Pediatric Dermatology

A 4-month-old has greasy yellow scale on the scalp without pruritus; erythema in the eyebrows and postauricular folds. First-line management?

A 6-month-old infant has an annular erythematous rash with “satellite” papules in the diaper area involving skin folds. Best treatment?

A 7-year-old with atopic dermatitis develops painful, punched-out erosions and fever after a cold sore exposure. Best next step?

A 3-year-old with bright red, sharply demarcated perianal erythema and pain with defecation; rapid strep test positive. Therapy?

A 2-day-old newborn has scattered erythematous macules with central pustules on trunk; Wright smear shows eosinophils. Diagnosis?

A 10-year-old with intensely pruritic papules and burrows on wrists, finger webs, and ankles; siblings itchy. In children, which site commonly involved that differs from adults?

A 5-year-old boy has a boggy tender scalp plaque with pustules and lymphadenopathy; KOH shows hyphae. Best management?

A 9-year-old girl with round smooth patches of hair loss, exclamation-point hairs, and nail pitting. First-line for limited disease?

A 6-year-old with dry, itchy flexural dermatitis and Dennie–Morgan folds. Which non-pharmacologic measure is most important?

A 2-month-old with scattered pustules on cheeks/forehead; otherwise well. KOH negative. Diagnosis and therapy?

A 7-year-old presents with multiple dome-shaped, umbilicated papules on trunk and flexures; mild eczema around lesions. Best management?

A 3-year-old with café-au-lait macules (≥6 >5 mm), axillary freckling, and a family history of similar findings. Next step?

A 1-month-old with a bright red rapidly growing plaque on the lower lip causing ulceration and poor feeding. Best first-line systemic therapy?

A segmental facial infantile hemangioma in the V1 distribution is noted in a 6-week-old. What associated workup is important?

A newborn girl has linear vesicles and bullae on the limbs following Blaschko lines; over weeks they evolve to verrucous and then hyperpigmented streaks. Likely diagnosis?

A 12-year-old with recent viral illness develops symmetric papular eruption on cheeks, extensor arms, and buttocks; pruritus mild; well otherwise. Diagnosis?

A 14-year-old with an oval herald patch on trunk followed by a “Christmas-tree” eruption of scaly oval plaques along cleavage lines. Best management?

A 2-year-old with annular hypopigmented patches on face with fine scale; atopic background. Diagnosis/first-line?

A 5-year-old with erythematous rough follicular papules on lateral arms and cheeks; worse in winter. Diagnosis/therapy?

A 7-year-old has annular erythematous plaque with central clearing on thigh; KOH positive for hyphae. Best therapy?

A 9-year-old boy has painful rapidly bleeding red papule on lip after minor trauma; histology shows lobular capillary proliferation. Management?

A 13-year-old with numerous flat-topped papules on the dorsum of hands and face; “koebnerization.” Best first-line therapy?

A 2-week-old newborn with collodion membrane at birth; now generalized fine scaling, ectropion and eclabium improving. Most likely diagnosis?

A 10-year-old with thick adherent dark scales on neck and trunk since infancy; history of prolonged labor; mother had infertility. Most likely type?

A 5-year-old with multiple tan macules that increase after sun exposure; smooth borders; fewer than six. Management?

A 4-year-old boy with flesh-colored papules clustered around the mouth and nose after prolonged topical steroid use for eczema. Diagnosis/therapy?

A 6-year-old develops annular bands of hypopigmented papules along Blaschko lines on one limb; resolves in months. Diagnosis?

A 3-year-old with annular erythematous plaques on the face and scalp; mother has Sjögren syndrome. Infant has bradycardia. Likely diagnosis?

A 12-year-old with photosensitivity, lilac eyelid discoloration, and scaly erythematous plaques over MCP/PIP joints. Which lab/imaging is important?

A 2-day-old African-descent neonate has vesiculopustules that rupture leaving hyperpigmented macules with collarettes of scale; neutrophils on smear. Diagnosis?

A 9-year-old with port-wine stain on forehead/upper eyelid (V1). What screening is recommended?

A 6-year-old with unilateral limb overgrowth, capillary malformation, and varicosities since infancy. Most likely syndrome?

A 7-year-old with scattered hypopigmented macules (“ash leaf”) visible under Wood lamp; later develops facial angiofibromas. Next step?

A 4-year-old with multiple yellow-orange papules/nodules; one on the iris; NF1 also present. Important risk to discuss?

A 1-day-old with a 2-cm ulcerated membranous defect on the scalp vertex with a hair collar sign. Diagnosis/next step?

A 13-year-old with annular urticaria-like lesions, facial edema, and acral swelling after viral illness; well-appearing and afebrile. Diagnosis?

A 15-year-old with deep inflammatory nodulocystic acne, scarring, and failure of oral antibiotics. Best definitive therapy?

A 5-year-old with widespread dry scale since infancy, keratosis pilaris, hyperlinear palms, and family history. Most likely?

A 12-year-old girl with tender, blue-red papules on fingers after cold exposure; otherwise healthy. Diagnosis/management?

A 2-year-old with multiple small infantile hemangiomas on skin (>5). What screening is recommended?

A 10-month-old has bright red rash on convex surfaces of the diaper area with sparing of inguinal folds; no satellites. Best initial therapy?

A 7-month-old has inflammatory papules/pustules and comedones on cheeks without systemic signs. Diagnosis/management?

A 2-year-old with widespread moderate atopic dermatitis refractory to emollients. Best next step to quickly calm flares?

A 3-year-old with periorbital/facial atopic dermatitis where parents fear steroids. Safe effective option?

A newborn with a 12-cm bathing-trunk congenital melanocytic nevus and multiple satellites. Next key evaluation?

A 6-year-old with a small (<1.5 cm) congenital melanocytic nevus on arm; parents ask about melanoma risk. Counseling?

A 9-year-old has a symmetric pink papule that grew rapidly for months then stabilized; dermoscopy shows starburst pattern. Likely diagnosis/step?

A 12-year-old with depigmented patch surrounding a pre-existing nevus; exam otherwise normal. Best approach?

A toddler with lumbosacral segmental infantile hemangioma and intermittent stridor. Concern and step?

A 3-month-old with large facial segmental hemangioma (V1–V3). Before starting propranolol, what evaluation is critical?

A 6-year-old girl has erythematous plaques in the diaper area involving the folds with no satellites; family history of psoriasis. Likely diagnosis/therapy?

A 4-year-old presents with honey-colored crusts around nostrils; limited area, afebrile. Best treatment?

A 7-year-old after streptococcal pharyngitis develops sudden scaly papules/plaques on trunk/extremities (“raindrop” pattern). First-line?

A 13-year-old with hypopigmented macules on chest/back, fine scale; KOH shows hyphae/spores. Best therapy?

A 5-year-old with intensely pruritic papules in summer on exposed areas; siblings unaffected; flea infested pet at home. Diagnosis/step?

A 2-month-old has clear vesicles/papules on neck/back after overheating. Diagnosis/management?

A 14-year-old athlete with malodorous sweaty feet develops shallow crater-like pits on weight-bearing soles. Treatment?

A 9-year-old presents with grouped vesicles on hands/feet and painful oral ulcers during a daycare outbreak. Best management?

A school-age child with multiple eyelid molluscum develops chronic unilateral conjunctivitis. Best step?

A 6-year-old with focal scaly annular facial plaque after new kitten exposure; KOH positive. Best systemic option?

A 4-year-old with suspected scabies; infant sibling is 6 weeks old. Safe regimen for the infant?

A 10-year-old with segmental vitiligo on the face. Evidence-based local therapy?

A 12-year-old with nonsegmental vitiligo asks about labs. Appropriate screening?

A 7-year-old with multiple asymptomatic flesh-colored papules on trunk/extremities; biopsy shows CD1a+, S100+ cells with kidney-shaped nuclei. Concern?

A 5-year-old with annular dermal papules on dorsal hands/feet; asymptomatic; KOH negative. Best plan?

A 13-year-old develops targetoid lesions and oral erosions after starting lamotrigine. Next step?

A 2-year-old with periorificial erosive dermatitis, alopecia, and chronic diarrhea after weaning. Best test/therapy?

A 6-month-old with generalized flushing/urtication when rubbed; multiple tan macules that wheal (Darier sign+). Best counseling?

A 4-year-old with widespread erythema and flaccid bullae; mucosa spared; positive Nikolsky; appears toxic. Best management?

A 15-year-old male with sudden explosive nodulocystic acne, fever, arthralgias. Best initial regimen?

A 6-year-old with multiple warts around nails; parents want at-home therapy. Most evidence-based?

A school-aged child with head lice after sleepover. Best first-line and contact advice?

A 9-year-old with large ulcerated infantile hemangioma on diaper area with pain. Best systemic therapy?

A 7-year-old with linear, firm, bound-down plaque on the limb and decreased range of motion; MRI shows fascial involvement. Best systemic therapy?

A neonate with slate-gray patches over lumbosacral area; parents worry about bruising. Diagnosis and counseling?

A 13-year-old swimmer with itchy macerated toe webs and moccasin-type plantar scale. Best treatment?

A 12-year-old with widespread atopic dermatitis and recurrent bacterial superinfection. Useful adjunctive measure?

A 10-year-old boy with faint reticulated erythema on legs after sitting near a space heater. Diagnosis?

A 6-year-old with numerous yellow-orange papules on trunk/extremities; one on iris. What eye risk and management?

A 15-month-old with varicella exposure; unimmunized. Best post-exposure prophylaxis?