Many rashes and skin lesions can be found first in the newborn period. For each of the descriptions listed below, select the most likely diagnosis. Each lettered option may be used once, more than once, or not at all. An adolescent boy complains of a splotchy red rash on the nape of his neck, discovered when he had his head shaved for football season.The rash seems to become more prominent with exercise or emotion. His mother notes that he has had the rash since infancy, but that it became invisible as hair grew. He had a similar rash on his eyelids that resolved in the newborn period.
Many rashes and skin lesions can be found first in the newborn period. For each of the descriptions listed below, select the most likely diagnosis. Each lettered option may be used once, more than once, or not at all. An adolescent boy complains of a splotchy red rash on the nape of his neck, discovered when he had his head shaved for football season.The rash seems to become more prominent with exercise or emotion. His mother notes that he has had the rash since infancy, but that it became invisible as hair grew. He had a similar rash on his eyelids that resolved in the newborn period.
💡 Explanation
**Core Concept**
The question is testing the student's knowledge of congenital skin lesions and their characteristics, particularly in the context of the neonatal period and early childhood. A salmon patch is a type of congenital vascular malformation that can be found on the face or nape of the neck.
**Why the Correct Answer is Right**
The description provided matches a salmon patch, which is a benign vascular lesion that appears as a splotchy red rash. It is often found on the eyelids, nose, or nape of the neck and is more noticeable when the infant is crying or after a warm bath. Salmon patches are thought to result from incomplete regression of fetal vascular channels. They typically resolve spontaneously within the first few months of life, but in some cases, they can persist into early childhood.
**Why Each Wrong Option is Incorrect**
**Option A:** Sebaceous nevus is a congenital skin lesion that presents as a yellowish or orange patch on the skin, often with a characteristic "flame-shaped" appearance. It is not typically associated with the nape of the neck or the eyelids.
**Option C:** Neonatal acne is a common skin condition that occurs in the first few weeks of life, characterized by comedones and papules. It is not typically associated with the nape of the neck or the eyelids.
**Option D:** Pustular melanosis is a benign skin condition that presents as small, dark spots on the skin, often on the face or neck. It is not typically associated with the nape of the neck or the eyelids.
**Clinical Pearl / High-Yield Fact**
A classic exam question like this one requires the student to recall the characteristics of common congenital skin lesions, including salmon patches, sebaceous nevi, neonatal acne, and pustular melanosis. The key to answering this question correctly is to match the description provided with the typical presentation of each condition.
**✓ Correct Answer: B. Salmon patch**
✓ Correct Answer: B. Salmon patch
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