A 9-year-old boy has a history of a seizure disorder and multiple white macules that first appeared in early infancy. A large, skin-colored, irregularly thickened plaque with an orange-peel or cobblestone texture has developed on the back in the lumbosacral area. Which is the most likely diagnosis?

Correct Answer: B

Rationale: Tuberous sclerosis presents with hypopigmented macules, seizures, and shagreen patches (thickened plaques).

Correct Answer: B

Rationale: Oral itraconazole is effective for tinea unguium (onychomycosis); topical treatments alone are less effective.

Correct Answer: D

Rationale: Pruritus (itching) is the hallmark symptom of pediculosis due to lice bites.

Correct Answer: A

Rationale: Osgood-Schlatter disease is managed with rest and activity modification.

Correct Answer: B

Rationale: Supination of the forearm reduces nursemaid's elbow; other options are unnecessary unless reduction fails.