A nine year old male presents to your office for well child | Figure 1

DrCherilynCecchini

Pediatrics

A nine year old male presents to your office for well child check. Parents mention that he developed rash on his extremities and abdomen about two months ago. It causes some mild itchiness. He has otherwise been well. He does not take any medications. He is growing nicely and developmentally in target. You note that he has scaling plaques (pictured here). What is the most likely diagnosis?

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10 year old with a recent history of evaluation of a rash 10 days prior. Strep test was positive and patient was treated with Zithromax (PCN allergy). He arrives today with this rash which fades and reappears, is not affected by antihistamines, and spares the face, hands, and feet. It is non pruritic.

Male, 47 years old. He has an erythematous and scaly lesion on lumbar area for 1 year. He's a chronic alcoholic and homeless. What is the probable diagnosis and which are the differential diagnoses?

male 40s with no Hx of medical problems. He presented several weeks ago with rash to arms, hands and feet. Labs drawn which were all normal except blood sugar mildly elevated. He was treated with climdamycin, decadron in office. the rash to his feet has resolved.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?

A 20-years male presented with a history of high fever (up to 40,5°C) for 6 days, rigors, and 3 days of few (<15) skin changes, mostly on the trunk, which is ~0,5 cm diameter, erythematous, ovoid with clear edges and with barely visible desquamation. First 2 days of illness he has loose stools. He had no other complaints. GP prescribed him cefixime, which he took for 3 days but without benefit.

On exam, he was febrile (38°C), slightly fatigued, in good condition. Lab. results: Le 7600 (ne. 77.9%); CRP 106.2.

I presumed syphilis because such previous quick response to penicillin and because of rash, so I prescribed penicillin again.

Four days later, he reported that fever abated after 1st dose of penicillin and that he is feeling well. The rash started to fade and now appeared only as salmon colored macules.

After 10 days of therapy, he is doing well and skin changes disappeared. Heart murmur persisted. TPHA & VDRL came back negative.