ABD Pediatric Dermatology 2 — Questions and Answers
Question 1: A newborn presents with a solitary, firm, flesh-colored nodule that dimples when compressed laterally (Fitzpatrick sign). What is the most likely diagnosis?
- Dermatofibroma
- Juvenile xanthogranuloma (Correct answer)
- Spitz nevus
- Mastocytoma
Correct answer: Juvenile xanthogranuloma
Juvenile xanthogranuloma is a benign yellow-orange papulonodule of infancy, though the dimple sign classically describes dermatofibroma in older patients.
Question 2: A 6-year-old develops a solitary tan macule with a 'coast of Maine' irregular border. This finding is most associated with which condition?
- Neurofibromatosis type 1
- McCune-Albright syndrome (Correct answer)
- Tuberous sclerosis
- Legius syndrome
Correct answer: McCune-Albright syndrome
Large café-au-lait macules with irregular 'coast of Maine' borders are characteristic of McCune-Albright syndrome.
Question 3: An infant presents with a rapidly enlarging strawberry-red plaque on the face. Which complication warrants urgent systemic beta-blocker therapy?
- Cosmetic disfigurement only
- Periocular location threatening the visual axis (Correct answer)
- Slow spontaneous involution
- Isolated truncal location
Correct answer: Periocular location threatening the visual axis
Periocular infantile hemangiomas obstructing the visual axis risk amblyopia and require prompt propranolol treatment.
Question 4: A child with atopic dermatitis develops punched-out monomorphic vesicles and erosions over the eczematous areas with fever. What is the diagnosis?
- Impetigo
- Eczema herpeticum (Correct answer)
- Molluscum contagiosum
- Contact dermatitis
Correct answer: Eczema herpeticum
Eczema herpeticum is a disseminated HSV infection over eczematous skin requiring systemic acyclovir.
Question 5: A neonate has a linear array of vesicles along Blaschko's lines followed by verrucous streaks. This first-stage finding suggests which X-linked disorder?
- Incontinentia pigmenti (Correct answer)
- Epidermolysis bullosa
- Hypomelanosis of Ito
- Goltz syndrome
Correct answer: Incontinentia pigmenti
Incontinentia pigmenti presents with vesicular, verrucous, hyperpigmented, and atrophic stages along Blaschko's lines in females.
Question 6: A well-appearing 2-week-old has small yellow-white papules on the nose that resolve without treatment. What are these lesions?
- Milia (Correct answer)
- Erythema toxicum neonatorum
- Neonatal acne
- Sebaceous hyperplasia
Correct answer: Milia
Milia are tiny keratin-filled cysts common on the neonatal face that resolve spontaneously.
Question 7: A toddler presents with an annular scaly plaque with central clearing and a raised active border. KOH prep confirms hyphae. First-line treatment for tinea corporis in children is?
- Oral griseofulvin
- Topical terbinafine (Correct answer)
- Oral fluconazole
- Topical corticosteroid
Correct answer: Topical terbinafine
Localized tinea corporis in children is treated with a topical antifungal such as terbinafine.
ABD Pediatric Dermatology 2
A newborn presents with a solitary, firm, flesh-colored nodule that dimples when compressed laterally (Fitzpatrick sign).
What is the most likely diagnosis?