14-Month-Old With Multiple Dome-Shaped Yellow Papulonodules

Poll

A previously healthy 14-month-old girl presents for evaluation following the gradual appearance and persistence of multiple 4- to 15-mm dome-shaped yellow papulonodules on the scalp, face, and upper trunk. Skin biopsy reveals that the lesions are composed primarily of lipid-laden histiocytes, with scattered Touton-type giant cells and small admixtures of eosinophils and lymphocytes. Predominant cells stained strongly with factor XIIIa immunostain, but did not stain with S-100. The remainder of the physical examination was normal. Specifically, neither organomegaly nor lymphadenopathy were clinically detected.

Which test is most urgent in this situation? Pick the best choice.

A. Battery of liver function tests
B. Chest radiograph
C. Complete blood count
D. Electrocardiogram