Figure 1
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Prepared by...
Pimlak Charoenkwan, M.D. |
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Department of Pediatrics,
Chiang Mai University
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| of hill
tribe origin was brought to the pediatric department with a history of progressive
jaundice, draining ears and seborrheic dermatitis for 6 months. He was the sixth child of the family. There was no history of consanguinity and the rest of the family were healthy. He had been treated for chronic otitis media at a community hospital without improvement. On physical examination, he was below the third percentile for both weight and height. He had moderate jaundice. Numerous scaly erythematous papules were present at face, especially below hairline, anterior chest wall and upper two thirds of back. He also had hypertrophic, friable gingiva with signs of inflammation and contact bleeding. Both fingernails and toenails were thickened with hemorrhagic lesions in the nail plates and subungual hyperkeratosis. A few tiny pustules were observed in periungual region and under nail plates. Generalized lymphadenopathy and hepatosplenomegaly were noted. The cardiovascular and respiratory systems were normal. The neurological examination was normal. Skin, gum and nail lesions are shown as figure 1-4. |
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Figure 1 |
Figure 2 |
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| Figure 3 | Figure 4 |
| 1. What is your diagnosis? |
| 2. What should be done for further investigations? |
