Image Challenge

May 08, 2025

A 6-month-old girl was brought to the emergency department with a 3-day history of redness and swelling of a toe. A physical examination is shown. Which of the following is the most likely underlying cause of the findings?

Allergic reaction

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Cellulitis

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11%

Hair tourniquet

68%

A diagnosis of hair tourniquet was made. This condition is characterized by a tightly wound hair or thread coiled around an appendage, most commonly a toe. The constriction may lead to pain, swelling, and ultimately ischemia. Treatment involves application of a chemical depilatory agent or manual removal of the hair for superficial cases, or surgery for deeper tourniquets.

Non-accidental trauma

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Insect bite

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10%

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