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Old 06-13-2011
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Skin Three Dermatology Case Scenarios!

For each patient with a cutaneous lesion, select the most likely diagnosis.

Item 1 of 3

A 6-week-old boy is brought to the physician because his mother noticed a yellowish-colored lesion located on his scalp. He is otherwise well. Physical examination demonstrates a single, 2-cm yellow-orange oval lesion with well-defined borders and absent hair follicles.


Item 2 of 3

A 2-day-old newborn girl is seen by the physician, because of a skin lesion on the nuchal area of the neck. The lesion is 4-cm light-red macule with an irregular, marginally defined border.

Item 3 of 3

A 7-month-old girl is brought to the physician, because of a red nodular lesion on the lip. The lesion was first noticed shortly after birth, but appeared as a pale white macule. It has been rapidly increasing in size over the last 3 months and has transformed in color. She is otherwise well. Examination demonstrates a solitary 2-cm, bright red nodule with a well-defined border.

Answer Choices

A. Café-au-lait spots
B. Capillary hemangioma
C. Cutis marmorata
D. Erythema toxicum
E. Milia
F. Mongolian spots
G. Neonatal acne
H. Nevus sebaceus
I. Port-wine stain
J. Salmon patch
K. Sebaceous hyperplasia
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I'll guess..

1. Nevus sebaceous

2. Salmon patch

3. Capillary hemangioma??
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Old 06-13-2011
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Case-3 capilary hemangioma!

Three Dermatology Case Scenarios!-capillary-hemangioma.jpg
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second case - Salmon patch!

Salmon patch is the name given to a very common group of birthmarks seen in babies. The birthmarks are caused by expansions (dilations) in tiny blood vessels called capillaries. When a salmon patch occurs on the face, it is often called an angel kiss, and when it occurs on the back of the neck, it is known as a stork bite. These types of birthmarks are very common, and at least 7 in 10 infants will be born with one or more salmon patches.

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Sebaceous naevus-the first one!

A sebaceous nevus (also known as sebaceous nevus of Jadassohn) is a yellow-orange, waxy, pebbly lesion present on the face or scalp of some newborns. Hair follicles are not present within the lesion itself, but lesions on the scalp may be covered over by surrounding hair, so careful examination is important.

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Were the questions easy ?????
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Quote:
Originally Posted by miss patho View Post
was the q is easy ?????
Certainly not..i had to look it up in a book before replying
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thank you for the question

item 1..... sebaceous hyperplasia

item 2 ..... salmon patch

item 3...... capillary hemangioma
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i answered all the 3 items correctly in a single go without looking it up in the book.my exam is in 9 days.though i answered it on the basis of the scenario only but the images were something new for me,which i really appreciate.thanks to miss patho.everyone out there wish me luck.thanks
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1-Option H (Nevus sebaceus) is correct. This child has a nevus sebaceus. These are the most common epidermal nevus in the newborn infant and appear as yellow-orange or yellow-pink lesions on the scalp. They usually begin a flat macule, but as they age, they become velvety plaques. Owing to the increased incidence of neoplastic transformation within a nevus sebaceus, they are prophylactically removed before or during adolescence.

2- Option J (Salmon patch) is correct. This child has a salmon patch, also known as a nevus simplex or a “stork bite.” The incidence is anywhere from 30% to 70% of newborns, and lesions usually occur either on the nape of the neck, upper eyelid, or glabella. Most facial lesions fade by 12 months of age, but those located in the nuchal region persist into adulthood.

High-yield Hit 1
87. What are the most common birthmarks?
Salmon patches (vascular stains or nevi): These are faint, pink-red, macular patches composed of distended dermal capillaries and found on the glabella, eyelids, and the nape of the neck. Seen in 70% of white infants and 60% of black infants. Usually fade, but may persist indefinitely, becoming more prominent during crying.
Mongolian spots (dermal melanosis): These blue-black macules are found on the lumbosacral area and occasionally on shoulders and backs. Seen in 80-90% of oriental, black, and Native American babies but ≤10% of white infants. Most Mongolian spots fade by age 2 and disappear by age 10.


3-Option B (Capillary hemangioma) is correct. This patient has a capillary hemangioma, also known as a superficial hemangioma or a strawberry hemangioma. They commonly begin as macular lesions that rapidly grow to a bright-red (“strawberry”) nodule and spontaneously regress within the first few years of life.

High-yield Hit 1
Virtually any tumor may be encountered in children, but within this wide array hemangiomas, lymphangiomas, fibrous lesions, and teratomas deserve special mention. You will notice that most common neoplasms of childhood are so-called soft tissue tumors, with a mesenchymal derivation. This contrasts with adults, where the most common tumors, benign or malignant, have an epithelial origin. Benign tumors of various tissues are described in greater detail in appropriate chapters, but here a few comments are made about their special features in childhood.
Hemangioma. Hemangiomas are the most common tumors of infancy. Architecturally, they do not differ from those encountered in adults. Both cavernous and capillary hemangiomas may be encountered, although the latter are often more cellular than in adults, a feature that is deceptively worrisome. In children, most are located in the skin, particularly on the face and scalp, where they produce flat-to-elevated, irregular, red-blue masses; some of the flat, larger lesions (considered by some to represent vascular ectasias) are referred to as port-wine stains. Hemangiomas may enlarge along with the growth of the child, but in many instances they spontaneously regress. In addition to their cosmetic significance, they can represent one facet of the hereditary disorder von Hippel-Lindau disease. Rarely, vascular tumors, particularly those in the liver and soft tissues, become malignant.

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