Twin-to-twin “transfusion”. Twins who develop with some form of common circulation in utero may show a temporary difference of cutaneous color related to oddities of hemodynamics. In the figure, one sees twin neonates, of whom the one on the right is uniformly and abnormally erythematous, whereas the other is abnormally pallid. The one looks plethoric, the other, anemic. In the course of time, restoration of normal blood counts and color will develop in both.
The first sign of bedbugs may be red, itchy bites on the skin, usually on the arms or shoulders. Bedbugs tend to leave straight rows of bites, unlike some other insects that leave bites here and there.
Phytophotodermatitis. In addition to perfumes, a number of plants, grasses, fruits, and vegetables contain psoralen as a photosensitizer. The child who helps mother or father slice limes before a trip to the park may develop an identical eruption on the hands. Celery and parsley may present similar problems. It is important to recognize this entity since some affected infants and children have been mistakenly thought to have bruising from child abuse.
Vitiligo. These are more illustrations of fairly extensive cases of vitiligo. The condition tends to progress and may even become universal. A variety of treatment modalities are commonly employed, with varying degrees of success. The patient and family should be made aware of the sophisticated cover-up cosmetics that are now available. The use of broad-spectrum sunscreen lotions during the summer months minimizes the con- trast between normal and involved skin. For some patients, the application of topical corticosteroids alone or with brief natural sunlight exposure early in the course of the disease may induce repigmentation. Narrowband UUB is also an effective treatment. Varying combinations of topical or oral psoralens and ultraviolet A light (PUVA) are used in the treatment of vitiligo.