DIRECTIONS: Each of the numbered items or incomplete statements in this section is followed by answers or by completion of the statements. Select the one lettered answer or completion that is best in each case.

48. A 10-year-old girl presents with multiple pigmented macules on the vermilion border of her lower lip. The dark brown lesions are 2-5 mm in size and are arranged in a cluster. The patient's older brother has similar lesions. The patient complains of recurrent bouts of abdominal pain. Which of the following is the most likely diagnosis?

a. Gardner syndrome b. Herpes simplex virus infection c. Freckles d. Peutz-Jeghers syndrome e. Hand-foot-and-mouth disease

49. A 16-year-old student with a history of herpetic gingivostomatitis develops a generalized and symmetric rash. The lesions are 1-2 cm in diameter and look like round patches. They consist of two concentric rings surrounding a central disk. The rash is burning and pru-ritic. A few erosive lesions are visible in the oral mucosa. Which of the following is the most likely diagnosis?

a. Erythema multiforme b. Secondary syphilis c. Systemic lupus erythematosus d. Pemphigus vulgaris e. Urticaria

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