A 5-year-old girl is brought to the clinic with a 3-month history of worsening vision and behavioral problems in school. Her mother received no prenatal care and,repos that the girl was delivered without complications at home. As an infant, she had a “walike” perioral maculopapular rash and three or four recurrent right-sided ear infections. Physical examination reveals that the girl is in the 30th percentile for weight and the 35th percentile for height. Additional observations include findings that are notable for nummular keratitis, prominent notching of her upper two incisors and molars, and outward bowing of the tibia bilaterally. What is the most likely diagnosis?
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