Lichen striatus. This is a common and benign self-limited childhood dermatosis that is easily diagnosed from its classic appearance. Onset is usually between the ages of 3 and 10 years, and it is rare in young infants, adolescents, and adults. The lesions consist of pink, flesh-colored, or slightly hypopigmented flat-topped papules that evolve in a linear array following lines of Blaschko. The linear course of the papules may eventually traverse the major part of an extremity. The area of involvement is often noted to become wider as it advances and may even include the nails.
Juvenile xanthogranuloma. This is a common and completely benign cutaneous nodule. Typically, a juvenile xanthogranuloma is firm and dome-shaped. At first, the lesion is reddish, but develops a fairly typical orangebrown hue over time. Most juvenile xanthogranulomas are located on the head or neck, as pictured in these two infants, but the lesions sometimes occur on the trunk or extremities. They may be present at birth, but most develop during the first year of life. Juvenile xanthogranuloma is not associated with abnormalities in serum cholesterol or triglycerides, and the individual lesions undergo spontaneous involution, usually over a period of 1–2 years. A diagnostic biopsy analysis is sometimes needed, but surgical intervention beyond this is certainly not required. Multiple juvenile xanthogranulomas on the skin may be accompanied by intraocular lesions. For this reason, the physician must pay careful attention to the examination of the eyes.
Granulomatous reaction caused by a bromide. Another baleful characteristic of drug eruptions from halides is persistence and extension of reaction once it occurs. The reason for such persistence or extension, even when a known source of the offending drug is removed, is the wide dispersion of occult iodine or bromine salts in foods, in the environment, and indeed in the body’s own chemistry. Iodine, for example, is a constituent of thyroid hormone.
Lyme disease is a bacterial infection transmitted by a tick Lyme disease was first recognized in 1975 after researchers investigated why unusually large numbers of children were being diagnosed with juvenile rheumatoid arthritis in Lyme, Connecticut and two neighboring towns.
Klippel-Trénaunay-Weber syndrome. This is a condition in which vascular malformations, varicosities, and phlebectasia cover an entire limb or other body area. There may be associated skeletal abnormalities including macrodactyly and syndactyly. A combination of port-wine stain and vascular malformations may be present from birth. The osteohypertrophy develops during the first several years of life.