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Handy paediatric dermatology
  1. Enrico Valerio1,
  2. Francesca Parata2,
  3. Mario Cutrone3
  1. 1Pediatric Intensive Care Unit, Ospedale San Bortolo, Vicenza, Italy
  2. 2Pediatrics Department, Ospedale Dell'Angelo, Mestre (Venice), Italy
  3. 3Pediatric Dermatology Unit, Ospedale Dell'Angelo, Mestre (Venice), Italy
  1. Correspondence to Dr Enrico Valerio, Pediatric Intensive Care Unit, Ospedale San Bortolo, Vicenza 35128, Italy;{at}

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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

Patient 1

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, …

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  • Contributors EV wrote the first draft of the manuscript; FP contributed to the critical revision of the manuscript; MC obtained the iconographic documentation and contributed to the critical revision of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Patient consent Obtained.