Pediatric Dermatology via MedWorm.com

Allopurinol-Induced DRESS Syndrome in an Adolescent Patient

Pediatric Dermatology — Sun, 04 Oct 2009 23:00:00 +0100

Abstract: A 16-year-old male patient, with a history of essential hypertension enrolled in an experimental drug protocol using allopurinol, presented to our emergency department with a 10-day history of fever. Initial laboratory evaluation revealed leukocytosis, eosinophilia, and transaminitis. After extensive work-up and exclusion of infectious and oncologic etiologies, the diagnosis of allopurinol-induced drug reaction and eosinophilia with systemic symptoms syndrome was carried out. The patient responded to administration of IV methylprednisolone, with complete resolution of symptoms and improvement of laboratory abnormalities. This case represents the first report of allopurinol-induced drug reaction and eosinophilia with systemic symptoms syndrome in a pediatric patient. (Source: Pedi...

Infant Skin Microstructure Assessed In Vivo Differs from Adult Skin in Organization and at the Cellular Level

Pediatric Dermatology — Sat, 03 Oct 2009 23:00:00 +0100

Abstract: Functional differences between infant and adult skin may be attributed to putative differences in skin microstructure. The purpose of this study was to examine infant skin microstructure in vivo and to compare it with that of adult skin. The lower thigh area of 20 healthy mothers (ages 25[ndash]43) and their biological children (ages 3[ndash]24 months) was examined using in vivo noninvasive methods including fluorescence spectroscopy, video microscopy, and confocal laser scanning microscopy. Stratum corneum and supra-papillary epidermal thickness as well as cell size in the granular layer were assessed from the confocal images. Adhesive tapes were used to remove corneocytes from the outer-most layer of stratum corneum and their size was computed using image analysis. Surface feat...

Comparative Study on the Efficacy, Safety, and Acceptability of Imiquimod 5% Cream versus Cryotherapy for Molluscum Contagiosum in Children

Pediatric Dermatology — Sat, 03 Oct 2009 23:00:00 +0100

Abstract: To compare the efficacy, safety and acceptability of imiquimod (IMQ) 5% cream with cryotherapy for the treatment of molluscum contagiosum (MC) in children. Prospective, randomized, comparative, observer blinded study. A total of 74 children, with MC were divided randomly to receive treatment with either IMQ 5% cream (group A) 5 days a week or cryotherapy (group B) once a week until clinical cure or up to a maximum of 16 weeks. All the patients were followed up weekly during active treatment. The patients were followed-up for 6 months after clinical cure to look for recurrence. In the IMQ group (group A), the overall complete cure rate was 91.8% (34 of 37), 22 of the 37 patients cleared by the end of 6 weeks and 12 more patients cleared by the end of 12 weeks, while the remaining ...

Childhood Vitiligo: A Long-term Study of Localized Vitiligo Treated by Noncultured Cellular Grafting

Pediatric Dermatology — Sat, 03 Oct 2009 23:00:00 +0100

Abstract: Segmental type was the second most commonly reported in childhood vitiligo. No significant difference has been reported in the prevalence of childhood and adult focal vitiligo. However, the prevalence of segmental vitiligo has been found to be higher in children compared with that in adults. All available medical and phototherapy options are limited by adverse effects or unsatisfactory efficacy. Surgical techniques may be preferred but are not recommended for children as they are time consuming and associated with technical difficulties. In a retrospective review, 25 children aged 4 to 16 years were treated by autologous, noncultured cellular grafting performed under sedation supplemented with local anaesthesia and were followed up for a period of 9 to 54 months postgrafting. Rep...

Steroid-induced Periorificial Dermatitis in Children—Clinical Features and Response to Azelaic Acid

Pediatric Dermatology — Sat, 03 Oct 2009 23:00:00 +0100

This study elaborates the clinical features of periorificial dermatitis in children as well as possible pathogenetic factors and the response to 20% azelaic acid cream. A total of 10 children aged 3 to 12 (mean 7.7) years suffering from nongranulomatous periorificial dermatitis for 3 to 7 (mean 4.9) months were evaluated, and dermatologic examination was carried out. Pretreatment was documented. Skin prick tests with a panel of six common inhalative allergens and patch tests with the European Standard Series were performed. An association between atopy and periorificial dermatitis was evaluated, and patients were screened for skin colonization by fungi, bacteria, and Demodex mites. They were treated with 20% azelaic acid cream, which was topically applied twice daily on all affected areas,...

Eccrine Squamous Metaplasia and Periadnexal Granulomas: New Cutaneous Histopathologic Findings in Cardiofaciocutaneous Syndrome

Pediatric Dermatology — Sat, 03 Oct 2009 23:00:00 +0100

We report the case of a 4-year-old boy who has cardiofaciocutaneous syndrome with previously unreported histopathologic findings of eccrine squamous metaplasia and periadnexal granuloma. (Source: Pediatric Dermatology)

A Case of Ankyloblepharon, Ectodermal Dysplasia, and Cleft Lip/Palate Syndrome with Ectrodactyly: Are the p63 Syndromes Distinct After All?

Pediatric Dermatology — Wed, 30 Sep 2009 23:00:00 +0100

We present the case of an infant with ankyloblepharon, cleft palate, scalp dermatitis, and ectrodactyly. She is unique for having a novel p63 mutation that has not been previously reported. Her case also points to the significant overlap between the p63-associated ectodermal dysplasias and challenges the traditional diagnostic schema for these rare syndromes. (Source: Pediatric Dermatology)

Acute Hemorrhagic Edema of Infancy: A Case Report

Pediatric Dermatology — Mon, 20 Jul 2009 23:00:00 +0100

Abstract: Acute hemorrhagic edema of infancy is a rare vasculitic syndrome affecting young children. Although presentation is dramatic and striking, it is a benign disorder. A 9-month-old boy with fever, rinorrhea, edema, and purpuric lesions involving the face, oral mucosa, ears, and extremities was presented. (Source: Pediatric Dermatology)

Halo Congenital Nevocellular Nevi Associated with Extralesional Vitiligo: A Case Series with Review of the Literature

Pediatric Dermatology — Sun, 19 Jul 2009 23:00:00 +0100

In this report, we present nine cases of patients with congenital nevi and vitiligo who uniquely developed both halo formation around the nevi in addition to vitiligo formation in distinctly separate locations. While the precise etiology of halo formation and vitiligo remains uncertain, several theories suggest that both phenomena result from an immunologic response to pigment cells, whether in the "normal" skin of vitiligo or in the excessively pigmented congenital nevus. (Source: Pediatric Dermatology)

Management of Nevus Sebaceous and the Risk of Basal Cell Carcinoma: An 18-Year Review

Pediatric Dermatology — Sun, 19 Jul 2009 23:00:00 +0100

Abstract: Nevus sebaceous (NS) is a common congenital hamartoma of the skin, usually found on the head and neck. It may undergo malignant transformation to basal cell carcinoma (BCC). However the incidence and lifetime risk of malignant transformation is unknown. We performed an 18-year review of all NS excisions at our institution, to report the number of cases of BCC and other neoplasms within excised NS. The aim is to inform physicians who must weigh the risks in recommending excision of a NS in a pediatric patient population with the risk of malignancy. After a database query for years 1990[ndash]2008, charts were reviewed and data were extracted on demographics and surgical history relating to NS. Thirty-one NS with abnormal findings were reviewed microscopically by a dermatopathologi...

Assessment of Elementary School Students' Sun Protection Behaviors

Pediatric Dermatology — Sun, 19 Jul 2009 23:00:00 +0100

Conclusion: Sun exposure at school poses a significant risk to student health and more needs to be carried out to promote the use of a wide-brimmed hat and limiting student sun exposure. (Source: Pediatric Dermatology)

Extensive Neonatal Dermatophytoses

Pediatric Dermatology — Sun, 19 Jul 2009 23:00:00 +0100

We report a 25-day-old boy who was referred to our dermatology unit for evaluation of extensive annular erythematous lesions on his body. We initially considered the differential diagnoses of candidiasis and neonatal lupus erythematosus but investigations revealed the case as tinea corporis due to a relatively uncommon causative agent, Microsporum gypseum. To the best of our knowledge it is the first case of extensive neonatal dermatophytoses caused by this organism. The possible causes and the role of steroids in producing the clinical picture in our patient are discussed. (Source: Pediatric Dermatology)

Disseminated Varicella Zoster Virus in an Immunized Child as the Acquired Immunodeficiency Syndrome-defining Illness

Pediatric Dermatology — Sun, 19 Jul 2009 23:00:00 +0100

We report a case of a 10-year-old boy previously immunized to Varicella who presented with herpes zoster with hematogenous dissemination as the Acquired Immunodeficiency Syndrome-defining illness. Disseminated VZV is more commonly seen in human immunodeficiency virus (HIV)-infected individuals with more advanced disease, as was the case with our patient. Disseminated VZV infection in a previously immunized child should raise suspicion for underlying immunosuppression. (Source: Pediatric Dermatology)

Quantitative Assessment of Combination Bathing and Moisturizing Regimens on Skin Hydration in Atopic Dermatitis

Pediatric Dermatology — Thu, 07 May 2009 04:00:00 +0100

This study quantified cutaneous hydration status after various combination bathing and moisturizing regimens. Four bathing/moisturizer regimens were evaluated in 10 subjects, five pediatric subjects with atopic dermatitis and five subjects with healthy skin. The regimens consisted of bathing alone without emollient application, bathing and immediate emollient application, bathing and delayed application, and emollient application alone. Each regimen was evaluated in all subjects, utilizing a crossover design. Skin hydration was assessed with standard capacitance measurements. In atopic dermatitis subjects, emollient alone yielded a significantly (p < 0.05) greater mean hydration over 90 minutes (206.2% baseline hydration) than bathing with immediate emollient (141.6%), bathing and delayed ...

Speckled Lentiginous Nevus Syndrome Associated with Musculoskeletal Abnormalities

Pediatric Dermatology — Sun, 03 May 2009 04:00:00 +0100

We report a 9-year-old boy with a large speckled lentiginous nevus on his trunk, bilateral upper extremities, and neck associated with hyperhidrosis and nonspecific pain in the distribution of the nevus in addition to prominent upper extremity asymmetry and scoliosis. Similar musculoskeletal abnormalities have been reported in patients with phacomatosis pigmentovascularis and phacomatosis pigmentokeratotica which feature speckled lentiginous nevus; however, this patient demonstrates striking musculoskeletal abnormalities in the absence of coexisting vascular lesions or nevus sebaceous. (Source: Pediatric Dermatology)

Morphea, Diabetes Mellitus Type I, and Celiac Disease: Case Report and Review of the Literature

Pediatric Dermatology — Sun, 03 May 2009 04:00:00 +0100

Abstract: An 11-year-old girl with a history of diabetes mellitus type I and celiac disease presented with multiple, depressed patches of purple-brown skin on the right lower extremity and central back, with histopathologic features of early morphea. Though morphea may coexist with other autoimmune diseases, its presentation with both diabetes mellitus type I and celiac disease has not yet been described. (Source: Pediatric Dermatology)

Knowledge, Attitudes, and Behaviors of Elementary School Students Regarding Sun Exposure and Skin Cancer

Pediatric Dermatology — Sun, 03 May 2009 04:00:00 +0100

Abstract: The aim of this study was to assess baseline knowledge of skin cancer, sun protection practices, and perceptions of tanning among third through fifth grade elementary students in Florida. A total of 4,002 students in nineteen elementary schools in Palm Beach County, Florida were surveyed. SunSmart America[trade] curriculum pretest responses were the main outcome measures. Overall students' knowledge using a students' mean knowledge scale scores of skin cancer and sun protection were low ( (Source: Pediatric Dermatology)

Familial Auriculotemporal Nerve (Frey) Syndrome

Pediatric Dermatology — Sun, 03 May 2009 04:00:00 +0100

We describe two Caucasian sisters with bilateral Frey syndrome, neither of whom was delivered with forceps assistance, and highlight its distinction from food allergy. Frey syndrome may occur in a familial pattern, and in the absence of a history of perinatal trauma. (Source: Pediatric Dermatology)

Serum Levels of Vascular Endothelial Growth Factor and Basic Fibroblastic Growth Factor in Children with Hemangiomas and Vascular Malformations—Preliminary Report

Pediatric Dermatology — Sun, 03 May 2009 04:00:00 +0100

We report here our preliminary results of serum vascular endothelial growth factor and basic fibroblastic growth factor levels as an aid in the diagnosis of hemangiomas and in the follow up of patients with this lesion. Twenty two children with infantile hemangioma (13 with proliferating hemangiomas, nine with involuting lesions), five children with vascular malformations, and 25 healthy children study group. Vascular endothelial growth factor and basic fibroblastic growth factor serum levels were analyzed by an ELISA assay. The serum vascular endothelial growth factor concentrations in children with proliferating hemangiomas were significantly higher than in patients with involuting hemangiomas, vascular malformations and healthy patients. The serum basic fibroblastic growth factor concen...

A Newborn with Acanthosis Nigricans: Can It Be Crouzon Syndrome with Acanthosis Nigricans?

Pediatric Dermatology — Fri, 17 Apr 2009 04:00:00 +0100

We present a 10-hour-old newborn who presented with bilateral choanal atresia, craniosynostosis and acanthosis nigricans. Molecular tests identified the FGFR3 Ala391Glu substitution confirming the diagnosis of CAN. Of the 35 cases of CAN reported in literature till date, only one child had acanthosis nigricans at birth. This is the first case from India to have been reported with this mutation. (Source: Pediatric Dermatology)

Corticosteroids' Effect on the Height of Atopic Dermatitis Patients: A Controlled Questionnaire Study

Pediatric Dermatology — Thu, 09 Apr 2009 04:00:00 +0100

Abstract: To investigate if children treated with topical corticosteroids have a significantly shorter height than the height of children not treated with corticosteroids and to see if corticosteroids affect the ability for treated children to meet growth potential defined as midparental height. Parents of patients attending the UNC's Dermatology clinic completed the survey. The patient's height and siblings' heights were measured by staff. Parents' heights were self reported as were the child's diagnosis of atopic dermatitis, and duration of use of corticosteroids. The patient's height was standardized using CDC charts. Additionally, the midparental height was calculated and standardized. The difference between present and predicted standardized heights was calculated; 151 surveys yielded...

Childhood Pityriasis Rosea

Pediatric Dermatology — Thu, 09 Apr 2009 04:00:00 +0100

Abstract: Pityriasis rosea (PR) is an acute, self-limiting papulosquamous disorder of unknown etiology. Published studies of childhood PR are scarce and most are reviews. The aim of this study was to determine the demographic and clinical features of childhood PR. (Source: Pediatric Dermatology)

Onychomadesis: A Rare Side-Effect of Valproic Acid Medication?

Pediatric Dermatology — Thu, 09 Apr 2009 04:00:00 +0100

We report on a child with onychomadesis as a possible side-effect of treatment with VPA. Normal nail growth was observed after stopping VPA. The pathomechanism of onychomadesis due to VPA treatment remains unclear. (Source: Pediatric Dermatology)

A First Case of Trimethoprim-Sulfamethoxazole Induced Sweet's Syndrome in a Child

Pediatric Dermatology — Thu, 09 Apr 2009 04:00:00 +0100

(Source: Pediatric Dermatology)

Experience with Cyclosporine in Children with Chronic Idiopathic Urticaria

Pediatric Dermatology — Thu, 09 Apr 2009 04:00:00 +0100

Conclusions: Our experience in children is consistent with a previous controlled clinical trial in adults and supports the efficacy and safety of cyclosporine for CIU. However, we recommend that it be reserved for those whose CIU that is resistant to conventional measures and that patients be carefully monitored with cyclosporine serum concentrations and measures of renal function. (Source: Pediatric Dermatology)

Retrospective Analysis of 32 Pediatric Patients with Anticonvulsant Hypersensitivity Syndrome (ACHSS)

Pediatric Dermatology — Thu, 09 Apr 2009 04:00:00 +0100

Conclusions: The ACHSS is a distinct clinical entity which may occur in pediatric patients treated with anticonvulsants, and may have potentially life-threatening consequences. Involvement of multiple organ systems, including the hematologic, hepatic, renal, and pulmonary systems was common. Treatment varied widely, but ranged from supportive care to systemic corticosteroids. (Source: Pediatric Dermatology)

Congenital Disseminated Pyogenic Granuloma

Pediatric Dermatology — Tue, 07 Apr 2009 04:00:00 +0100

We report two newborns with congenital disseminated PG who were otherwise healthy. In both of these cases, negative GLUT-1 staining supported the proper diagnosis. (Source: Pediatric Dermatology)

Autosomal Dominant Epidermodysplasia Verruciformis Lacking a Known EVER1 or EVER2 Mutation

Pediatric Dermatology — Thu, 02 Apr 2009 04:00:00 +0100

We present epidermodysplasia verruciformis in a father and a son with typical histologic and clinical findings that occur in the absence of mutations in EVER1 or EVER2. Epidermodysplasia verruciformis in this father/son pair in a nonconsanguinous pedigree is consistent with autosomal dominant inheritance. This is the first report of autosomal dominant transmission of epidermodysplasia verruciformis, providing further evidence of the genetic heterogeneity of epidermodysplasia verruciformis. (Source: Pediatric Dermatology)

Knowledge and Perception of Melanocytic Nevi and Sunburn in Young Children

Pediatric Dermatology — Thu, 02 Apr 2009 04:00:00 +0100

Conclusion: Children aged from 6 to 10 years know exactly why they had suffered from sunburn, can describe the sunburn and how to avoid it. They do not feel bothered by their nevi and are alert to the appearance of new nevi. (Source: Pediatric Dermatology)

Fluocinolone Acetonide 0.01% in Peanut Oil: Safety and Efficacy Data in the Treatment of Childhood Atopic Dermatitis in Infants as Young as 3 Months of Age

Pediatric Dermatology — Thu, 02 Apr 2009 04:00:00 +0100

Abstract: Fluocinolone acetonide 0.01% in a blend of refined peanut and mineral oils has been established as effective and safe treatment for atopic dermatitis in patients 2 years and older, including those with peanut sensitivity, for several years. We sought to study the safety of fluocinolone acetonide 0.01% oil and its potential for adrenal axis suppression in infants as young as 3 months of age. A controlled, open-label study was performed in children aged 3 months to 2 years with moderate to severe atopic dermatitis at two academic pediatric dermatology centers. Patients received topical fluocinolone acetonide 0.01% oil twice daily to affected areas involving a minimum of 20% body surface ratio for 4 weeks. Cortisol stimulation testing was performed at baseline and at the end of the ...

Systematized Contact Dermatitis and Montelukast in an Atopic Boy

Pediatric Dermatology — Thu, 02 Apr 2009 04:00:00 +0100

We present a case of a 9-year-old Caucasian boy with a history of mild atopic dermatitis that experienced severe systematized dermatitis after being started on montelukast chewable tablets containing aspartame. Patch testing revealed multiple chemical sensitivities which included a positive reaction to formaldehyde. Notably, resolution of his systemic dermatitis only occurred with discontinuation of the montelukast chewables. (Source: Pediatric Dermatology)

A Phase II, Open-Label Study of the Efficacy and Safety of Imiquimod in the Treatment of Superficial and Mixed Infantile Hemangioma

Pediatric Dermatology — Thu, 02 Apr 2009 04:00:00 +0100

Conclusions: Treatment of infants with infantile hemangioma with imiquimod up to seven times per week for 16 weeks was generally well tolerated with low systemic exposure. Improvement was observed in hemangioma coloration, but not lesion size, suggesting effects were limited to the superficial component. (Source: Pediatric Dermatology)

Pyogenic Granuloma in Ten Children Treated with Topical Imiquimod

Pediatric Dermatology — Sun, 29 Mar 2009 04:00:00 +0100

We report a series of 10 children, highlighting the safety and efficacy of topical 5% Imiquimod as an alternative noninvasive treatment of pyogenic granuloma. Ten children with a mean age of 2.5 years and 10.8 week duration of facial pyogenic granuloma lesion were recruited. Treatment regime with topical Imiquimod 5% cream varied in frequency of application and duration according to clinical response. Clinical outcome in the majority of the children was satisfactory. Three had no evidence of disease and five had small hypopigmented or erythematous lesions which were continuing to improve and more acceptable then a surgical scar. One child required a prolonged treatment course, and one progressed to surgical excision when prolonged treatment failed. There were no systemic side effects noted...

Lyme Disease as a Cause of Acropapular Dermatitis of Childhood

Pediatric Dermatology — Fri, 20 Mar 2009 04:00:00 +0100

We present a child with typical findings of acropapular dermatitis of childhood whose serologic workup revealed an acute Lyme infection. (Source: Pediatric Dermatology)

Extensive Tinea in a Patient With Severe Combined Immunodeficiency

Pediatric Dermatology — Wed, 18 Mar 2009 04:00:00 +0100

We reported a case of SCID which was associated with a widespread skin infection with Trichophyton mentagrophytes. (Source: Pediatric Dermatology)

Cantharidin Use Among Pediatric Dermatologists in the Treatment of Molluscum Contagiosum

Pediatric Dermatology — Wed, 18 Mar 2009 04:00:00 +0100

Abstract: Cantharidin is cited often in the dermatology and pediatric literature as a valuable treatment option for molluscum contagiosum (MC). However, there have been no prospective, randomized, vehicle-controlled trials that have been able to quantify cantharidin's efficacy in MC. The purpose of this study was to determine the breadth of usage of cantharidin, most frequently used protocols, and common side effects seen with use of cantharidin. An eighteen question survey was administered to the Society of Pediatric Dermatology. The survey sought to evaluate treatments used in MC and experiences with cantharidin including: protocol, side effects, specific products used, and satisfaction with cantharidin. A total of 300 surveys were distributed via email, 101 surveys were initiated, and 9...

Metastatic Cutaneous Crohn's Disease in Children: Case Report and Review of the Literature

Pediatric Dermatology — Wed, 18 Mar 2009 04:00:00 +0100

We present a case of a 13½-year-old girl whose initial symptom of Crohn's disease was asymptomatic labial swelling. An overview of metastatic cutaneous Crohn's disease in childhood is also provided. (Source: Pediatric Dermatology)

A Novel Gel Formulation of 0.25% Tretinoin and 1.2% Clindamycin Phosphate: Efficacy in Acne Vulgaris Patients Aged 12 to 18 Years

Pediatric Dermatology — Wed, 18 Mar 2009 04:00:00 +0100

This study reports the efficacy data from the 1,716 12- to 18-year-old adolescents with mild to severe acne included in the trials. The multicenter, double-blind, randomized, vehicle-controlled studies evaluated efficacy by assessing changes in inflammatory, noninflammatory, and total lesion counts over a 12-week study interval. The adolescents treated with CLIN/RA gel had statistically greater reductions in mean inflammatory, noninflammatory, and total lesions than tretinoin, clindamycin, or vehicle. The combination formulation appears efficacious in 12 to 18 year olds and is more effective than the individual constituents. (Source: Pediatric Dermatology)

Two Pediatric Cases of Primary Cutaneous B-cell Lymphoma and Review of the Literature

Pediatric Dermatology — Sat, 14 Mar 2009 04:00:00 +0100

We describe two cases of marginal zone primary cutaneous B-cell lymphoma in young boys. Thus far, both have been managed with local therapy. We review the literature of this rare malignancy. (Source: Pediatric Dermatology)

5% 5-Fluorouracil Cream for Treatment of Verruca Vulgaris in Children

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

Abstract: Warts are a common pediatric skin disease. Most treatments show only modest benefit, and some are poorly tolerated because of pain. 5-fluorouracil interferes with deoxyribonucleic acid and ribonucleic acid synthesis, and is used to treat genital warts in adults. Efficacy, safety, and tolerability of topical 5% 5-fluorouracil for treatment of common warts were examined in an open-label pilot study with pediatric patients. Thirty-nine children who have at least two hand warts applied 5% 5-fluorouracil cream (Efudex, Valeant Pharmaceuticals International) once or twice daily, under occlusion for 6 weeks. Assessment of treatment response and side effects was performed at baseline, treatment completion, and 3- and 6-month follow-ups. Hematology measures, liver function tests, and medi...

The Prevalence, Characteristics of and Risk Factors for Eczema in Belgian Schoolchildren

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

Abstract: Childhood eczema is common in infants, but its nature and extent during later childhood remains unclear. In this cross-sectional study we examined the prevalence and characteristics of eczema in an unbiased community population of 2,021 Belgian schoolchildren, aged 3.4 to 14.8 years with skin prick testing and parental questionnaires. Our study identified an eczema prevalence of 23.3% and a considerable allergic co-morbidity, mainly in sensitized children. The reported prevalence of eczema in infancy was 18.5% and for current eczema 11.6%. The overall sensitization rate (33.2%) as well as sensitization rates for the individual allergens were significantly higher in children with "eczema ever." Sensitization to Dermatophagoides pteronyssinus (19.6%), mixed grass pollen (15.1%), an...

Gadolinium-Associated Nephrogenic Systemic Fibrosis in a 9-Year-Old Boy

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

We describe a 9-year-old boy on chronic hemodialysis who presented with hyperpigmented, tightly bound-down, indurated plaques of his bilateral lower extremities. Pertinent history included a recent series of magnetic resonance imaging tests utilizing gadolinium-based contrast media. Histopathology showed widened septae with increased fibroblasts and collagen in the subcutis consistent with nephrogenic systemic fibrosis. Nephrogenic systemic fibrosis is a unique fibrosing disorder characterized by skin thickening of the extremities and trunk, resembling that seen in systemic sclerosis. The majority of cases have been reported in dialysis or renal transplant patients. This case of nephrogenic systemic fibrosis in a young child is presented to raise awareness in the pediatric community of nep...

Acrodermatitis Enteropathica-Like Eruption in Metabolic Disorders: Acrodermatitis Dysmetabolica Is Proposed as a Better Term

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

Conclusion: In this study, acrodermatitis enteropathica-like eruption was noted in various metabolic disorders, including organic acidemias. We suggest that acrodermatitis dysmetabolica might be a better term for acrodermatitis enteropathica-like eruption occurring secondary to metabolic disorders other than acquired zinc deficiency. (Source: Pediatric Dermatology)

Clinical Demonstration of Skin Mildness and Suitability for Sensitive Infant Skin of a New Baby Wipe

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

Abstract: Background: A cleansing baby wipe with sufficient pH buffering capacity may help to restore the pH balance of skin following exposure to urine and feces in the diaper environment and maintain skin health.Objective: To evaluate the skin effects of a novel baby wipe formulation with increased pH buffering.Subjects and Methods: A series of clinical studies was designed and conducted to evaluate the skin effects of the new baby wipe, including a 21-day cumulative skin irritation patch study in adults (n = 31), a 4-week study in babies with medically confirmed atopic dermatitis (n = 32), a 2-week study comparing skin pH of babies (n = 15) following use of wipes compared with water and wash cloth, a series of clinical skin pH measurements following fecal exposure and subsequent cleanin...

Premenarchal Vulvar Ulceration: Is Chronic Irritation a Causative Factor?

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

Conclusion: Girls with vulvar ulcerations who have deny being sexually active should be thoroughly evaluated for infections, Behcet's disease, and other health problems, but, in addition, should be questioned about use of tight-fitting clothing in the perineal area. We hypothesize that chronic irritation because of tight clothing may play a role in causing vulvar ulcerations in this setting. (Source: Pediatric Dermatology)

An 18-year-old Male with Severe Bilateral Cataracts and Atopic Dermatitis—A Case Report and Review of the Literature

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

(Source: Pediatric Dermatology)

What Is "High Risk"? A Systematic Review of Atopy Risk and Implications for Primary Prevention

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

Abstract: Atopic diseases are common and becoming more prevalent. Efforts have focused on primary disease prevention by identifying high-risk children and applying preventative strategies. Our aim was to evaluate methods used to identify high-risk children in atopy prevention studies. A literature search for relevant articles published between 1986 and 2006 was conducted, and all abstracts were reviewed. The search yielded 1,535 publications, 133 were reviewed in detail, and 57 met inclusion criteria. High risk was defined by 30 different methods. First-degree relatives with an atopic disorder were included in all methods, but only three publications used referenced questionnaires to determine this. Less frequently included were cord blood immunoglobulin E measurements and skin prick or ra...

Treatment of Juvenile Pemphigus Vulgaris with Intravenous Immunoglobulin Therapy

Pediatric Dermatology — Wed, 11 Mar 2009 04:00:00 +0100

We report the clinical response and follow-up on eight patients with juvenile pemphigus vulgaris treated with intravenous immunoglobulin. Six Caucasian females and two Caucasian males ages 15 to 18 (mean 15.5) were treated with intravenous immunoglobulin based on a published protocol. The indications were lack of response and development of serious side-effects to conventional therapy in four, lack of response to dapsone in two, and parental choice in two patients. In seven patients, a prolonged clinical remission was achieved. They received a mean of 28.5 cycles of intravenous immunoglobulin in a mean of 43.4 months and were followed for a mean of 29.8 months after discontinuing treatment. The remaining patient responded, but was lost to follow-up. Mean follow-up was 71.7 months. Six pati...

Successful Treatment of Severe Iatrogenic Calcinosis Cutis with Intravenous Sodium Thiosulfate in a Child Affected by T-Acute Lymphoblastic Leukemia

Pediatric Dermatology — Fri, 12 Dec 2008 05:00:00 +0100

We describe a 5-year-old boy with acute lymphoblastic leukemia who developed severe calcinosis cutis in the right forearm and hand, and in the left leg and foot after extravasation of calcium gluconate during treatment for tumor-lysis-syndrome-related hypocalcaemia. Surgical debridement, local wound care, hyperbaric oxygen therapy, and sodium thiosulfate infusion achieved a complete healing of all lesions in an eight-month period with a short discontinuation of chemotherapy. No functional or sensitive impairment remained. (Source: Pediatric Dermatology)

Diffuse Nonscarring Alopecia of Scalp: An Indicator of Early Infantile Scurvy?

Pediatric Dermatology — Sat, 25 Oct 2008 04:00:00 +0100

Abstract: An infant with diffuse nonscarring alopecia of scalp and radiologic features of scurvy responded dramatically to oral vitamin C therapy. The characteristic cutaneous manifestations of scurvy are usually not seen in infancy. The manifestations of initial stage of scurvy that are not related to collagen synthesis, as in the present case, should alert to the possibility of this potentially fatal condition. (Source: Pediatric Dermatology)

Phototherapy in Childhood

Pediatric Dermatology — Fri, 24 Oct 2008 04:00:00 +0100

Conclusion: Phototherapy is a well-tolerated treatment for childhood dermatoses, and is especially efficacious in psoriasis and pityriasis lichenoides chronica patients. (Source: Pediatric Dermatology)

Hair Shaft Videodermoscopy in Netherton Syndrome

Pediatric Dermatology — Fri, 24 Oct 2008 04:00:00 +0100

We present the case of an 11-year-old female patient with Netherton syndrome in whom hair and scalp videodermoscopy (trichoscopy) was used to visualize typical bamboo hairs and hairs with golf tee type endings in the scalp hairs and eyebrows. Trichoscopy is a method, which allows noninvasive viewing of hair shafts in many-fold magnification without the need of pulling hair for diagnostic purposes. This case shows that trichoscopy may be employed to significantly improve the chance of establishing the diagnosis of Netherton syndrome in patients. (Source: Pediatric Dermatology)

Eccrine Angiomatous Hamartoma: Report of Five Congenital Cases

Pediatric Dermatology — Fri, 24 Oct 2008 04:00:00 +0100

We report five congenital cases of eccrine angiomatous hamartoma, emphasizing a clinically uncommon tumor-like appearance, with numerous telangiectasias on their surfaces resembling vascular lesions, in two of them. (Source: Pediatric Dermatology)

Outbreak of Rash in Children Associated with Recreational Mud Exposure

Pediatric Dermatology — Fri, 24 Oct 2008 04:00:00 +0100

Abstract: We conducted an investigation of a rash outbreak in children who attended the "Mud Mania Festival." The mean incubation period of illness was 26 hours, and mean duration was 4.3 days. Time spent in mud was associated with the extent of rash in a dose[ndash]response fashion. The cultures from lesions of two unrelated cases yielded Enterobacter cloacae. (Source: Pediatric Dermatology)

News and notices

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

(Source: Pediatric Dermatology)

Remembering Marc Larrègue (1935–2007)

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

(Source: Pediatric Dermatology)

The Church of 80% Sincerity

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

(Source: Pediatric Dermatology)

A Further Case of Annular Lichenoid Dermatitis of Youth: Role of the Anti-Hepatitis B Immunization?

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed two pages of text including references. Two copies of all letters should be submitted along with one copy on disk. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided. (Source: Pediatric Dermatology)

Streptococcus pyogenes and β-lactam antibiotics

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

Easy Griseofulvin Dosing

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

Trichotillomania in Early Childhood––a Report of two Cases with a Peculiar Habit

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We present two cases of trichotillomania in young children, both using a pacifier to pull out their hair. (Source: Pediatric Dermatology)

Congenital Mucinous Eccrine Nevus in a 5-Month-Old Girl with Frequent Intertriginous Dermatitis

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We present a 5-month-old girl with one localized plaque in a bandlike distribution on the left wrist since birth. Localized hyperhidrosis was also noted. Histopathologic examination of the lesion showed typical findings of mucinous eccrine nevus. Our report may serve to alert dermatologists to consider this entity in congenital lesions. (Source: Pediatric Dermatology)

Infectious and Inflammatory Skin Diseases in Children with HIV Infection and their Relation with the Immune Status—Evaluation of 127 Patients

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

Abstract: Human immunodeficiency virus infection causes changes in the immune system and disease evolution can be partially measured by levels of T CD4+ lymphocytes. Knowledge of the chronology of skin disease in relationship to the immune status of the patient may help understand the pathogenesis of AIDS. One hundred twenty-seven children were prospectively evaluated for skin diseases and their relationship to immune status. Immunodeficiency in human immunodeficiency virus-infected children was correlated with infectious dermatoses whereas normal CD4+ T lymphocyte levels was correlated with diseases mediated by hypersensitivity mechanisms. (Source: Pediatric Dermatology)

Topical Tacrolimus in the Treatment of Lichen Planus in a Child

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We report the case of a child with cutaneous lichen planus who did not respond to topical steroids but showed complete resolution once switched to 0.03% tacrolimus ointment. (Source: Pediatric Dermatology)

Presentation of Perianal Group A Streptococcal Infection as Irritability Among Children

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We report on a series of 11 children with perianal Streptococcus group A infection who presented with intermittent episodes of irritability. Awareness and recognition of this disease by pediatricians and its early diagnosis by a rapid-strep test will lead to appropriate treatment and prompt recovery. (Source: Pediatric Dermatology)

Mycosis Fungoides with Focal CD 30 Transformation in an Adolescent

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We describe a 16-year-old girl with patch/plaque stage mycosis fungoides who developed a nodule within one of the plaques, which on histopathology showed large cell transformation, with positive labeling with the CD30 immunostain. To the best of our knowledge, this is the second reported case of mycosis fungoides with CD30+ large cell transformation in a child. (Source: Pediatric Dermatology)

Enhanced Response of Childhood Psoriasis to Narrow-Band UV-B Phototherapy with Preirradiation Use of Mineral Oil

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

Abstract: Studies in adults show that pretreatment with an optimal emollient may improve transmission of ultraviolet-B. In our study, we evaluated whether the preirradiation use of mineral oil enhanced the efficacy of narrow-band ultraviolet-B phototherapy in childhood psoriasis. Twenty children, aged 5 to 14 years with widespread, symmetrical psoriasis involving >20% body surface area were enrolled in a prospective, single-blind, controlled study. Mineral oil was applied prior to irradiation over one half of the body and the other half was emollient-free control. Narrow-band ultraviolet-B phototherapy was administered to whole body twice a week on nonconsecutive days with initial dose of 50 mJ/cm2 and increment of 10% at each session. Clinical response was evaluated as grades of erythema,...

Hypotrichosis, Bulbous Nose, and Cone-Shaped Epiphyses in an 8-Year-Old Girl

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

(Source: Pediatric Dermatology)

A Newborn Born with a Large Rubbery Mass on the Left-Hand Side of the Nose

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

(Source: Pediatric Dermatology)

Thick Skin, Nodules, and Immobility in an Infant

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

(Source: Pediatric Dermatology)

Congenital Molluscum Contagiosum: Report of Four Cases and Review of the Literature

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We report on four more infants with congenital molluscum, two children with congenital lesions, and two children with onset of lesions at 6 weeks of age. Two children had single cutaneous lesions on the extremities and two had lesions of the scalp consistent with the site of cervical pressure. Congenital molluscum appears to be a more common entity than previously reported. Vertical transmission of molluscum should be considered for all infantile cases of molluscum. (Source: Pediatric Dermatology)

Microphthalmia with Linear Skin Defects: A Case Report and Review

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We present a patient with classic clinical and genetic findings of MLS syndrome and discuss the primary characteristics and management of this disorder. (Source: Pediatric Dermatology)

Two Cases of Cushing's Syndrome Due to Overuse of Topical Steroid in the Diaper Area1

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We report two cases with iatrogenic Cushing's syndrome with different clinical outcomes due to abuse of same potent topical steroid clobetasol propionate. One of them died because of fatal disseminated cytomegalovirus infection. The other patient recovered completely. Physicians and parents should be informed about the adverse effects of such potent topical corticosteroids and physicians should prescribe less potent agents, especially during infancy. (Source: Pediatric Dermatology)

Use of Suprathel® Dressing in a Young Infant with TEN

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We report that a 3-month-old infant, a patient with toxic epidermal necrolysis, who in addition to a standard resuscitation protocol for burns received treatment with Suprathel® (PolyMedics Innovations GmbH, Filderstadt, Germany) and fatty gauze as topical wound dressings in the form of a whole body cover with complete recovery. This is the first case report of Suprathel® being used successfully in a baby with toxic epidermal necrolysis. (Source: Pediatric Dermatology)

A Report of GJB2 (N14K) Connexin 26 Mutation in Two Patients—A New Subtype of KID Syndrome?

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

We report two patients who presented with a combination of clinical features of keratitis[ndash]ichthyosis[ndash]deafness syndrome (e.g., congenital bilateral neurosensory hearing loss and erythrokeratoderma), however, lacking other characteristics typical of this condition. In addition, they both demonstrated striking mucocutaneous findings (e.g., chronic lip fissuring, gingival hyperemia), resulting in diagnostic difficulties. In both patients, a GJB2 mutation (N14K) was identified, which shares the same gene with classic Keratitis[ndash]ichthyosis[ndash]deafness syndrome but has never been described in patients with this condition. We propose that the findings observed in our patients are a distinct subtype of Keratitis[ndash]ichthyosis[ndash]deafness syndrome, thus expanding the spectr...

Methicillin-Resistant Staphylococcus aureus Colonization in Children with Atopic Dermaitis

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

This study investigates the prevalence of risk factors for community-associated, methicillin-resistant S. aureus colonization among pediatric atopic dermatitis patients encountered at an academic pediatric dermatology clinic. An observational cross-sectional study was conducted at the Children's Hospital of Philadelphia in which 54 patients previously diagnosed with atopic dermatitis were enrolled. A detailed patient questionnaire, a complete cutaneous examination, and an evaluation of eczema severity according to the Eczema Area and Severity Index were completed at the time of enrollment. Bacterial cultures from the skin and nares were obtained to determine the frequency of colonization with either methicillin-sensitive S. aureus or methicillin-resistant S. aureus. Although most atopic de...

Clinically Relevant Patch Test Reactions in Children—A United States Based Study

Pediatric Dermatology — Thu, 02 Oct 2008 04:00:00 +0100

Abstract: Allergic contact dermatitis in the pediatric population is more common than previously recognized, with recent prevalence estimates of positive patch test reactions in the range of 14[ndash]70% of children patch tested. The aim of this study was to confirm the prevalence of clinically relevant allergic contact dermatitis in children at two referral centers and determine the most common contact allergens. We performed a retrospective case series analysis of 65 symptomatic children (35 girls and 30 boys) aged 1[ndash]18 years old who were patch tested over a 5-year period for recalcitrant dermatitis. Positive patch test reactions were noted in 54 of the 65 children (prevalence rate of 83%) to 80 different allergens. Fifty children (77%) had positive reactions which were determined ...

Neutrophilic Dermatoses in Children

Pediatric Dermatology — Mon, 01 Sep 2008 04:00:00 +0100

Abstract: The neutrophilic dermatoses are rare disorders, especially in children, and are characterized by neutrophilic infiltrates in the skin and less commonly in extracutaneous tissue. The neutrophilic dermatoses share similar clinical appearances and associated conditions, including inflammatory bowel disease, malignancies, and medications. Overlap forms of disease demonstrating features of multiple neutrophilic dermatoses may be seen. The manuscript attempts to provide an up-to-date review of (i) classical neutrophilic dermatoses, focusing on distinctive features in children and (ii) neutrophilic dermatoses which may largely be pediatric or genodermatosis-associated (Majeed, SAPHO [synovitis, severe acne, sterile palmoplantar pustulosis, hyperostosis, and osteitis] syndrome, PAPA (pyo...

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