Dermis

Dermis involved primarily

Ring around the nevus

A healthy adolescent boy is dragged by his concerned mother to your office for evaluation of several moles with surrounding white rings (figure1) . She noticed the asymptomatic lesions on her son’s back several days ago following a trip to the beach. What's the diagnosis?

Fat lip in a teen

This 15-year boy complains that the left side of his lower lip has been swollen for 6 months. Although he has a history of Crohn’s disease, he has no bowel symptoms and is growing normally. What’s the diagnosis?

Loose lax kid

You are asked to evaluate a 9-year-old boy with a history of loose baggy scars resulting from wounds on his shins that took 2 months to heal following minor trauma. He is camera shy about his legs but demonstrates his rubbery skin (fig. 1) and double jointedness (fig. 2). What’s the diagnosis?

Peculiar pigmented patch

An 18-year- old girl complains of a peculiar brown patch on her right anterior thigh for 3 weeks. With bikini season around the corner she wants it gone! She does admit to leaning her laptop on her right thigh for a few hours each day. What's the diagnosis?

A one-sided story

An anxious father schedules an urgent office visit for his 5-year-old boy who has a total body red bumpy rash. It started on the left flank 3 weeks ago and is still most prominent in this area (fig. 1). The boy appears well and the rash is only minimally itchy. The father refuses to leave the office until you give him the answer. What’s the diagnosis?

Early recalcitrant persistent zits

You are asked to see a 9-year-old girl with a history of asymptomatic erythematous papules on her chin and cheeks (fig. 1). She has been compulsive about applying tretinoin 0.05% cream nightly and washing with benzoyl peroxide for 4 months, and she and her mother see no improvement. She is health, and growing and developing normally. What's the diagnosis

A Teen with Persistent Painful Papules and Plaques

Fearful frustrated parents deliver their ill appearing 17-year-old daughter to your office for evaluation of persistent painful papules and plaques associated with high fever, sore throat, and arthralgias (fig1, 2, 3). The eruption first appeared on the distal extremities 3 days ago and has now disseminated to the proximal extremities and trunk. She was sent home from the local emergency room yesterday with instructions to take plenty of fluids and ibuprofen.

Persistent congenital pigmented plaque

You are called to the newborn nursery to evaluate a healthy vigorous newborn with a large dark brown area on the back of the scalp and neck. The anxious first-time parents are tapping on the nursery window as you examine the child. What's the diagnosis