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PHOTOCLINIC
Graves Disease
August 9, 2010
Henoch-Schönlein purpura with gastric wall thickening
August 9, 2010
Atopic dermatitis superinfection caused by Staphylococcus sciuri and Enterobacter asburiae
August 9, 2010
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A15-year-old girl was referred to a pediatric endocrinologist for evaluation of hyperthyroidism. Her primary concerns were intermittent increases in heart rate and appetite (with a weight gain of 7 kg within the past year), feeling hot at night even in winter, persistent lower extremity edema that had been present since age 4 years, and difficulty in concentrating. She denied having diarrhea, sweating, fatigue, breathing difficulties, hair loss, or changes in hair texture.
For 3 days, a 7-year-old girl had severe, generalized abdominal pain. The patient described the pain as sharp and achy without radiation; she denied any relieving or aggravating factors. She also reported decreased appetite and energy for the past week.
The rash on this 4-week-old girl had appeared 5 days earlier on her face as thickened scales on an erythematous base and subsequently spread to the scalp, shoulder, chest, abdomen, and extremities. A few bullae were noted on the neck and hands. Initial treatment with cephalexin failed to control the rash, and the infant was admitted to the hospital for further evaluation.
For the past several years, I’ve listed “difficult parents” on my department’s conference evaluation form as my answer to the question, “What do you consider to be the single biggest problem that you face in your practice?” At times, I have to admit that difficult parents have made me dread my decision to become a pediatrician. 
Thoughts of my summer vacation are on the back burner now as I prepare to welcome the incoming pediatric residents. July 1st has a special meaning to all of us who have survived the grind of an internship. Fear was probably my main emotion at the start of my residency, while I’m sure for others it was excitement and anticipation. On July 8, I have to give a talk to the newcomers at our institution.
I’ve just committed my family to a 5-day July vacation to Orlando so we can visit a new amusement park dedicated to Harry Potter. The famous series of books about the teenage wizard has really sparked the love of reading in many children, including mine. My kids are really excited about seeing Hogwarts come to life, but my husband is not so thrilled about being in the potentially sweltering heat of Florida in the middle of the summer. 
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