Treating the "Outsides" of the Inpatient: Pediatric Consults for the General Dermatologist

Cheryl Bayard, a pediatric dermatologist, presented multiple complex inpatient cases that illustrate the collaboration among various specialties for optimal patient care. One significant case involved a 20-month-old male from Guatemala with a large, friable mass in the perineal area, leading to various diagnoses, including HPV-related issues. The child, who was malnourished and showed signs of anemia, required a multidisciplinary approach involving surgery, immunology, and systemic therapies such as acetretin and bevacizumab. This case emphasized the importance of nutritional support in immune function. Another case featured a young girl with muscle weakness and a rash, leading to a diagnosis of juvenile dermatomyositis, successfully treated with immunosuppressive therapies. Lastly, an 18-year-old female was presented with systemic lupus erythematosus (SLE) and severe lymphadenopathy impacting her neurological functions that initially raised concerns about lymphoma. Her case highlighted the complexities of SLE and the potential for negative ANA results despite clear clinical manifestations. Bayard's experiences underscored the critical role of thorough examinations and the need for clear communication across teams, as photographs alone may miss vital diagnostic details.