Handy paediatric dermatology

Abstract

Dermatological hand signs are common and can be benign (with or without treatment implications), linked to a change in patient's behaviour or herald more severe systemic conditions (dermatomyositis). Despite the peculiarity of underlying diseases, their visual appearances may overlap and sometimes be deceptive. It is therefore important for clinicians to be aware of the possible similarities in such diverse conditions, in order to make a correct diagnosis and target treatment. ### Which would be the most likely diagnosis for each image based on the cases below: 1. Gottron's papules 2. Psoriasis 3. Cutaneous T-cell lymphoma 4. Chewing pads 5. Knuckle calluses 6. Herpetic lesions 7. Idiopathic/familial knuckle pads 8. Cold burns (frost bites) 9. Common warts 10. Occupational lesions We evaluated a 17-year-old girl with dark phototype with an upper respiratory tract infection. Physical examination incidentally revealed plaque lesions located only at the extensor surface of her right hand, at the proximal interphalangeal joints (IJ) (figure 1A). Left hand was unharmed. The rest of the examination, apart from the concomitant respiratory infection, was negative. The girl also reported a recent school change as a current stressor. Figure 1 (A) Self-induced ‘chewing pads’, (B) Gottron’s papules, …