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Now I Need to Select an Antidepressant...and Tailor the Regimen

In medical school, many of us were taught that ADD and ADHD generally affected boys who would eventually outgrow the disorder. We now know better. Girls have ADD/ADHD. And many children never outgrow the disorder. 

Dr . . . Can You Give Me Adderall for My ADD?


These 2 patients presented with a swollen hand and rapidly proximally progressive edema secondary to a bite.

These 2 patients presented with a swollen hand and rapidly proximally progressive edema secondary to a bite. What creature did the biting?

Swollen Hands-What’s Biting?

A 76-year-old woman seeks your attention for an asymptomatic “red spot” on her neck. She has a history of multiple non-melanoma skin cancers.

Squamous cell carcinoma in situ (Bowen  disease)

Lichenoid keratosis (an inflammatory variant of seborrheic keratosis)

A 76-year-old woman seeks your attention for an asymptomatic “red spot” on her neck. What does this look like to you?

Clinical Topics

What's This "Red Spot"?

A 27-year-old woman intermittently experiences painful oral lesions such as this one on her upper lip. She denies a history of genital lesions or ophthalmologic problems and is otherwise in superb health.

A 27-year-old woman intermittently experiences painful oral lesions such as this one on her upper lip. Your impression?

Oral Lesions

A 9-year-old boy presented with a 1-week history of pruritus and rash on his elbows, knees, back, and legs. Several areas of excoriation were noted. He had recently run through a field of tall grass but denied any other exposure history.

A 9-year-old boy presented with a 1-week history of pruritus and rash on his elbows, knees, back, and legs. He had recently run through a field of tall grass but denied any other exposure history. Your Dx?

What Cause of This Itchy Rash?


This intensely itchy, blistering rash on the forearms and upper chest of a 13-year-old girl occurred after a day at the beach. The girl had polymorphic light eruption (PMLE), the most common abnormal reaction to UV light.

A. PMLE classically presents as a papular or papulovesicular eruption on the arms and anterior chest

B. The reaction usually begins 12 to 24 hours after an initial exposure to light of a suddenly increased intensity

C. Some parts of the body are severely involved while similarly exposed areas are paradoxically spared

D. The rash resolves after 7 to 10 days, often leaving whitish scarring

What are the characteristics of this blistering rash caused by exposure to UV light? 

Intensely Pruritic Rash After Sun Exposure in a Tween Girl 

The mother of a 10-year-old boy brings him in for evaluation of his moles (which are all benign). During the visit, the mother asks about the lesions on the first 2 knuckles of his right hand; she initially noticed them several months earlier. The boy is otherwise healthy.

White Knuckles

Sidney Weissman, MD

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