ABSTRACT
This chapter presents the case study of a 9-year-old boy who attends the paediatric dermatology clinic. Both he and his parents are concerned about an accumulation of facial lesions over several months. His mother has tried several over-the-counter anti-acne remedies without apparent benefit. He is otherwise well, although in comparison with his siblings he has struggled at school; closer questioning suggests that he has problems academically as well as with his behaviour, although this has never been formally evaluated. He does not take medication. His family are all well, his parents are non-consanguineous. His neurological system is normal including fundoscopy, vision and hearing. He does appear to be easily frustrated and requires significant reassurance from his mother throughout the examination, avoiding eye contact and following only the instructions of his mother.
