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Pediatric Dermatology

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https://www.readbyqxmd.com/read/29341312/recurrent-terbinafine-resistant-trichophyton-rubrum-infection-in-a-child-with-congenital-ichthyosis
#1
Louise Schøsler, Louise Kronborg Andersen, Maiken Cavling Arendrup, Mette Sommerlund
Dermatophytosis in children caused by Trichophyton rubrum is preferably treated with topical or systemic terbinafine. We report the first case of terbinafine resistance in a child with recurrent T. rubrum dermatophytosis and congenital ichthyosiform erythroderma.
January 16, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29341258/utility-of-ultrasonography-in-hair-thread-tourniquet-syndrome
#2
Deshan F Sebaratnam, Ángela Hernández-Martín
A 2-year-old girl presented with a 2-month history of an erythematous, indurated plaque with well-defined borders on the third toe of the right foot. Bedside high-resolution ultrasonography demonstrated a thickened epidermis overlying a hyperechoic focus within the dermis. Her clinical and sonographic presentation was in keeping with a foreign body causing hair-thread tourniquet syndrome. The foreign body was surgically extirpated without neurovascular sequelae. Ultrasonography expedited accurate diagnosis and is a promising adjunct to clinical evaluation for radiolucent foreign bodies...
January 16, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29341221/pediatric-penile-porokeratosis-a-case-report
#3
Omar Bari, Antoanella Calame, Sarah Marietti-Shepherd, Victoria R Barrio
We present what we believe to be the second case of pediatric penile porokeratosis and the youngest case reported. A 6-year-old boy presented with a pruritic, verrucous growth at the urethral meatus that recurred after two meatotomies. The diagnosis of porokeratosis was confirmed by biopsy. Porokeratosis should be added to the differential diagnosis of chronic hyperkeratotic penile lesions in children.
January 16, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29334143/childhood-alopecia-areata-data-from-the-national-alopecia-areata-registry
#4
Iris Wohlmuth-Wieser, Joyce S Osei, David Norris, Vera Price, Maria K Hordinsky, Angela Christiano, Madeleine Duvic
BACKGROUND/OBJECTIVES: Alopecia areata may occur at any age and is the third-most-common dermatosis in children. The objective of this study was to investigate the clinical and epidemiologic features of children and adolescents with alopecia areata based on the data of the National Alopecia Areata registry on children and adolescents. METHODS: Two thousand two hundred eighteen children and adolescents with alopecia areata self-enrolled in the National Alopecia Areata Registry and completed a web-based, self-administered, short-intake screening questionnaire (first tier)...
January 15, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29334142/severe-ectropion-in-lamellar-ichthyosis-managed-medically-with-oral-acitretin
#5
Manpreet Singh, Manpreet Kaur, Ripanjeet Kaur, Shakeen Singh
Congenital ectropion is commonly associated with lamellar ichthyosis. Severe eyelid ectropion may cause corneal exposure, keratopathy, and permanent corneal scarring. We report a neonate with severe, bilateral, congenital ectropion and eclabium managed using oral retinoids. Both corneas were protected with topical antibiotics and lubricating eyedrops and eye ointments. At 12-month follow-up, the child was doing well, with no ectropion or corneal opacity.
January 15, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29334134/a-comprehensive-next-generation-sequencing-assay-for-the-diagnosis-of-epidermolysis-bullosa
#6
Anne W Lucky, Neha Dagaonkar, Karen Lammers, Ammar Husami, Diane Kissell, Kejian Zhang
BACKGROUND: Historically, diagnosis of epidermolysis bullosa has required skin biopsies for electron microscopy, direct immunofluorescence to determine which gene(s) to choose for genetic testing, or both. METHODS: To avoid these invasive tests, we developed a high-throughput next-generation sequencing (NGS)-based diagnostic assay called EBSEQ that allows simultaneous detection of mutations in 21 genes with known roles in epidermolysis bullosa pathogenicity. Mutations are confirmed with traditional Sanger sequencing...
January 15, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29334132/oxybutynin-3-gel-for-the-treatment-of-primary-focal-hyperhidrosis-in-adolescents-and-young-adults
#7
Nicholas V Nguyen, Jane Gralla, James Abbott, Anna L Bruckner
BACKGROUND/OBJECTIVES: There are no reliably effective, well-tolerated topical agents for the treatment of hyperhidrosis. We sought to evaluate the efficacy and tolerability of oxybutynin 3% gel in adolescents and young adults with primary focal hyperhidrosis. METHODS: Patients with severe axillary hyperhidrosis were treated with topical oxybutynin 3% gel for 4 weeks. Response to treatment was assessed by calculating change in Hyperhidrosis Disease Severity Score from baseline to weeks 1 and 4...
January 15, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29334124/use-of-antiviral-medications-in-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-a-case-of-infantile-dress
#8
Maggie L Chow, David Kim, Sonia Kamath, David Peng, Minnelly Luu
A 3-month-old girl with Sturge-Weber syndrome presented with a morbilliform rash, eosinophilia, and fulminant liver failure to our tertiary pediatric hospital. She was diagnosed with drug reaction with eosinophilia and systemic symptoms complicated by viremia and evidence of viral hepatitis on liver biopsy. We discuss the role of viral reactivation in drug reaction with eosinophilia and systemic symptoms and the relevance of antiviral therapy in management.
January 15, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29315812/doing-the-math-a-simple-approach-to-topical-timolol-dosing-for-infantile-hemangiomas
#9
Renata Dalla Costa, Brea Prindaville, Karen Wiss
Topical timolol maleate has recently gained popularity as a treatment for superficial infantile hemangiomas, but calculating a safe dose of timolol can be time consuming, which may limit the medication's use in fast-paced clinical environments. This report offers a simplified calculation of the maximum daily safe dosage as 1 drop of medication per kilogram of body weight.
January 9, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29315793/mood-changes-with-methotrexate-therapy-for-dermatologic-disease
#10
Trisha Bhat, Carrie C Coughlin
Neurotoxicity and cognitive effects of low-dose methotrexate for rheumatologic disease have often been described, but the neuropsychiatric effects of low-dose methotrexate for cutaneous disease have been underreported in the dermatology literature. We describe two children who experienced mood changes with methotrexate treatment for lichen sclerosus with morphea overlap and psoriasis, with rapid resolution of these symptoms after methotrexate cessation. We also detail possible mechanisms underlying psychiatric changes with methotrexate therapy...
January 9, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29315782/exogenous-cushing-syndrome-due-to-misuse-of-potent-topical-steroid
#11
Fatma Özgüç Çömlek, Sevim Örüm, Salih Aydın, Filiz Tütüncüler
We report an infant with exogenous Cushing syndrome after being treated for 2 months with a potent topical corticosteroid via the mother's application of topical clobetasol for diaper rash without a prescription. We emphasize that potent topical steroids should be used with great caution, especially when used under occlusion (e.g., diaper area) and that parents should be warned about potential side effects of these medications, particularly when used in infants.
January 9, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29315771/pityriasis-lichenoides-long-term-follow-up-study
#12
Julie B Zang, Sarah J Coates, Jing Huang, Eric C Vonderheid, Bernard A Cohen
BACKGROUND/OBJECTIVES: Pityriasis lichenoides is an uncommon papulosquamous disorder of unknown etiology. The objective of this study was to review the clinical features and treatment responses of individuals with pityriasis lichenoides seen at a tertiary referral center. METHODS: Seventy-five patients diagnosed with pityriasis lichenoides between 1997 and 2013 were reviewed, and 46 had long-term follow-up via telephone interviews. RESULTS: Fifty (67%) patients were diagnosed with pityriasis lichenoides chronica, 22 (29%) with pityriasis lichenoides et varioliformis acuta, and 3 (4%) with mixed pityriasis lichenoides chronica and pityriasis lichenoides et varioliformis acuta features...
January 9, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29315761/incidence-outcomes-and-resource-use-in-children-with-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#13
James W Antoon, Jennifer L Goldman, Brian Lee, Alan Schwartz
BACKGROUND/OBJECTIVES: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening cutaneous reactions, typically to drugs or infection. The incidence and outcomes of these conditions in children are unknown. The objective of this study was to report the overall burden of Stevens-Johnson syndrome and toxic epidermal necrolysis in children in the United States. METHODS: We performed a retrospective cohort analysis of children and adolescents younger than 18 years of age using the 2009 and 2012 Kids' Inpatient Database...
January 9, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314202/neutrophilic-superficial-eccrine-ductitis-proposal-of-a-new-disease-concept
#14
Hiroshi Nagai, Chikako Nishigori
A 3-year-old Japanese boy presented with a 3-month history of itchy erythematous papules on his trunk and forearms, the histologic findings of which were characterized by predominantly neutrophilic inflammation within and around the eccrine sweat ducts and obliteration and disruption of the superficial eccrine sweat ducts. Although the skin disorder had some clinical and histopathologic similarity to miliaria and neutrophilic eccrine hidradenitis, it was ultimately conformed to be neither disorder. Based on this and a case report in the Japanese literature of a 1-year-old boy with erythematous eruptions whose clinical and histopathologic findings were similar to those in our case, we propose the skin disorder in our case, referred to as "neutrophilic superficial eccrine ductitis," as a unique entity...
January 5, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314297/wound-infection-after-inpatient-pediatric-skin-biopsy
#15
Hannah Song, Arash Mostaghimi, Jennifer T Huang
Punch and shave biopsies are important dermatologic procedures in the inpatient setting but have a risk of wound infection. Data on the incidence of infection in this setting are limited and conflicting. This retrospective study of 127 pediatric inpatients at two tertiary care centers who underwent biopsy demonstrated a low overall risk of infection (n = 1, 0.8%). Twenty-five (19.7%) were neutropenic, and 51 (40.2%) were not taking systemic antibiotics at the time of biopsy; none of these patients developed a wound infection...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314271/potassium-iodide-in-refractory-recurrent-pediatric-sweet-syndrome-guidance-in-dosing-and-monitoring
#16
Jennifer Aileen Ang Tangtatco, Nhung Ho, Aaron Drucker, Catherine Forse
We describe a 5-month-old boy with clinical and histopathologic presentation of Sweet syndrome. He responded to systemic corticosteroids, with multiple flares on tapering; potassium iodide was added, which provided complete resolution of Sweet syndrome. Potassium iodide has been used in only a few cases, and no standard dosage has been established in children. We discuss calculation of a pediatric dosage for potassium iodide in Sweet syndrome.
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314260/approach-to-the-jewelry-aficionado
#17
Lauren A Ivey, Brittanya A Limone, Sharon E Jacob
Children's and teens' frequent use of inexpensive "costume" jewelry exposes them to a variety of contact allergens. Greater use heightens the risk of developing allergic contact dermatitis, especially in the setting of body piercings. Several clinical pearls, prevention strategies, and avoidance alternatives are provided in this article to guide clinicians and patients in the management of jewelry-related allergic contact dermatitis.
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314259/clinical-features-and-nail-clippings-in-52-children-with-psoriasis
#18
Marjorie Uber, Vânia O Carvalho, Kerstin T Abagge, Renata Robl Imoto, Betina Werner
BACKGROUND/OBJECTIVES: Nail clipping, the act of cutting the distal portion of a nail for microscopic analysis, can complement the diagnosis of skin diseases with nail involvement, such as psoriasis. This study aimed to describe histopathologic findings on 81 nails from 52 children and adolescents with skin psoriasis and to determine whether these changes correlated with the severity of skin and nail involvement. METHODS: Children with psoriasis were enrolled in this cross-sectional study to obtain Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314244/rapid-successful-treatment-of-atopic-dermatitis-recalcitrant-to-topical-corticosteroids
#19
Daniel J Lewis, Steven R Feldman
Atopic dermatitis is responsive to midpotency topical corticosteroids, which are the mainstay of treatment, yet many patients have disease that is "resistant" to triamcinolone prescribed for outpatient use. Such resistance is often due to poor adherence, but patients and caregivers may remain adamant that the steroid was ineffective and assure the physician that it was applied as recommended. We describe the case of a young girl with a 2-year history of atopic dermatitis resistant to triamcinolone whose condition rapidly improved with continued use of triamcinolone...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29314240/isotretinoin-induced-acne-fulminans-without-systemic-symptoms-with-concurrent-exuberant-granulation-tissue
#20
Alvin W Li, Richard J Antaya
Acne fulminans is a severe form of acne characterized by painful, inflammatory nodules that progress into ulcers and concurrent systemic symptoms. Treatment of acne with isotretinoin can precipitate a syndrome called isotretinoin-induced acne fulminans without systemic symptoms. An exuberant granulation tissue response, another known adverse event associated with isotretinoin, can occur concurrently, inhibiting wound repair and complicating treatment. We report a case of isotretinoin-induced acne fulminans without systemic symptoms with exuberant granulation tissue response that was treated successfully with topical clobetasol ointment...
January 4, 2018: Pediatric Dermatology
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