(BMJ)—This iodine stained, circular, and tender plaque covered with broken hairs and multiple pustules developed on the scalp of a 5-week-old baby over 10 days. The lesion had been unresponsive to mupirocin ointment. The family had no pets, but the baby’s grandmother reported scratching the baby’s scalp when bathing her two weeks previously. What's the dx?
seborrheic dermatitis
folliculitis
tinea capitis
impetigo
You are correct. Fungal culture of the baby’s hair grew Trichophyton rubrum and the diagnosis of tinea capitis was confirmed by DNA sequencing.

Tinea capitis is rare in newborns. Kerion is a severe form of tinea capitis caused by inflammatory reactions to dermatophyte scalp infections, often associated with zoophilic dermatophytes. Differential diagnoses include bacterial scalp abscess, bacterial folliculitis, seborrhoeic dermatitis, eczema, and psoriasis. Transmission can occur from pets as well as from humans. Although systemic antifungal agents are indicated, the baby’s parents preferred that she was treated with topical bifonazole and terbinafine, to good effect. Early identification and treatment can avoid complications, including permanent scarring and alopecia.

BMJ 2024;384:e077392
Can you identify this pill?
morphine sulfate
fenofibric acid
perphenazine
carbamazepine
You are correct. Carbamazepine is an anticonvulsant used to treat seizures in adults and children, as well as trigeminal neuralgia and bipolar disorder (off-label) in adults.

As a reminder, you can use the Pill ID feature to identify a pill based on its imprint code or physical characteristics, including shape, color, and scoring. Find Pill ID in the epocrates app or on epocrates Web.
[Source: Pill ID]
By rray, 29 January, 2024

CAT