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Pediatric Dermatology

Sarah E Henrickson, James R Treat
Verrucae vulgaris in patients with severe combined immunodeficiency (SCID) after hematopoietic stem cell transplantation (HCST) can be challenging to manage. We describe two brothers with X-linked SCID who had severe, persistent verrucae that did not respond to traditional topical therapies, including liquid nitrogen, imiquimod, salicylic acid, sinecatechins, 40% urea, and 5-fluorourcil. Both brothers had full response to topical 3% cidofovir, which should be considered in recalcitrant warts in individuals with SCID after HSCT...
October 4, 2016: Pediatric Dermatology
Maria S Kryatova, Barbara M Rainer, Jiawei Zhao, Vadim A Villarroel, Anna Yasmine Kirkorian, Anna L Grossberg, Katherine B Puttgen, Bernard A Cohen
BACKGROUND/OBJECTIVES: Nasal infantile hemangiomas (IHs) pose serious medical complications and psychosocial stress if tumor involution is incomplete or prolonged. The objective was to determine which IH characteristics are associated with complications and are predictive of outcome, assessed as the presence of IHs or residual skin changes upon kindergarten entry, to better manage these lesions and counsel families. METHODS: A retrospective chart review of all patients seen in the Division of Pediatric Dermatology at Johns Hopkins Medicine between 2001 and 2014 for nasal IHs (N = 89) was performed...
October 4, 2016: Pediatric Dermatology
Jin Young Lee, Woo Seog Sim, Ryung A Kang, Eun Kyung Lee, Jae Young Yang, Dae Yoon Kim
Erythromelalgia is often refractory and resistant to many forms of treatment. Numerous therapeutic options have been tried, but effective treatment remains elusive. The sympathetic nervous system has been involved in various painful conditions of neuropathic, vascular, and visceral origin. Sympathetic block is helpful in making a diagnosis and managing pain. We report a case of excellent pain relief after lumbar sympathetic pulsed radiofrequency treatment in a patient with primary erythromelalgia of the lower extremities...
October 4, 2016: Pediatric Dermatology
Jennifer J Schoch, Stanislav N Tolkachjov, Jonathan A Cappel, Lawrence E Gibson, Dawn Marie R Davis
BACKGROUND/OBJECTIVES: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis rarely seen in children. Its features have not been well characterized in children. We sought to characterize the clinical features, etiologic associations, and treatment of PG in children younger than 18 years. METHODS: We performed a retrospective review of children younger than 18 years with PG at the Mayo Clinic from January 1976 to August 2013. RESULTS: Thirteen children with PG were identified (n = 8; 62% female)...
October 4, 2016: Pediatric Dermatology
Chen Amy Chen, Valerie Carlberg, Daniela Kroshinsky
Alopecia areata (AA) involves the immune-related destruction of hair follicles, resulting in patches of complete hair loss, most often on the scalp. The topical sensitizer squaric acid dibutylester (SADBE) is a popular treatment option given its low side-effect profile, hair regrowth potential, and lack of cross-reactivity with other chemicals. We describe a unique case of a 6-year-old girl who developed angioedema after SADBE treatment for AA.
October 4, 2016: Pediatric Dermatology
Abdullah Alakeel, Marie Ferneiny, Nicole Auffret, Christine Bodemer
Acne fulminans (AF) is a rare manifestation and the most severe form of the entire clinical spectrum of acne. The disease is destructive and is characterized by the sudden onset of painful and ulcerative pustules and systemic symptoms including high fever, hepatomegaly, polyarthralgia, leukocytosis, plaquetose, and increased inflammatory markers and transaminases. Osteolytic lesions in multiple skeletal sites could also be associated. The use of isotretinoin is considered a related trigger, as well as the use and cessation of testosterone, although a bacterial infection, a drug-induced disease, or an intake of anabolic androgenic steroids has been suggested...
October 4, 2016: Pediatric Dermatology
Shehla Admani, Hannah Hill, Sharon E Jacob
Children are at risk of developing allergic contact dermatitis to fragrances. Personal hygiene products, even those labeled hypoallergenic or considered all natural, may be a significant source of fragrance exposure in this population.
October 4, 2016: Pediatric Dermatology
Surabhi Dayal, Priyadarshini Sahu, Nidhi Gupta
BACKGROUND/OBJECTIVES: A combination of narrowband ultraviolet B (NBUVB) phototherapy plus topical tacrolimus has been used in adult vitiligo but has not yet been explored in children. We therefore sought to highlight the efficacy of this synergistic combination in childhood vitiligo. The objective was to study the clinical efficacy and safety of a combination of NBUVB with topical tacrolimus ointment 0.03% in childhood vitiligo. METHOD: In this open-label study, 20 children, 4 to 14 years of age, with symmetrical vitiligo lesions were enrolled for 24 weeks...
October 4, 2016: Pediatric Dermatology
Christine R Totri, Stephanie Feldstein, Shehla Admani, Sheila F Friedlander, Lawrence F Eichenfield
BACKGROUND: Onychomycosis (OM) is thought to be a rare disease in children, although there are few epidemiologic studies. METHODS: This 3-year retrospective case series of nearly 400 children seen at Rady Children's Hospital-San Diego (RCHSD) describes the characteristics of OM found in this pediatric population. RESULTS: From 2011 to 2013, the Pediatric and Adolescent Dermatology Clinic at RCHSD saw a total of 36,634 unique patients, of whom 433 were unique patients with OM...
October 4, 2016: Pediatric Dermatology
Georgios Xirotagaros, Sergio Hernández-Ostiz, Juan Ignacio Aróstegui, Antonio Torrelo
Specific gene mutations leading to dysregulation of innate immune response produce the expanding spectrum of monogenic autoinflammatory diseases (AIDs). They are characterized by seemingly unprovoked, recurrent episodes of systemic inflammation in which a myriad of manifestations usually affect skin. Novel genetic technologies have led to the discovery of new AIDs and phenotypes that were not previously clinically described. Consequently the number of AIDs is continuously growing and their recognition and the disclosure of their pathophysiology will prompt early diagnosis and targeted treatment of affected patients...
October 4, 2016: Pediatric Dermatology
Christina Wlodek, Adam Trickey, David de Berker, Elizabeth Johnson
This is the largest study of laboratory-diagnosed onychomycosis in England for children younger than 17 years. The most common (91.5%) cultured organism in this population was Trichophyton rubrum. Candida species were isolated only from fingernails, and the majority were from children younger than 5 years. Continued analysis of fungal pathogens is vital to identify changing trends.
September 22, 2016: Pediatric Dermatology
Brian S Buckley, Jacinto Blas Mantaring, Rodney B Dofitas, Marie Carmela Lapitan, Aceleen Monteagudo
BACKGROUND: One methodologic challenge in conducting research relating to diaper dermatitis (DD) is the absence of a reliable, objective, validated scale for assessing severity. The aim of this study was to develop and validate such a scale. METHODS: Scale development was based on experience of DD assessment and clinical and photographic data collected during the early stages of a randomized controlled trial of two DD treatments. The severity score is the sum of scores of four domains: severity of erythema and irritation, area with any DD, papules or pustules, and open skin...
September 22, 2016: Pediatric Dermatology
Stephen J Malachowski, Mackenzie Creasey, Nancy Kinkley, Michael R Heaphy
Annular lichenoid dermatitis of youth, first described in 2003, is a rare and occasionally chronic skin disease. We report a case of annular lichenoid dermatitis of youth relapsing over the course of 5 years successfully treated and maintained with topical pimecrolimus cream.
September 22, 2016: Pediatric Dermatology
Devorah R Shagalov, Georgina M Ferzli, Temima Wildman, Sharon A Glick
BACKGROUND/OBJECTIVES: The past several decades have witnessed unprecedented advances in genomic technology, bringing genetic testing to the forefront of medical practice and moving us towards the practice of personalized medicine. Genetic testing has become an important aspect in preempting and successfully treating diseases in dermatology, yet difficulty remains in regards to obtaining genetic testing for patients. We conducted a survey for pediatric dermatologists in order to try to gauge and understand where difficulties lie in obtaining genetic testing and to analyze how best these issues can be resolved...
September 22, 2016: Pediatric Dermatology
Enrique Rodríguez-Lomba, Irene Molina-López, Verónica Parra-Blanco, Ricardo Suárez-Fernández, Minia Campos-Domínguez
Papular elastorrhexis (PE) is an uncommon elastic tissue disorder clinically characterized by the onset of asymptomatic flesh-colored to whitish papules over the trunk and upper limbs in children. Its etiology remains unknown, although isolated familial cases have suggested that acquired and inherited forms of the disease may exist. We present the case of a 13-year-old boy with human immunodeficiency virus who presented with such lesions after immunological recovery from very low CD4(+) counts after introducing highly active antiretroviral therapy...
September 22, 2016: Pediatric Dermatology
Sara de Menezes, Adrian Mar, John Dowling, Annaliesa Wright
Inflammatory myofibroblastic tumor (IMT) rarely occurs as a primary cutaneous lesion. We report a case of cutaneous IMT in an 8-year-old girl presenting with an ulcerated nodule on the cheek. Although cutaneous IMT poses a diagnostic challenge because of its rarity, excision of the lesion is likely to be curative.
September 22, 2016: Pediatric Dermatology
Sody Abby Naimer
Microcomedonal lesions can be aesthetically and psychologically displeasing. The burden of comedones increases when considering their frequency and demand for time-consuming attention. The objective of the current study was to describe a novel technique to facilitate open microcomedone extraction. The instrumentation used includes smartphone photography with dermatoscopy. The dermatoscope is an effective tool for diagnosing a broad range of dermatologic conditions. The polarized dermatoscope can facilitate execution of cutaneous procedures whenever magnification and optimal illumination are necessary...
September 21, 2016: Pediatric Dermatology
Mimi C Tran, Joseph M Lam
Mucopolysaccharidoses (MPSs) are a group of inherited lysosomal storage disorders characterized by deficiencies in specific enzymes involved in the catabolism of glycosaminoglycans (GAGs). These deficiencies cause excessive metabolites to accumulate in multiple organs. There are eight different MPS disorders, contributing to the wide variation in clinical presentation. Depending on the severity and subtype of the disease, some children live normal life spans, while others have a more grim prognosis. Children with MPS can present with neurologic, behavioral, skeletal, cardiovascular, gastrointestinal, or respiratory abnormalities...
September 7, 2016: Pediatric Dermatology
Elodie Bou-Assi, Bertille Bonniaud, Marianne Grimaldi, Laurence Faivre, Pierre Vabres
We report a case of transient neonatal cutis laxa and hypertrichosis lanuginosa as an initial presentation in Sotos syndrome. Little is known about skin involvement in Sotos syndrome. Our observation highlights that Sotos syndrome is a rare cause of cutis laxa and suggests that it is a useful neonatal skin clue to the diagnosis of overgrowth syndromes.
September 7, 2016: Pediatric Dermatology
Avikam Harel, Ana Maria Kutz, Smail Hadj-Rabia, Jacob Mashiah
BACKGROUND/OBJECTIVES: Molluscum contagiosum (MC) is a common viral disease primarily affecting children. The objective was to compare the effectiveness of curettage as a treatment modality for MC with no treatment. METHODS: We performed a retrospective study of 2,022 children with MC between 2008 and 2012. Epidemiologic, clinical, and treatment data, including effectiveness, safety, and satisfaction, were reviewed. RESULTS: Fifty-six percent of the children were 2 to 5 years of age...
September 7, 2016: Pediatric Dermatology
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