ASPD Quiz Case 14

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ASPD Quiz Case 14

This 15- month old Indonesian boy, born to healthy non- consanguineous parents at 36 weeks’ gestation via normal vaginal delivery, presents with progressive rashes affecting his scalp, face, trunk and extremities for the past 6 months. The rashes are slightly pruritic. In the last 2 months, he also had persistent white plaques in his oral cavity. On examination, he is afebrile and weighs 8.6kg (10th centile). He is irritable but consolable. The rashes as depicted in the figures.

1. What is the most likely diagnosis? *

1 point

Infected Scabies

Seborrheic Dermatitis

Eczema Herpeticum

Langerhans Cell Histiocytosis

Disseminated Candidiasis

2. What investigations would you perform in this child to confirm the diagnosis? *

1 point

Skin Scrape for Scabies

Skin Scrape for Fungal Microscopy and Culture

Skin Scrape for Herpes Simplex Virus PCR

Watchful Observation and No Further Investigations are Required

Punch Biopsy of Affected Skin for Histology

3. What is the classical triad for multifocal disease? *

1 point

Disseminated Lymphadenopathy, Vesiculopustular Lesions and Hepatomegaly

Skull Lesions, Diabetes Insipidus and Exophthalmos

Skull Lesions, Hepatomegaly and Disseminated Lymphadenopathy

Pancytopenia, Diabetes Insipidus, Vesiculopustular Lesions

Pancytopenia, Skull Lesions, Hepatomegaly

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