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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?

See the spots

During a sports physical you note a localized area of brown spots on the right side of the abdomen and right leg of a healthy 14-year-old girl. Her mother tells you that this has been present since birth. Although you clear her for sports activities, you consider the implications of the pigmented lesions. What’s the diagnosis?

Hold your tongue!

A healthy 11-year-old girl complained of a lump on her tongue for 3 weeks. It felt funny when she was eating or talking but did not interfere with swallowing. Although it seemed to be growing for the first 2 weeks, it was unchanged for the last week. (Fig. 1) What's the diagnosis?

More than ugg(ly) feet

A 6-year-old girl with peeling soles is your first urgent patient of the day (fig 1). Although the peeling is not usually symptomatic, her feet become cracked, fissured, tender, and occasionally infected during the middle of the winter and summer when the eruption is at the worst. She is in the midst of her summer flare, when she can only wear her soft loose-fitting Uggs, and her mother won’t leave the office until you have the answer! What's he 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.

Flea-bitten baby

You are called to the emergency room to calm a panicked mother with a healthy 9-day old baby who awoke this morning with disseminated pustules (figures 1-3). What’s the diagnosis?

A red scaly baby

A frantic mother brings her 6-week-old daughter to you for evaluation of a generalized scaly eruption which has blossomed over the last 10 days (Fig.1, 2). The baby is thriving and asymptomatic, and the skin lesions have defied therapy with topical antibiotics, topical antifungals, and emollients. What's the diagnosis?