Rosh Pediatrics Practice Exam

What is the most likely diagnosis for a child with salmon-colored papules and a history of recent sore throat?

1. Atopic dermatitis

2. Pityriasis rosea

3. Psoriasis

4. Tinea corporis

The correct answer is: Pityriasis rosea

The presence of salmon-colored papules, especially following a recent sore throat, suggests a diagnosis of pityriasis rosea. This condition often starts with a herald patch, which is a larger initial lesion that resembles the subsequent smaller lesions, all typically exhibiting a distinct salmon or pink color. After initial symptoms, such as a sore throat, the rash usually develops within a few days or weeks. Pityriasis rosea is generally considered a self-limiting condition, often associated with viral infections, which is consistent with a recent history of upper respiratory tract symptoms like a sore throat. The typical distribution of the rash follows the lines of skin tension, often showing a "Christmas tree" pattern on the back. While atopic dermatitis is characterized by itchy, inflamed skin, it does not typically present with the distinct salmon-colored papules following an upper respiratory infection. Psoriasis is associated with silvery scales and often affects extensor surfaces, which does not align with the provided description. Tinea corporis, or ringworm, presents with annular lesions that are often scaly and may have a raised border, which again differs from the characteristics of pityriasis rosea. Thus, the features of the rash and the clinical history provided make pityri