A. Call child protective services
B. Prescribe topical nystatin and hydrocortisol
C. Reassess on a follow-up visit
D. Reassure the mother that …show more content…
Mongolian spots (congenital dermal melanocytosis) is an asymptomatic macular, blue-gray rash commonly present at birth or appearing on the sacral region of infants within the first weeks of life. It results from entangled melanocytes in the dermis as they migrate from the neural crest to the epidermis. In most cases, it resolves spontaneously during the first four years of life.
Choice "A" is not the best answer. The possibility of child abuse should always be explored when lesions that resemble bruises are encountered. However, in this case, bruising is unlikely in view of a congenital onset, chronicity of the lesion and appearance.
Choice "B" is not the best answer. Diaper rash is a form of chemical contact dermatitis, which results from prolonged contact of the skin with wet diapers. This makes the skin more susceptible to physical, chemical and enzymatic damage, and also to superimposed fungal infections especially from Candida albicans. It often presents as a multiform erythematous rash in the diaper areas with papulovesicular and/or bullous