Thrush is an infection of the mouth caused by the candida fungus, also known as yeast. Candida infection is not limited to the mouth; it can occur in other parts of the body as well, causing diaper rash in infants or vaginal yeast infections in women.
Dermatofibroma. These are benign dermal nodules that represent a focal proliferation of fibroblasts; the overlying epidermis is slightly thickened. Their occurrence is not unusual in children and adolescents. Dermatofibromas are firm and may be black, red, brown, or flesh-colored. Their diameter generally ranges from 0.5 to l.5 cm, although they may occasionally be larger. Dermatofibromas may be solitary or multiple, and they develop either spontaneously or after minor trauma to the skin, such as an insect bite. Most are asymptomatic but sometimes may be painful on palpation. A very useful diagnostic maneuver is executed by exerting lateral pressure on the lesion. The skin overlying a dermatofibroma will frequently dimple. Dermatofibromas require surgical treatment only when they are of cosmetic concern to the patient. However, biopsy analysis is occasionally required in order to confirm the diagnosis and to differentiate it from more serious disorders.
Drug eruptions (dermatitis medicamentosa). Diagnosing drug eruptions has become a common experience to practitioners in all branches of modern medicine. The profusion of drugs now available, the continuous influx of new drugs, and the capability of drugs to cause actions different from or in addition to their pharmacologically desirable actions make adverse cutaneous reactions an inevitable fact of modern medical practice. The kinds of cutaneous reactions are varied. Exanthems (erythematous, morbilliform or maculopapular), urticaria, fixed drug eruptions, and erythema multiforme are the most common. Figure 18-1 is an urticarial reaction from Augmentin and Fig. 18-2 shows a morbilliform eruption from ampicillin. Constitutional symptoms of low-grade fever and malaise may be associated with such drug eruptions. Morbilliform eruptions from ampicillin are more frequently seen in children with infectious mononucleosis.
Fordyce’s condition. The face abounds in sebaceous glands. Normally their distribution stops sharply at the junction of the skin and vermilion of the lips. Commonly, however, ectopic sebaceous glands are found within the lips under the vermilion and sometimes within the oral mucosa of the lips and even in the buccal mucosa. The condition is harmless and may have been present long before the patient or parents became aware of it. No treatment is required or available.
Erythema toxicum neonatorum. This very common and completely benign condition usually arises in the first 2 days of life. It is seen in about half of healthy newborns and occurs less frequently in preterm infants. The lesions are erythematous macules, within which papules and pustules may develop. The trunk is the most common site, but all other body surfaces, except for the palms and soles, may be involved. Occasionally, these lesions may occur in plaques. The eruption shown in Fig. 1-1 began 2 hours after delivery and involved the face and trunk.