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Dermatological hand signs are common and can be benign (with or without treatment implications), linked to a change in patient's behaviour or herald more severe systemic conditions (dermatomyositis). Despite the peculiarity of underlying diseases, their visual appearances may overlap and sometimes be deceptive. It is therefore important for clinicians to be aware of the possible similarities in such diverse conditions, in order to make a correct diagnosis and target treatment. ### Which would be the most likely diagnosis for each image based on the cases below: 1. Gottron's papules 2. Psoriasis 3. Cutaneous T-cell lymphoma 4. Chewing pads 5. Knuckle calluses 6. Herpetic lesions 7. Idiopathic/familial knuckle pads 8. Cold burns (frost bites) 9. Common warts 10. Occupational lesions We evaluated a 17-year-old girl with dark phototype with an upper respiratory tract infection. Physical examination incidentally revealed plaque lesions located only at the extensor surface of her right hand, at the proximal interphalangeal joints (IJ) (figure 1A). Left hand was unharmed. The rest of the examination, apart from the concomitant respiratory infection, was negative. The girl also reported a recent school change as a current stressor. Figure 1 (A) Self-induced ‘chewing pads’, (B) Gottron’s papules, …

Which would be the most likely diagnosis for each image based on the cases below: 1. Physiological breast enlargement 2. Subcutaneous fat necrosis 3. Neonatal mastitis 4. Breast abscess 5. Nipple capillary haemangioma 6. Naevus flammeus of the nipple 7. Port wine stain of the nipple 8. Nipple eczema 9. Pityriasis versicolor A 13-day-old term infant was evaluated for bilateral breast enlargement; no tenderness or discharge was evident (figure 1A). Figure 1 The rest of the physical examination and laboratory were unremarkable. The patient remained well and thriving at regular follow-up; the appearances had completely regressed by 6 weeks. A term female infant was admitted to hospital at 7 days of life for fever (body temperature 38.2°C) and a swollen right breast with erythematous periareolar skin (figure 1B). The patient was slightly miserable on evaluation; the rest of the physical examination was normal. A 1-month-old girl was evaluated for a left nipple lesion which had evolved over the previous 2 weeks: the mother described gradual development of sparse similar smaller lesions over the areolar region, which had coalesced (figure 1C). The remaining physical examination was normal and she had a normal newborn examination. A normal male term newborn was evaluated at 1 month of age for a right nipple lesion with reddish, desquamated areolar and …