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Pediatric Dermatology

Robert J Smith, Kevin Osterhoudt, Richard J Lin, Albert C Yan
A 27-month-old girl with a history of congenital myopathy presented with two indurated, pink plaques involving the right arm and left thigh. Closer examination identified central puncta within these plaques, which reportedly occurred at sites of witnessed arachnid bites. After confirmation of the spider species as Trachelas tranquillus, she was treated to address cutaneous inflammation and suspected superinfection using oral and topical antibiotics as well as topical corticosteroid resulting in prompt resolution of her lesions...
September 19, 2018: Pediatric Dermatology
Bruno Ferrari, María Sol Díaz, Micaela López, Margarita Larralde
Parvovirus B19 is a DNA virus of the Parvoviridae family. We present four children with unusual exanthems associated with parvovirus infection: a purpuric periflexural pattern, a purpuric vasculitic pattern, and a combination of the two.
September 19, 2018: Pediatric Dermatology
Pauline Janssens, Valérie Dekeuleneer, An Van Damme, Pascal Brouillard, Nicole Revencu, Philippe Clapuyt, Ingrid Ferreira, Fanny Ballieux, Miikka Vikkula, Liliane Marot, Marie Baeck, Laurence M Boon
We herein report the case of a 3-year-old girl with atypical congenital right upper limb lymphedema who developed an angiosarcoma. Only a few cases have been reported following congenital form of lymphedema and only 4 in such a young child. We also summarize all cases of angiosarcoma associated with congenital lymphedema reported in the literature.
September 14, 2018: Pediatric Dermatology
Lily Chen, Andy C Hsi, Alok Kothari, Louis P Dehner, Robert J Hayashi, Carrie C Coughlin
We present a 3-year-old boy with Langerhans cell histiocytosis who developed granulomatous dermatitis while taking vemurafenib. Vemurafenib currently has Food and Drug Administration approval for the treatment of BRAF V600E+ metastatic melanoma in adults, but recent discoveries of BRAF V600E in more than half of tested Langerhans cell histiocytosis lesions have prompted clinical trials of vemurafenib therapy for children with refractory, multisystem Langerhans cell histiocytosis. This report contributes to the knowledge of its potential side effects when used in children...
September 14, 2018: Pediatric Dermatology
Thomas Stringer, H Shonna Yin, Vikash S Oza
Eczema action plans (EAPs) are written, customizable documents that guide patients through the self-management of atopic dermatitis. Here, we distributed a survey regarding the use patterns and perceptions of eczema action plans to 1068 members of the Society for Pediatric Dermatology and received 87 responses. Although a strong majority of respondents endorsed the ability of EAPs to improve adherence (79%) and improve prevention and/or management of flares (70%), reported rates of EAP editing or provision sharply decline from initial to follow-up visits (61%-33%)...
September 14, 2018: Pediatric Dermatology
Olivia Boccara, Sonia Ariche-Maman, Smail Hadj-Rabia, Bertrand Chrétien-Marquet, Annonciade Frassati-Biaggi, Frédéric Zazurca, Francis Brunelle, Veronique Soupre, Christine Bodemer, Sylvie Fraitag
Verrucous hemangioma or verrucous venous malformation is a superficial venous malformation frequently misdiagnosed as a lymphatic malformation because of its classical hyperkeratotic appearance. Clinical characteristics of VVM were studied in patients with a histologically confirmed VVM, and validated in a prospective study of 18 patients. VVM was made of separated vascular elements with irregular shape, in a linear disposition, with variable thickness and keratosis. Its specific vascular pattern consisting of an erythematous patch with scattered small red to violet dots was easily identified using dermoscopy...
September 14, 2018: Pediatric Dermatology
Walter Liszewski, Sheilagh Maguiness, Emily Greengard, Christina Boull
Soft tissue tumors are a known, albeit uncommon, cause of cutaneous malignancy in children. Little is known about which types and how frequently these tumors initially present in the skin or subcutis of children. Using data from the 2000-2014 SEER-18 database, we have identified 12 malignant soft tissue tumor types, which initially presented in the skin or subcutis of children in over 50% of cases.
September 14, 2018: Pediatric Dermatology
Sarah Law-Ping-Man, Fabienne Toutain, Frédéric Rieux-Laucat, Capucine Picard, Solène Kammerer-Jacquet, Aude Magérus-Chatinet, Alain Dupuy, Henri Adamski
Transporter associated with antigen processing (TAP) is essential for the stabilization and surface expression of major histocompatibility complex class I molecules of all nucleated cells. TAP deficiency syndrome, also known as bare lymphocyte syndrome type I, is a rare primary immunodeficiency disorder. We report a case of TAP1 deficiency revealed by skin lesions long before the occurrence of respiratory infectious manifestations.
September 6, 2018: Pediatric Dermatology
Melody Maarouf, Marilyn Wickenheiser, Jeffrey M Krase, Sierra Wolter, Vivian Y Shi
We present a special case of an 8-year-old girl diagnosed with severe drug reaction with eosinophilia and systemic symptoms due to trimethoprim-sulfamethoxazole for urinary tract infection prophylaxis for congenital vesicoureteral reflux. The patient is believed to have developed drug reaction with eosinophilia and systemic symptoms because of her underlying renal disease.
September 6, 2018: Pediatric Dermatology
Jennifer J Schoch, Manrup K Hunjan, Katelyn R Anderson, Christine M Lohse, Jennifer L Hand, Dawn M R Davis, Megha M Tollefson
BACKGROUND/OBJECTIVES: Specific maternal risk factors have recently been identified in the development of infantile hemangiomas (IH), including gestational diabetes (GDM), maternal antihypertensive medication use or gestational hypertension (GHTN), maternal progesterone use, and artificial reproductive technologies (ART). We sought to explore the change in incidence of these risk factors over time and determine their association with the increased incidence of hemangiomas over 35 years, as previously reported...
September 6, 2018: Pediatric Dermatology
Jeannette W C Ting, Sarbjit Kaur, Malobi Ogboli, Kiri Irani, Andrea Jester
Kindler disease is a type of epidermolysis bullosa associated with acral blistering, diffuse cutaneous atrophy, poikiloderma, mucosal stenosis, and photosensitivity. This is the first case report in the literature to describe constriction bands associated with Kindler disease causing ischemia of the fingertips requiring urgent release and full-thickness skin grafts. Dermatologists reviewing such patients need to be aware of this condition and refer to a children's hand surgeon early to avoid leaving patients with prolonged periods of pain...
September 6, 2018: Pediatric Dermatology
Louise Cutts, Richard Parslew, Karen Eustace
A neonatal boy presented with a persistent urticarial rash. Initial investigations showed raised inflammatory markers and evidence of systemic inflammation. A working diagnosis of cryopyrin-associated periodic syndrome (CAPS) was made, and the patient responded extremely well to Anakinra. Molecular genetic testing revealed a somatic mutation (affecting 12.5% of cells) in the NLRP3 gene, accounting for the persistent inflammatory state but milder phenotype as seen in our patient.
September 6, 2018: Pediatric Dermatology
Christina N Kraus, Pooja Sodha, Priya Vaidyanathan, A Yasmine Kirkorian
The extrathyroid manifestations of Graves disease (GD) include thyroid orbitopathy, dermopathy, and acropachy. Thyroid dermopathy (TD), also known as pretibial myxedema, classically presents as nonpitting edema or plaquelike lesions on the pretibial region, while thyroid acropachy (TA) is seen in cases of severe TD, characterized by soft tissue swelling and clubbing of fingers and toes, as well as a periosteal reaction of the bones of the hands and feet. Both TD and TA are rare manifestations of thyroid disease and uncommonly reported in pediatric patients...
September 6, 2018: Pediatric Dermatology
Mark Mansour, Carmen Liy Wong, Francesco Zulian, Suzanne Li, Kimberly Morishita, Eluen Ann Yeh, Katie Stewart, Ronald M Laxer, Elena Pope
BACKGROUND: Congenital morphea is a form of localized scleroderma that presents at birth. There is limited information on its presentation and progression. METHODS: Patients with congenital morphea were identified from five pediatric dermatology and rheumatology tertiary care centers in Canada, the United States, and Italy from 2001 to 2016. Cases from the literature were identified by searching Ovid (EMBASE and MEDLINE) from inception to June 30, 2017. Disease characteristics and prevalence of extracutaneous involvement were analyzed...
September 6, 2018: Pediatric Dermatology
Anna-Marie Hosking, Joy Makdisi, Francesca Ortenzio, Sebastien de Feraudy, Janellen Smith, Kenneth Linden
A 6-month-old boy was referred to our burn unit with a recurrent bullous dermatitis, fever, and emesis, originally diagnosed as staphylococcal scalded skin syndrome (SSSS) at an outside hospital. Infectious workup was negative and shave biopsy revealed a dense, diffuse dermal infiltrate of mast cells, consistent with diffuse cutaneous bullous mastocytosis-a rare variant of cutaneous mastocytosis. Treatment included a prolonged course of corticosteroids and antihistamines. Recognition of this rare form of mastocytosis is important, as it can be easily mistaken for other pediatric bullous diseases and is associated with life-threatening complications including vasodilation, anaphylactic shock, gastrointestinal bleeding, and death...
September 6, 2018: Pediatric Dermatology
Nicole S Stefanko, Beth A Drolet
Subcutaneous fat necrosis of the newborn is an uncommon disorder, and although usually benign, associated hypercalcemia can lead to complications such as failure to thrive and renal failure. Many sources suggest screening for hypercalcemia for 6 months following resolution of skin lesions, but little data are available to support this recommendation. This study examines existing published literature to better guide practitioners regarding screening evaluations of asymptomatic patients with subcutaneous fat necrosis...
September 6, 2018: Pediatric Dermatology
June Kunapareddy, Chris White, Cindy Davis, Carlos Nousari
We report a unique case of pressure-induced alopecia (PIA) in a 11-year-old boy following the use of electroencephalogram (EEG) electrodes on the scalp for 4 days. PIA is caused by localized ischemia leading to vascular congestion and discrete, often circumscribed patches of hair loss within 3-28 days of pressure interface. The synchronous conversion of follicles from anagen to catagen or telogen phase is the most distinctive finding of PIA. PIA is a nonscarring alopecia which often resolves over time without treatment...
September 6, 2018: Pediatric Dermatology
Jennifer Aileen Tangtatco, Carolyn Freedman, John Phillips, Elena Pope
First-line treatment for problematic infantile hemangiomas (IH) consists of systemic corticosteroids or, more recently, beta-blockers, while treatment failures or residual lesions may require surgical intervention. There is limited knowledge if prior medical intervention is associated with a better surgical outcome. This retrospective cohort study revealed that medical intervention, whether systemic steroids or beta-blockers, did not influence ultimate surgical outcomes when compared with patients who were not medically treated...
September 6, 2018: Pediatric Dermatology
Bryce Owen, Kimberly Foster, Andrew Carlson, Karen Santa Cruz, Aimee Smidt
Melanotic neuroectodermal tumors of infancy are rare tumors arising from the neural crest and typically present during the first 12 months of life. The majority involve the facial bones, although melanotic neuroectodermal tumors of infancy of the skull and extremities have been observed with less frequency, as in the present case. This entity may initially be presented to the dermatologist as a scalp mass and should be considered in the differential diagnosis of infants with rapidly growing head and neck lesions...
September 4, 2018: Pediatric Dermatology
Matthias K Bernhard, Matthias Krause, Steffen Syrbe
BACKGROUND/OBJECTIVES: Plantar hyperhidrosis can have severe social effects on children and adolescents. Therapeutic options include antiperspirants and surgical interventions (eg, sympathectomy). Botulinum type A toxin is approved for axillary hyperhidrosis in adults only. The aim of the study was the determination of effect and safety of botulinum type A toxin in plantar hyperhidrosis in juvenile patients. METHODS: Children and adolescents with idiopathic focal plantar hyperhidrosis were treated with 50-100 U of botulinum type A toxin per sole...
September 4, 2018: Pediatric Dermatology
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