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Pediatric Dermatology

»	What is the most common skin disease seen in children?
»	Name the papulopustular facial eruption often associated with inappropriate topical steroid use.
»	At what age does atopic dermatitis typically begin?
»	What is the natural history of atopic dermatitis?
»	What organism commonly complicates irritant diaper dermatitis?
»	Red, scaly, itchy, weight-bearing skin surfaces of the feet in children are usually not due to tinea pedis, but to what?
»	Plant dermatitis, such as poison ivy, is the most prevalent cause of allergic contact dermatitis in children. What are some others?
»	One- to 2-mm keratotic papules located on the face, outer upper arms, and thighs are frequently misdiagnosed as folliculitis. What are they really?
»	What is the most common cutaneous bacterial infection in children?
»	What two organisms are most often responsible for tinea capitis?
»	How is tinea capitis treated?
»	What is the hypersensitivity reaction to tinea capitis that is commonly mistaken for a bacterial superinfection?
»	Name the three conditions most often misdiagnosed as tinea corporis.
»	What percentage of children with psoriasis will have guttate psoriasis?
»	Describe the rash associated with childhood dermatomyositis.
»	A child’s mother tells you that the rash started at one end of her child’s extremity and has now progressed to form a line the entire length of the limb. What is your diagnosis?
»	Name the most common sun-induced disease of childhood.
»	If it is not sunburn but a photosensitive eruption is suspected, what is it?
»	Name the mildly inflammatory tongue eruption with day-to-day changes in appearance.
»	Which disease should be considered in a child with easy blistering of the skin?
»	Two common nodules are seen in childhood. Name them.
»	Crusted purpuric papules and a scaly seborrheic-like eruption in the scalp and groin are seen in what serious disease of childhood?
»	Name the skin nodule in childhood that is characterized by frequent bleeding.
»	Flesh-colored to brown macules and papules that hive when stroked (Darier’s sign) are diagnostic of what eruption?
»	The onset of annular erythema in sun-exposed areas in children less than 6 months of age should make you want to do what test on the infant’s mother?
»	Which is the most common type of vasculitis seen in children?
»	What is a spider telangiectasia (nevus araneus)?
»	Outline the major classes of hair loss in children.
»	List the three most common types of acquired circumscribed hair loss in children.
»	What are the two most common causes of congenital circumscribed hair loss?
»	What should you think of in a 3-year-old who has never required a haircut?
»	What are the cutaneous findings seen in tuberous sclerosis complex?
»	How many café-au-lait macules must be present on a child to make you worry about neurofibromatosis type 1 (von Recklinghausen’s disease)?
»	What is a Mongolian spot (middermal melanocytosis)?
»	What are congenital pigmented nevi, and who cares?
»	Child abuse is often incorrectly suspected when a young girl presents with what disease?

What are congenital pigmented nevi, and who cares?

Fig. 58.9 Large blue-gray Mongolian spot of the sacral area and dark brown congenital nevus. (Courtesy of the William L. Weston, M.D. Collection.)

Congenital pigmented nevi (see Fig. 58-9) are developmental errors of pigment cells (melanocytes). They should be defined as small (<1.5 cm), medium (1.5 to 20 cm), and large (>20 cm) in their largest diameter at birth. Some authorities define large as covering >5% of the body surface. Small/medium congenital pigmented nevi are quite common (1/100), whereas large congenital pigmented nevi are rare (1/20,000). The controversy surrounding these lesions concerns their malignant potential. Lifetime risk for the development of melanoma in large congenital pigmented nevi is 1% to 2%.

Kinsler VA, Birley J, Atherton DJ: Great Ormond Street Hospital for Children Registry for Congenital Melanocytic Naevi: prospective study 1988–2007. Part 1— epidemiology, phenotype and outcomes, Br J Dermatol 160:143–150, 2009.