Pediatric Board Review Quiz : Can you Identify the Rash : Part 2

This is classic for Psoriasis which is fair game for the Pediatric Board Certification exam, as well as the Pediatric MOCA series.

The important details to look for are as follow:

• Auspitz sign which is pinpoint bleeding when picked.
• Koebner reaction which are the appearance of new lesions at the site of trauma
• Well demarcated red thick plaques often with dry silvery scales

There is also a strong genetic basis with the description of a child with Scandanavian or Eastern European heritage being a tipoff. RElapsing disease and in the patient would be an important part of the history to note.

They might show pitted nails.

Bonus: Zebras can sometimes appear on the exam, and Guttate psoriasis is one such case. They could show small drop like scaley plaques on the trunk and extremeties. IF they add that the patient recently had a strep infection, you have your answer!