. Treatment Options for Severe Acne
7.8. In Severe Acne, Nodules and Scarring are Present
8.1. Erythematous Papules and Pustules Distributed Widely on the Face and Scalp
8.2. Papules and Pustules on the Cheek of an Infant Who Has Neonatal Acne
8.3. Erythematous Papules and Pustules on the Cheek in Infantile Acne
9.1. Periorificial Dermatitis
9.2. Granulomatous Periorificial Dermatitis
Table(s)
7.1 Topical Retinoids and Fixed-Dose Combination Products for Acne
Skin Infections
Box(es)
13.1 Optimizing Use of Over-the-Counter Salicylic Acid Therapy for Warts
Figure(s)
10.1. Clustered Vesicles on an Erythematous Base in an Infant with Neonatal
10.2. Vesicles and Ulcers Affecting the Perioral Skin are Observed in Herpes Gingivostomatitis
10.3. Herpes Labialis (cold Sore)
10.4. Vesicles Located on the Finger are Characteristic of Herpetic Whitlow
10.5. Eczema Herpeticum is Characterized by Vesicles and Monomorphous Erosions
10.6. Tzanck Test in Herpes Simplex Virus Infection; Multinucleated Giant Cells are Present
11.1. Herpes Zoster is Characterized by Grouped Vesicles in a Dermatomal Distribution
12.1. Somewhat Erythematous, Translucent Papules are Typical of Molluscum Contagiosum
12.2. molluscum Dermatitis
12.3. Molluscum Contagiosum with Koebnerization, Manifested as Several Lesions in a Linear
12.4. Molluscum Lesions with Enlargement and Erythema, Signifying the Host Immune Response
13.1. Common Warts Appear as Rough (Ie, Verrucous) Papules
13.2. Flat Warts are Small, Flat-Topped Papules
13.3. Condylomata Acuminata Appear as Skin-Colored Papules and Plaques
14.1. Patients Who Have Erythema Infectiosum Exhibit Erythematous Cheeks
14.2. Erythema Infectiosum Produces a Lacy, Reticulated Erythema on the Extremities
15.1. Erythematous Papules on the Face of a Child with Gianotti-Crosti Syndrome
15.2. The Papules of Gianotti-Crosti Syndrome Often are Located on the Extensor
16.1. Ulcers May Occur on the Tongue or Buccal Mucosa in Hand-Foot-and-Mouth Disease
16.2. Oval Vesicles with Surrounding Erythema on the Hand of a Child
16.3. Hand-Foot-and-Mouth Disease. Oval Vesicles with Mild Surrounding Erythema
16.4. Ruptured Bullae and Large Erosions in a Young Girl with Atypical
16.5. Perioral Vesicles and Erosions in a Toddler with Atypical Hand-Foot-and-Mouth Disease
16.6. Onychomadesis (Nail Shedding) Following Hand-Foot-and-Mouth Disease in an Otherwise Healthy 4-Year-Old
17.1. Koplik Spots (Arrows): Punctate White-Gray Papules on an Erythematous Base
17.2. Measles Produces an Erythematous Macular and Papular Eruption
18.1. Erythema and Edema of the Palms Early in the Course
19.1. Roseola Infantum
20.1. An Erythematous Macular Eruption Occurs in Rubella
20.2. Blue-Purple Nodular Eruption (blueberry Muffin Rash) in an Infant with Congenital
21.1. Erythematous, Fine, Papular Eruption Involving the Axilla and Lateral Chest
21.2. Erythematous Papules and Plaques on the Right Abdomen and Upper Extremity
22.1. Varicella. Typical Vesicles (dewdrop on a Rose Petal) are Present (Arrows)
22.2. In Varicella, Lesions are in Different Stages of Development
23.1. Acute Paronychia with Inflammation, Pustule Formation, and Crusting of the Periungual
23.2. Acute Paronychia with Loculated Pus and Surrounding Erythema
24.1. Blistering Distal Dactylitis. Note Tense Bulla of the Thumb
25.1. Ecthyma Lesion with Central Necrotic Crust
26.1. Folliculitis with Erythematous Papules and Papulopustular Eruption of the Buttocks
26.2. The Lesions of Folliculitis are Erythematous Papules and Pustules Centered around
26.3. Furuncles. These Nodular Lesions May Drain from the Central Portion
27.1. Nonbullous Impetigo. Note Honey-Colored Crusting
27.2. Bullous Impetigo
27.3. Erythematous Round Erosions, Each with a Collarette of Scale,
28.1. Perianal Bacterial Dermatitis is Characterized by Marked Perianal Erythema and Purulent
28.2. Streptococcal Balanoposthitis (Ie, Inflammation of the Glans Penis and Foreskin)
29.1. Annular Erythema Migrans Lesion of Early Localized Lyme Disease
30.1. Meningococcemia. Purpuric Plaques with Jagged Borders and Early Necrosis
30.2. Meningococcemia. Disseminated Intravascular Coagulation
31.1. Rocky Mountain Spotted Fever. Note Erythematous Petechial Macules on the Palm
31.2. Rocky Mountain Spotted Fever with Petechial Lesions of the Legs
32.1. The Rash of Scarlet Fever is Composed of Tiny Papules
32.2. In Scarlet Fever, the Rash Often is Accentuated in Skinfolds
32.3. Scarlet Fever. Red Strawberry Tongue or Raspberry Tongue
32.4. Scarlet Fever with Desquamation of the Ankles and Feet in a 5-Year-Old Girl Receiving Antibiotic Therapy
33.1. Staphylococcal Scalded Skin Syndrome. Flaccid Bullae Form and Rupture Rapidly
33.2. In Staphylococcal Scalded Skin Syndrome, Erosions around the Mouth Often Take
34.1. Toxic Shock Syndrome
35A.1. Erythema, Maceration, and Fissuring of the Corners of the Mouth
35A.2. A Potassium Hydroxide Preparation Reveals Pseudohyphae (Red Arrow) and Spores (Yellow
35B.1. Bright Red Patches that Involve the Creases and Convexities are Observed
35C.1. Chronic Paronychia Caused by Candida
35D.1. Congenital Candidiasis is Characterized by Erythematous Papules, Pustules, and Scaling
35D.2. Nail Dystrophy in Congenital Candidiasis
35E.1. White Patches on the Tongue or Buccal Mucosa are Characteristic of Thrush
35E.2. White Plaques on the Lips of an Infant Who Has Thrush
36.1. Thickening and Yellowing of the Nail and Separation of the Nail Plate
36.2. In Superficial White Onychomycosis, the Surface of the Nail Appears White
37.1. Tinea Capitis. A Well-Defined Patch of Alopecia within Which are Scale
37.2. Diffuse Scaling of the Scalp is Observed in the Seborrheic Form of Tinea Capitis
37.3. A Kerion is a Tender, Boggy Mass Located on the Scalp
37.4. Tinea Capitis Caused by Trichophyton Tonsurans Produces an Endothrix Infection
37.5. The Diagnosis of Tinea Capitis May be Confirmed by Performing a Fungal Culture
38.1. Lesions of Tinea Corporis are Rings (Ie, Annuli) that Have an Elevated, Erythematous, Scaling Border and Central Clearing
38.2. Occasionally, the Lesions of Tinea Corporis May be Atypical in Their Appearance
38.3. Lesions of Tinea Corporis May be Multiple
38.4. This Child Developed Trichophytic (Majocchi) Granuloma after a Lesion of Tinea
38.5. A Potassium Hydroxide Preparation in Tinea Corporis; Branching Hyphae are Seen (Arrows)
39.1. Tinea Cruris is Characterized by an Erythematous or Hyperpigmented Patch
40.1. Scaling, Fissuring, and Erosions Between the Toes are Seen
40.2. Erythematous Papules and Ruptured Vesicles on the Midfoot in Vesicular Tinea Pedis
41.1. Well-Defined Hypopigmented Scaling Macules in Tinea Versicolor
41.2. Well-Defined Hyperpigmented Scaling Macules in Tinea Versicolor
41.3. In Tinea Versicolor, Potassium Hydroxide Preparation on Scale Obtained from a Lesion
Fungal and Yeast Infections
35. Candida
35A. Angular Cheilitis/Perlèche
35B. Candidal Diaper Dermatitis
35C. Chronic Paronychia
35D. Neonatal/Congenital Candidiasis
35E. Thrush
36. Onychomycosis
37. Tinea Capitis
38. Tinea Corporis
39. Tinea Cruris
40. Tinea Pedis
41. Tinea Versicolor
Localized Bacterial Infections
23. Acute Paronychia
24. Blistering Distal Dactylitis
25. Ecthyma
26. Folliculitis/Furunculosis/Carbunculosis
27. Impetigo
28. Perianal Bacterial Dermatitis
Localized Viral Infections
10. Herpes Simplex
11. Herpes Zoster
12. Molluscum Contagiosum
13. Warts
Systemic Bacterial, Rickettsial, or Spirochetal Infections With Skin Manifestations
29. Lyme Disease
30. Meningococcemia
31. Rocky Mountain Spotted Fever (RMSF)
32. Scarlet Fever
33. Staphylococcal Scalded Skin Syndrome (SSSS)
34. Toxic Shock Syndrome (TSS)
Systemic Viral Infections
14. Erythema Infectiosum/ Human Parvovirus B19 Infection (Fifth Disease)
15. Gianotti-Crosti Syndrome
16. Hand-Foot-and-Mouth Disease (HFMD) and Other Enteroviral Exanthems
17. Measles
18. Papular-Purpuric Gloves-and-Socks Syndrome (PPGSS)
19. Roseola Infantum (Exanthem Subitum)
20. Rubella
21. Unilateral Laterothoracic Exanthem (ULE)
22. Varicella
Table(s)
34.1 Diagnostic Criteria for Staphylococcal and Streptococcal Toxic Shock Syndrome
37.1 Recommended Therapy for Tinea Capitis
Infestations and Bites
42. Cutaneous Larva Migrans
43. Head Lice
44. Insect Bites and Papular Urticaria
45. Scabies
46. Cercarial Dermatitis (Swimmer's Itch)
Figure(s)
42.1. Cutaneous Larva Migrans. Papules and Serpiginous Plaques on the Lower Extremity
42.2. Cutaneous Larva Migrans. Note the Serpiginous Erythematous Tracts
43.1. Head Lice. Note Numerous Nits Attached to Hair Shafts
43.2. Head Lice
44.1. Mosquito Bites
44.2. Bullous Flea Bite Reaction
44.3. Flea Bites. Note the breakfast, Lunch, and Dinner Sign
44.4. Mite Bites. Multiple, Clustered, Edematous Red Papules and Plaques
44.5. Bedbug
44.6. Papular Urticaria
45.1. Scabies. Note Papules, Pustules, and Linear Burrows on the Plantar Surfaces
45.2. Scabies. Note Linear Burrows
45.3. Scabies Nodules in a Young Boy
45.4. Scabies Nodules in an Infant
45.5. Mineral Oil Preparation in Scabies (40x Magnification)
46.1. Cercarial Dermatitis. There are Erythematous Papules on the Patient's Back
46.2. Seabather's Eruption, a Look-Alike of Cercarial Dermatitis, Usually Appears after Saltwater
Papulosquamous Diseases
47. Lichen Nitidus
48. Lichen Planus (LP)
49. Lichen Striatus
50. Pityriasis Lichenoides
51. Pityriasis Rosea
52. Psoriasis
53. Pityriasis Rubra Pilaris (PRP)
54. Seborrheic Dermatitis
Figure(s)
47.1. White, Flat-Topped Papules, Some in a Linear Arrangement, are Characteristic
48.1. Violaceous, Flat-Topped Papules are Observed in Lichen Planus
48.2. White, Lacy, or Reticulated Lesions Often are Observed on the Buccal
49.1. Linear Arrangement of Papules on the Posterior Thigh and Leg in Lichen Striatus
49.2. Close-Up View of the Patient in Figure 49
50.1. Erythematous-Crusted Papules of Pityriasis Lichenoides Et Varioliformis Acuta are Seen
50.2. Crops of Scaling Papules are Seen in This Patient with Pityriasis Lichenoides Chronica
51.1. The Herald Patch is a Round or Oval Erythematous Patch
51.2. On the Back, the Alignment of Lesions Along Lines of Skin
51.3. Papules and Plaques in a Black Child Who Has Pityriasis Rosea
52.1. Typical Lesions of Psoriasis are Erythematous Papules and Plaques
52.2. In Psoriasis, Removal of Scale from a Lesion Causes Pinpoint Bleeding
52.3. In Occluded Areas, Such as the Axilla, the Lesions of Psoriasis May Lack Scale
52.4. In Infants, Psoriasis May Involve the Diaper Area, Appearing as Sharply
52.5. Guttate Psoriasis is Characterized by an Eruption Composed of Widespread Macules
52.6. On the Scalp, Psoriasis Causes Erythema and Thick Scale
53.1. Well-Demarcated Erythematous Scaly Plaques with Follicular Prominence in a Young Boy
53.2. Well-Demarcated Thickening of the Soles (Ie, Keratoderma) with Mild Scaling
54.1. Greasy Scale on the Scalp of an Infant (Ie, Cradle Cap)
54.2. Erythematous Patches with Greasy Scale on the Face of an Infant
54.3. In the Diaper Area, Seborrheic Dermatitis Produces Salmon-Colored Patches with Greasy
54.4. Seborrheic Dermatitis Involving the Nasolabial Folds Has Resulted in Postinflammatory Hypopigmentation
Vascular Lesions
55. Cutis Marmorata
56. Cutis Marmorata Telangiectatica Congenita (CMTC)
57. Infantile Hemangioma
58. Kasabach-Merritt Phenomenon
59. Pyogenic Granuloma
60. Telangiectasias
61. Vascular Malformations
Figure(s)
55.1. Cutis Marmorata Presents as a Lacy, Reticulated, or Mottled Erythema or
56.1. Cutis Marmorata Telangiectatica Congenita. Reticulated Mottling of the Lower Extremity
56.2. Cutis Marmorata Telangiectatica Congenita
57.1. Superficial Infantile Hemangioma
57.2. Deep Infantile Hemangioma of the Nasal Bridge. Note the Surface Telangiectasias
57.3. Combined Infantile Hemangioma
57.4. Combined Infantile Hemangioma of the Breast
57.5. Segmental Infantile Hemangioma. Note the Broad Anatomic Region Involved
57.6. Non-Involuting Congenital Hemangioma
57.7. Neonatal Hemangiomatosis. This Infant Had Multiple Small Hemangiomas in the Liver as Well
57.8. Beard Distribution Infantile Hemangioma
57.9. Infantile Hemangioma with ledge Effect in a 3-Month-Old
58.1. Kasabach-Merritt Phenomenon
58.2. Kaposiform Hemangioendothelioma
59.1. Pyogenic Granuloma. A Pedunculated, Vascular Papule on the Scalp
59.2. Pyogenic Granuloma. This Multilobulated, Vascular Papule Was Prone to Recurrent Bleeding
59.3. Pyogenic Granuloma Overlying Port-Wine Stain
60.1. Spider Angioma
60.2. Unilateral Nevoid Telangiectasia
61.1. Salmon Patch. Erythematous Patches Involving the Glabella and Eyelids
61.2. Port-Wine Stain
61.3. Port-Wine Stain. This Lesion Involved the Upper Lateral Back, Chest, Shoulder,
61.4. Venous Malformation
61.5. Microcystic Lymphatic Malformation
61.6. Macrocystic Lymphatic Malformation
61.7. Arteriovenous Malformation
61.8. Combined Vascular Malformation
61.9. Klippel-Trenaunay Syndrome
Disorders of Pigmentation
Figure(s)
62.1. Oculocutaneous Albinism. Absence of Pigment in the Skin, Hair, and Irides
63.1. Pigmentary Mosaicism, Hypopigmented Type. A Large, Shaggy-Bordered, Hypopigmented Patch
63.2. Pigmentary Mosaicism, Hypopigmented Type. Whorled and Curvilinear Streaks of Hypopigmentation
64.1. Pityriasis Alba. Hypopigmented Macules with Indistinct Borders
65.1. Postinflammatory Hypopigmentation. Hypopigmented Macules Located at Sites of Prior Bullous Impetigo
66.1. Vitiligo Appears as Well-Defined Areas of Complete Loss of Pigmentation
67.1. Velvety, Hyperpigmented Thickening of the Skin Characterizes Acanthosis Nigricans
67.2. In This 4-Year-Old Boy Who Had Morbid Obesity, Changes of Acanthosis
68.1. Junctional Nevus
68.2. Compound Nevus
68.3. Intradermal Nevus
68.4. A Halo Nevus is an Acquired Nevus with a Ring
68.5. Atypical Nevi are Often Larger (Often 5-12 mm in Diameter) and Have Irregular Borders
68.6. This Benign eclipse Nevus Reveals Pink and Brown Color
69.1. Cafe Au Lait Macule on the Face
69.2. Multiple Cafe Au Lait Macules in a Child Who Has Neurofibromatosis Type 1
70.1. Congenital Melanocytic Nevus
70.2. Congenital Melanocytic Nevus Demonstrating Surface Textural Change
70.3. A Large (Ie, giant) Congenital Melanocytic Nevus Involving the Posterior Trunk
70.4. A Large (Ie, giant) Congenital Melanocytic Nevus Involving the Posterior Trunk
71.1. Ephelides (Freckles) are Small Tan or Red Macules that Appear in Sun-Exposed Areas
72.1. In Peutz-Jeghers Syndrome, Lentigines Appear on the Face, Lips, and Oral
73.1. Congenital Dermal Melanocytosis. Blue-Gray Hyperpigmented Macules over the Buttocks
73.2. Congenital Dermal Melanocytosis. Blue-Gray Patches over the Buttocks and Upper Back
74.1. Pigmentary Mosaicism, Hyperpigmented Type. This Young Girl Has a Large Hyperpigmented
74.2. Pigmentary Mosaicism, Hyperpigmented Type. This Boy Has Linear and Curvilinear Hyperpigmented
Hyperpigmentation
67. Acanthosis Nigricans
68. Acquired Melanocytic Nevi
69. Café au Lait Macules
70. Congenital Melanocytic Nevi (CMN)
71. Ephelides
72. Lentigines
73. Congenital Dermal Melanocytosis
74. Pigmentary Mosaicism, Hyperpigmented
Hypopigmentation
62. Albinism
63. Pigmentary Mosaicism, Hypopigmented
64. Pityriasis Alba
65. Postinflammatory Hypopigmentation
66. Vitiligo
Lumps and Bumps
75. Cutaneous Mastocytosis
76. Dermoid Cysts
77. Epidermal Nevi
78. Granuloma Annulare
79. Juvenile Xanthogranuloma
80. Pilomatricoma
81. Spitz Nevus
Figure(s)
75.1. Solitary Mastocytoma
75.2. Mastocytoma with a Positive Darier Sign after Stroking; the Lesion Has Become Red and More Elevated
75.3. In Urticaria Pigmentosa, Multiple Hyperpigmented Macules and Papules are Present
75.4. Bullous Mastocytosis
76.1. Dermoid Cyst of the Lateral Eyebrow in a 3-Week-Old
76.2. Dermoid Cyst on the Mid-Lateral Forehead in a 2-Month-Old
77.1. Epidermal Nevus on the Scalp. A Verrucous, Brown, Linear Plaque
77.2. Extensive Epidermal Nevi on the Left-Sided Trunk
78.1. Annular Plaque of Granuloma Annulare
78.2. Subcutaneous Granuloma Annulare
79.1. Juvenile Xanthogranuloma of the Scalp
79.2. Juvenile Xanthogranuloma of the Scalp. A Small Yellow-Orange Papule
80.1. A Pilomatricoma in the Temporal Fossa Has an Overlying Blue Color
80.2. A Pilomatricoma with an Overlying Pink Color
80.3. The teeter-Totter Sign in Pilomatricoma
80.4. The tent Sign in Pilomatricoma
81.1. Spitz Nevus. This Girl Had a Rapidly Growing Pink Papule
81.2. This Boy Had a Rapidly Enlarging Pink Papule on the Posterior
Bullous Diseases
82. Childhood Dermatitis Herpetiformis
83. Epidermolysis Bullosa (EB)
84. Linear IgA Dermatosis
Figure(s)
82.1. Dermatitis Herpetiformis. Vesicles and Erosions are Present
83.1. Epidermolysis Bullosa Simplex (Localized or Weber-Cockayne Type)
83.2. Numerous Bullae and Erosions in a Patient with Junctional Epidermolysis Bullosa,
83.3. Denudation of the Lower Leg and Foot in a Newborn Girl
83.4. Multiple Milia with Scarring over the Dorsal Hand and Fingers
83.5. Mitten Deformity of the Hand of a Patient with Recessive Dystrophic Epidermolysis Bullosa
84.1. Linear Iga Dermatosis Lesions Showing Bullae Surrounding a Crust the cluster
Genodermatoses
85. Ichthyosis
86. Incontinentia Pigmenti
87. Neurofibromatosis (NF)
88. Tuberous Sclerosis Complex (TSC)
89. Ectodermal Dysplasia
Figure(s)
85.1. In Ichthyosis Vulgaris, Fine Scales with a pasted on Appearance
85.2. Recessive X-Linked Ichthyosis
85.3. This Neonate is Covered with a Thick Collodion Membrane and There is Mild Eclabium
85.4. Lamellar Ichthyosis is Characterized by Thick, Platelike Scales
85.5. Patients Who Have Nonbullous Congenital Ichthyosiform Erythroderma Exhibit Diffuse Erythema
85.6. Epidermolytic Ichthyosis. The Skin Takes on a Cobblestone Appearance on the Extremities
86.1. In the First Stage of Incontinentia Pigmenti, Vesicles and Crusting Appear
86.2. Warty Papules in This Infant, Who Has the Second Stage of Incontinentia Pigmenti
86.3. Whorled and Linear Hyperpigmentation, Arranged Along the Blaschko Lines, are Observed
86.4. Hypopigmented Atrophic Streaks (Arrows) are Observed in the Fourth Stage
86.5. Hairless, Atrophic Streaks on the Leg of the Affected Mother
87.1. Multiple Cafe Au Lait Macules in a Patient Who Has Neurofibromatosis Type 1
87.2. Neurofibromas and a Cafe Au Lait Macule in a Patient Who Has Neurofibromatosis Type 1
87.3. Plexiform Neurofibromas (Ie, Large, Subcutaneous Masses [arrows]) in a Patient
87.4. Axillary Freckling in a Patient Who Has Neurofibromatosis Type 1
87.5. Lisch Nodules, Iris Hamartomas, are Observed in Patients Who Have Neurofibromatosis
88.1. Hypopigmented Macules on the Chest of a Child Who Has Tuberous Sclerosis Complex
88.2. Facial Angiofibromas are Pink Papules that May Mimic the Lesions of Acne
88.3. Shagreen Patches Have an Orange-Peel or Cobblestone Texture and Often
88.4. Periungual Fibromas Usually Appear after Puberty in Patients Who Have Tuberous
89.1. Light-Colored, Short, Sparse Hair is Seen in This Young Patient
89.2. This Infant with Anhidrotic (Hypohidrotic) Ectodermal Dysplasia Has Conical Teeth
89.3. This Child with Anhidrotic (Hypohidrotic) Ectodermal Dysplasia Exhibits the Typical Facial Features
Hair Disorders
90. Alopecia Areata
91. Loose Anagen Syndrome
92. Telogen Effluvium
93. Traction Alopecia
94. Trichotillomania
Figure(s)
90.1. Smooth, Well-Defined Patches of Complete Hair Loss in a Child with Alopecia Areata
90.2. Extensive Patchy Hair Loss in a Child with Alopecia Areata
90.3. Nearly Complete Hair Loss in a Child with Severe Alopecia Areata (Alopecia Totalis)
90.4. Complete Loss of Eyelashes and Eyebrows in This Child with Alopecia Universalis
90.5. Multiple Small Nail Pits May be Observed in Patients Who Have Alopecia Areata
91.1. Typical Appearance of a Patient with Loose Anagen Syndrome
91.2. Fine, Short, Lightly Pigmented Hair that Does Not Grow Well
91.3. Typical Microscopic Appearance of a Dysplastic Anagen Hair in a Patient
92.1. Diffuse Thinning of Scalp Hair Typical of Telogen Effluvium
92.2. Diffuse Thinning of the Scalp Hair in This Child with Telogen Effluvium
93.1. Marked Thinning of the Temporal Scalp Due to Traction Alopecia
93.2. Partial Alopecia Involving the Hairline in This Child with Traction Alopecia
94.1. Trichotillomania. There is a Well-Defined Patch of Relative Alopecia
94.2. Trichotillomania. Irregular Patch of Alopecia with Broken-Off Hairs
94.3. Trichotillomania Involving the Vertex Scalp
94.4. Patchy, Irregular Loss of Eyebrows and Eyelashes in This Patient with Trichotillomania
94.5. Trichotillomania Localized to the Eyelashes
Skin Disorders in Neonates/Infants
100. Intertrigo
101. Miliaria
102. Nevus Sebaceus (of Jadassohn)
103. Transient Neonatal Pustular Melanosis
104. Subcutaneous Fat Necrosis (SFN)
95. Aplasia Cutis Congenita
96. Diaper Dermatitis
97. Eosinophilic Pustular Folliculitis
98. Erythema Toxicum
99. Infantile Acropustulosis
Figure(s)
100.1. A Superficially Eroded Area of Intertrigo that Was Secondarily Infected
100.2. Intertrigo is Characterized by Erythematous Superficial Erosions Located in the Skinfolds
101.1. Erythematous Papules (Miliaria Rubra) and Pustules (Miliaria Pustulosa) Located
101.2. Miliaria Crystallina is Characterized by Fragile Superficial Vesicles Without Surrounding Erythema
102.1. Nevus Sebaceus. Yellow-Tan Hairless Plaque Located on the Scalp
102.2. A Linear Nevus Sebaceus Located on the Face
103.1. Pustules Without Surrounding Erythema May be Observed in Neonates
103.2. Hyperpigmented Macules, Some with a Rim of Scale
103.3. Transient Neonatal Pustular Melanosis. Hyperpigmented Macules on the Chin
104.1. Subcutaneous Fat Necrosis
95.1. Stellate Ulcer with Overlying Crust Characteristic of Aplasia Cutis Congenita
95.2. Aplasia Cutis Congenita Presenting as an Atrophic Scar
95.3. Aplasia Cutis Congenita in Which a Thin Membrane is Surrounded by
96.1. Irritant Diaper Dermatitis. Erythematous Patches Sparing the Skinfolds
96.10. Erythematous Papules of Langerhans Cell Histiocytosis
96.11. Condylomata Lata, Flat-Topped Papules and Plaques, Occur in the Diaper Area
96.2. Erythematous Patches that Involve the Creases and Convexities are Characteristic
96.3. Salmon-Pink Patches with Greasy Scale Involve the Creases and Convexities
96.4. Flaccid Bullae that Rupture Easily Leaving Round, Crusted Erosions Occur
96.5. Folliculitis Often Involves the Buttocks
96.6. Intertrigo, Shown Here Involving the Neck, Produces Superficial Erosions in Areas
96.7. Jacquet Erosive Diaper Dermatitis. Well-Defined Shallow Ulcers and Ulcerated Nodules
96.8. Psoriasis in the Diaper Area Produces Erythematous Patches or Plaques
96.9. Acrodermatitis Enteropathica Causes Erythematous Patches in the Diaper Area and around
97.1. Ruptured Pustules on the Scalp of an Infant Who Has Eosinophilic Pustular Folliculitis
98.1. Erythematous Macules, Each with a Central Papule, are Typical of Erythema Toxicum
98.2. Erythematous Papules of Erythema Toxicum Located on the Knee
99.1. Tense Vesicles or Pustules on the Foot in Infantile Acropustulosis
Acute Drug/Toxic Reactions
105. Drug Hypersensitivity Syndrome
106. Erythema Multiforme (EM)
107. Exanthematous and Urticarial Drug Reactions
108. Fixed Drug Eruption
109. Serum Sickness-Like Reaction
110. Stevens-Johnson Syndrome (SJS) and Mycoplasma pneumoniae-Induced Rash and Mucositis (MIRM)
111. Toxic Epidermal Necrolysis (TEN)
112. Urticaria
Figure(s)
105.1. Drug Hypersensitivity Syndrome. This Patient Developed an Eruption of Erythematous Macules
105.2. Drug Hypersensitivity Syndrome. Therapy with Phenytoin
106.1. Erythema Multiforme
106.2. Erythema Multiforme. Target Lesions May Develop Central Bullae or Vesicles
107.1. This Erythematous Eruption of Macules and Papules Occurred after Amoxicillin/Clavulanic Acid
107.2. Exanthematous Drug Eruption
107.3. Urticarial Drug Eruption
108.1. Fixed Drug Eruption. This Single Lesion Occurred in Response to Sulfonamide Ingestion
108.2. Fixed Drug Eruption
109.1. Serum Sickness-Like Reaction. Urticarial Papules and Plaques with a Purple Hue
109.2. Serum Sickness-Like Reaction. Hand Swelling and Urticarial Plaques with a Purple Hue
109.3. Serum Sickness-Like Reaction. Purple Urticaria is Present on the Lower Extremity
110.1. Target Lesion in a Patient Who Has Stevens-Johnson Syndrome
110.2. Erythematous Erosions in a Patient Who Has Stevens-Johnson Syndrome
110.3. Extensive Ulceration of the Lips and Oral Mucosa are Observed in Stevens-Johnson Syndrome
110.4. Prominent Erosions of Nasal and Oral Mucosa in a Patient
110.5. Small Targetoid Bullae of the Dorsal Hands (A) and Dorsal Feet
111.1. In Toxic Epidermal Necrolysis, Flaccid Bullae Appear (Arrow) and Rapidly Rupture
111.2. Toxic Epidermal Necrolysis is Characterized by Shedding of Large Areas
112.1. Urticaria. Erythematous Wheals with Multiple Shapes, Including Papules and Incomplete Rings
112.2. This Child Who Has Urticaria Also Exhibits Angioedema, an Indistinct Swelling
Cutaneous Manifestations of Rheumatologic Diseases
113. Juvenile Dermatomyositis (JDM)
114. Morphea
115. Systemic Lupus Erythematosus (SLE)
Figure(s)
113.1. Heliotrope Rash and Telangiectatic Erythema of the Cheeks in a School-Aged
113.2. More Pronounced Erythematous to Violaceous Patches on the Face of This Child
113.3. Typical Gottron Papules (Erythematous to Violaceous, Flat-Topped Papules) Overlying the Knuckles
113.4. Numerous Gottron Papules in a 2-Year-Old Who Has Juvenile Dermatomyositis
113.5. Dilated Capillaries of the Nail Folds (Arrows) in a Patient
113.6. Calcinosis Cutis of the Fourth Finger as Well as Gottron Papules
114.1. Circumscribed (Plaque) Morphea
114.2. Linear Morphea Involving the Arm
114.3. Linear Morphea Involving the Face
114.4. En Coup De Sabre Form of Linear Morphea
114.5. In This Child with the En Coup De Sabre Form
114.6. This 5-Year-Old Had Extensive Morphea of the Lower Extremity, Resulting
114.7. Generalized Morphea
115.1. Lesions of Active Discoid Lupus Erythematosus on the Arm in Addition
115.2. Multiple Erythematous Papules and Plaques on the Face of a Boy
115.3. Atrophic Scarring Plaques on the Face of a Teenaged Girl
115.4. Palatal Ulcerations in This Young Adult Woman with Systemic Lupus Erythematosus
115.5. Large Edematous, Erythematous, Arcuate, and Annular Plaques on the Arms
115.6. Multiple Annular Plaques with Dusky Atrophic Centers on the Face
115.7. Young Infant with Widespread Erythematous, Slightly Atrophic Patches and Plaques Secondary
Nutritional Dermatoses
116. Acrodermatitis Enteropathica (AE)
117. Kwashiorkor
Figure(s)
116.1. Acrodermatitis Enteropathica. Erythema, Scaling, and Crusting on the Hand
116.2. Acrodermatitis Enteropathica
116.3. Erythema and Crusting in the Diaper Area of an Infant Who Has Acrodermatitis Enteropathica
116.4. The Patient Shown in Figure 116.2 Ten Days after Beginning Zinc Supplementation
117.1. Toddler Who Had Kwashiorkor and Zinc Deficiency
117.2. Sharply Marginated Patches with flaky Paint Scale are Present in the Patient
117.3. Scalp Involvement in Kwashiorkor with a Prominent Flaky Paint Appearance
Other Disorders
118. Erythema Nodosum
119. Henoch-Schönlein Purpura
120. Kawasaki Disease
121. Langerhans Cell Histiocytosis
122. Lichen Sclerosus et Atrophicus (LSA)
123. Polymorphous Light Eruption
124. Confluent and Reticulated Papillomatosis (CARP)
125. Hyperhidrosis
Figure(s)
118.1. A Tender Red Nodule on the Shin Characteristic of Erythema Nodosum
118.2. Two Tender Erythema Nodosum Nodules on the Shin with Less Pronounced Erythema
119.1. A Mixture of Urticarial, Violaceous, and Purpuric Plaques on the Legs
119.2. Lesions Became Progressively More Confluent and Purpuric in This Patient
119.3. In More Extensive Cases of Henoch-Schönlein Purpura, Lesions Can be Seen
119.4. Purpura Involving the Scrotum in a Patient with Henoch-Schönlein Purpura and Scrotal Pain
120.1. In Kawasaki Disease, Nonexudative Conjunctival Injection is Present, Often with Perilimbic
120.2. Kawasaki Disease. Hyperemia, Edema, and Fissuring of the Lips
120.3. Kawasaki Disease. Strawberry Tongue Was Present in This Boy with Severe
120.4. Kawasaki Disease. Erythematous Patches and Plaques with Foot Swelling
120.5. Perineal Accentuation in Kawasaki Disease
120.6. Kawasaki Disease. Peripheral Gangrene Involving the Fourth and Fifth Digits Occurred
121.1. Erythema and Scaling with Some Associated Hemorrhage in the Posterior Auricular
121.2. Erythema of the Inguinal Creases with Scattered Lichenoid, Hemorrhagic Papules
121.3. Eroded, Crusted Papules on the Lower Abdomen and Suprapubic Area
121.4. Langerhans Cell Histiocytosis. Hemorrhagic Papules and Erosions in the Inguinal Crease
121.5. Scaly and Hemorrhagic Papules on the Palm of This Child
122.1. Circumferential Hypopigmented Atrophic Patches in a Figure 8 Configuration Characteristic
122.2. Characteristic Shiny, Hypopigmented, Atrophic Plaques of the Vulvar Region with Associated
122.3. Balanitis Xerotica Obliterans
123.1. Polymorphous Light Eruption. Urticarial Papules and Plaques
123.2. Juvenile Spring Eruption
124.1. The Eruption of Confluent and Reticulate Papillomatosis is Confluent Centrally
124.2. Confluent and Reticulate Papillomatosis Often Affects the Upper Back
Front Matter
Dedication
Editors' Note
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