Children's Doctor Online
In this Issue
Dermatology
Welcome. The Children’s Hospital of Philadelphia’s newsletter for pediatricians now has an online home. You’ll find everything you enjoy about the printed version of Children’s Doctor, plus expanded content and, as our site grows, even more features. Please drop by for a “consult” with us regularly!
Make the Diagnosis
Our most popular Children’s Doctor feature
The parents of a 9-year-old shy, socially awkward but historically healthy girl are concerned about recent changes in behavior. For the past 3 months, the child has become increasingly distressed regarding school. She is an excellent student, but now worries about her homework being “perfect” and spends hours erasing and rewriting assignments, often until midnight. Her teachers have noticed that she is having difficulty completing classroom assignments, and cries when there are slight changes in classroom schedules or activities.
The parents also report that their daughter has increased concerns about cleanliness, which include showering up to 6 times per day and washing her hands so often that they are cracked and bleeding. When they interrupt these activities she cries and tantrums for up to an hour, and she is unresponsive to their reassurance. Her parents brought her to the emergency department because she had been crying for hours and saying that she was afraid that she might die if she could not rewrite her homework before falling asleep.
What is the most likely diagnosis?
Congratulations to Leon B. Mesina, MD, of Old Bridge, NJ, who sent in the first correct answer to last issue’s challenge. The correct diagnosis was Kawasaki disease, the topic of the first article in this issue.