Purple-Blue NodulesA 7-year-old girl presented to the emergency department with a subjective fever, nonradiating right upper quadrant abdominal pain, dizziness, generalized headache, blurry vision, and photophobia of 6 days’ duration.
Thigh Pain and Swelling<p><img src="/sites/default/files/transfer/Untitled-48_0.jpg" style="margin-left: 8px; margin-right: 8px; float: left;" width="150" height="246">An 18-year-old boy presents with pain and swelling of his left thigh that developed suddenly 2 days earlier. He denies any recent trauma to the site, fevers, or weight loss.</p><p>On examination, an area of swelling is visible over the lower half of his left thigh. No erythema or other associated skin changes are noted. Distal pulses are palpable. The patient has full range of motion.</p>
Enlarged Toes<p><img src="/sites/default/files/transfer/Enlarged2and3toe.jpg" style="float: left; margin-left: 8px; margin-right: 8px; border: 1px solid black;" width="150" height="130">A male infant was born at term with enlarged, asymmetrical second and third toes on the right foot. Family history was noncontributory. The mother had received adequate prenatal care and had no complications during pregnancy or delivery. Radiographs of the foot demonstrated osseous overgrowth of the bones in the involved digits, with otherwise normal underlying bony structures.</p>
Congenital EpulisA full-term, vaginally-delivered 3164-g female newborn was noted to have a fleshy mass intermittently protruding from her mouth.
allergic reactionAfter mowing the lawn for the first time, a 12-year-old boy had severe pruritus all over his body, watery and puffy eyes, and a husky voice.
Agminated Spitz NeviThis 30-month-old boy was brought for evaluation of a cluster of 4 dark pink, firm, nonblanchable papules, ranging from 1 to 5 mm, near the right lateral canthus.
AutismThe recent article in Archives of Pediatrics & Adolescent Medicine by Shattuck and colleagues1 should act as a wake-up call to all policymakers about the use of resources for families with a disabled child.
Facial rashThis 11-year-old girl is concerned about the persistent redness and roughness of her cheeks, which she has had since age 7 years.
Lead toxicityA 3-year-old boy with a history of pica presented for a well-child checkup. He had missed numerous checkups, and his immunizations were delayed. His development was appropriate for age.
Melanonychia Striata and OnychomycosisCan fungal infections present with a brown band along the longitudinal axis of the nail similar to melanonychia striata but perhaps affect other digits?