Pediatric Dermatology Clinical Vignettes

Listen to the podcast for why each multiple choice answer is right or wrong!

#1 A 2 year old boy presents with a 3 day history of rhinorrhea, conjunctivitis, barky cough, and a fever of 102 degrees. On physical examination you appreciate cervical lymphadenopathy, an erythematous throat most likely from the cough, and while you’re inspecting the mouth, you see a number of 1-3 mm white and gray elevations in the back of the cheek. Otherwise he has normal heart and breath sounds. This presentation is most consistent with:

A. Roseola

B. Rubeola

C. Rubella

D. streptococcal pharyngitis

#2 A 5 year old boy presents with a 2 day history of fever and runny nose. His father states that he woke up this morning with rosy cheeks, and sure enough he’s sitting on your exam table with rosy cheeks. Physical exam reveals a light reticular rash over the extensor surfaces. Which of the following is the most likely diagnosis?

A. Scarlet fever

B. Erythema infectiosum

C. Varicella

D. Epstein-Barr virus

#3 A 6-year-old boy presents with a fever for the past week. His mother states that over the course of the week, he has been getting worse. You take a look at the boy and doesn’t look very good. He has a 38.5C fever, bilateral conjunctival injection, a macular, erythematous rash on his abdomen and arms and a beefy red tongue. Which of the following is the most likely diagnosis?

A Herpes simplex 1

B Hand Foot and Mouth disease

C Tinea capitis

D Kawasaki disease

Answers

#1 B. Rubeola

#2 B. Erythema infectiosum

#3 D. Kawasaki disease

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