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An otherwise 12 year old boy is concerned about his facial "acne”. His mom who appears frustrated using several OTC acne medication for the past three years says the lesions are worse and she is requesting you prescribe doxycycline. You note 3 mm, well demarcated domed papules with a reddish-brown color on the nose, cheeks and nasolabial folds. His lesions are most commonly associated with
a) Multiple endocrine neoplasia type 1
b) Neurofibromatosis
c) Incontinentia pigmenti
d) Androgen exposure
e) Rubeinstein taybi syndrome


source of question Your Intraining Pediatric Manual QBANK. Answer will be posted in 12 hours

d.

D

i guesss b

ddd

My bad, I see this one is too hard.. I will give you guys a clue. You all have 0%.. Now start guessing

A - doomed papules are angiofibromas???

If it's not answers B and D then C and E are not the right answers either. And what clue or hint can I get from the question that it's a multiple endocrine neoplasia? Too early age for beginning of the acne?Although acne in 9 yrs old boy is not usual ,I agree.

dd

Answer is a
Patient has angiofibroma a benign dermal tumor. They are most commonly associated with Tuberous sclerosis and Multiple endocrine neoplasia type 1. Neurofibromatosis may be associated with isolated angiofibromas but MEN-type 1 is more commonly associated. The patient doesn’t have acne. Note acne in quotes? Quotes on the exam usually imply or mean what the patient or caregiver thinks and not what the patient actually has.