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Pediatric Dermatology

Ester Muñoz-Aceituno, Isabel Colmenero, Beatriz González-Meli, Antonio Torrelo, Ángela Hernández-Martín
Nevoid hyperkeratosis (NH) of the nipple and areola is an extremely uncommon condition in prepubertal children. We report on a prepubertal girl with NH and provide dermoscopic findings that helped to make the diagnosis.
February 17, 2019: Pediatric Dermatology
William C Fix, Christine Cornejo, Kelly A Duffy, Evan R Hathaway, Jennifer M Kalish, Adam I Rubin, James R Treat
Chondrodermatitis nodularis helicis is an idiopathic degenerative process that presents as a painful nodule, papule, or ulcer on the helix or antihelix. It predominantly affects adults and is thought to be associated with trauma to the ear. We describe a case of pediatric chondrodermatitis nodularis helicis occurring in a child with a history of Beckwith-Wiedemann syndrome that was successfully treated with an excisional biopsy and relief from a recurrent source of pressure on the ear.
February 17, 2019: Pediatric Dermatology
Louise Muguet Guenot, Helene Aubert, Bertrand Isidor, Annick Toutain, Juliette Mazereeuw-Hautier, Corinne Collet, Emmanuelle Bourrat, Marie Denis Musquer, Sébastien Barbarot
Early development of extensive acanthosis nigricans (AN) is a key feature in some patients who have hypochondroplasia (HCH) in association with FGFR3 mutations. We here report regarding five new patients with HCH who exhibited AN, and we compare their characteristics to the eight patients previously described in the literature. In these patients, the AN lesions began in childhood, and they were extensive. These lesions were located on the torso, the abdomen, and the face, in addition to the typical skin fold sites...
February 14, 2019: Pediatric Dermatology
Megan S Evans, Donna A Culton, Luis A Diaz, Paul B Googe, Dean S Morrell
Pemphigus foliaceus (PF) is an autoimmune bullous disorder that has occasionally been reported to present as a polycyclic or arcuate eruption in children. We present a case of childhood PF presenting as an annular and polycyclic eruption, which initially led to a diagnostic conundrum and a delay in diagnosis but which ultimately responded well to therapy with systemic steroids and rituximab infusions. We briefly review the literature on polycyclic presentations of PF in childhood as well as the use of rituximab for pediatric pemphigus...
February 14, 2019: Pediatric Dermatology
Eugénie Belzile, Deana Funaro, Julie Powell
Localized vulvar bullous pemphigoid of childhood is an excessively rare variant of bullous pemphigoid and affects almost exclusively young girls of 7-12 years of age. In contrast to adult-onset bullous pemphigoid, a prompt response to potent topical corticosteroids is observed in the majority of cases, with a favorable prognosis and rare relapses. We report the case of a 7-year-old girl who presented with this condition. Our case reinforces the recognition of this rare subtype of childhood bullous pemphigoid as a distinct entity and enlightens the importance of performing a cutaneous biopsy when clinically indicated...
February 14, 2019: Pediatric Dermatology
Andrew S Desrosiers, Jamil M Ibrahim, Stephanie K Jacks
A chart review was performed of all patients diagnosed with infantile hemangioma in the pediatric dermatology clinic to determine whether distance traveled by the patient affected adherence to follow-up and treatment plans. An increase in distance was associated with an increase in likelihood of nonadherence to treatment or follow-up plans. Compared to patients who lived within 10 miles of a pediatric dermatologist, families who lived farther away were less likely to adhere to treatment plans. Families who traveled over 20 miles to clinic were 7...
February 14, 2019: Pediatric Dermatology
Arti Nanda, Hanan Al-Abboh, Akmal Zahra, Humoud Al-Sabah, Arun Gupta, Adekunle D Adekile
Neutrophilic panniculitis (NP) with myelodysplasia has been described in adults but not in children. We report a case of NP associated with myelodysplasia in a child with MYSM1 deficiency, a newly described syndrome with primary immunodeficiency (PI), bone marrow failure, and developmental aberrations.
February 12, 2019: Pediatric Dermatology
José M Martín, Encarnacion Montesinos, Pilar Cordero, Victor Gonzalez, Dolores Ramon
Trichotillomania is a form of traction alopecia resulting from repetitive and compulsive hair pulling and plucking. Trichotillomania and patchy alopecia areata may have similar clinical and dermoscopic features in some cases. On trichoscopic examination, the presence of black dots, coiled or hook hair, shafts of varying lengths with fraying or split ends (trichoptilosis), and an absence of exclamation mark hairs and yellow dots are suggestive of trichotillomania.
February 11, 2019: Pediatric Dermatology
Selcen Kundak, Yasemin Çakır
OBJECTIVE: Lichen nitidus (LN) is an uncommon inflammatory skin eruption. The present study aims to describe a case series of children with LN seen at a tertiary-care health center. METHODS: Retrospective study of 17 children with biopsy-proven LN between January 2007 and March 2017. Data related with epidemiologic, clinical, and histopathologic characteristics were recorded. RESULTS: The mean age for the onset of LN was 9 years (range: 5-17 years), and the mean duration of the skin lesions was 13 months (range: 1-48 months)...
February 11, 2019: Pediatric Dermatology
Kriti Mishra, Arun Sood, Aimee Smidt, Harper N Price
Parry-Romberg syndrome (PRS) is characterized by hemiatrophy of facial structures, including skin, subcutaneous fat, muscle, bone, and cartilage. Complications associated with PRS include headaches, seizures, and chronic facial pain. Protocol for the treatment of chronic facial pain is not clear; reports on the use of botulinum toxin A injections for pain reduction in adults but not in the pediatric/adolescent population are available. Here, we discuss two pediatric PRS cases in which treatment with botulinum toxin A injections reduced or eliminated facial pain...
February 10, 2019: Pediatric Dermatology
Andrew M Armenta, Sasha D Jaquez, Moise L Levy, Lucia Z Diaz
The fear of painful procedures is at an increased incidence within the pediatric population. This can be an extremely challenging obstacle in dermatology where injections, blood draws, and cryotherapy are often required during the care of patients. Psychologic techniques based on cognitive behavioral therapy (CBT) can be implemented leading up to and while performing these procedures to help reduce patient anxiety.
February 10, 2019: Pediatric Dermatology
Lawrence F Eichenfield, Jeffrey L Sugarman, Eric Guenin, Susan Harris, Varsha Bhatt
BACKGROUND: Acne vulgaris (acne) is a common skin condition in children and adolescents. Efficacy of tretinoin is well documented in studies that included pediatric patients (12-18 years of age). With acne routinely presenting in younger patients, data are needed in this important group. Lotion formulations are commonly used across dermatology and are well liked by patients. OBJECTIVE: To evaluate the safety and efficacy of a novel once-daily tretinoin 0.05% lotion in preadolescent subjects (≤ 13 years) with moderate-to-severe acne...
January 18, 2019: Pediatric Dermatology
Jusleen Ahluwalia, Jenna Borok, Rahul S Ahluwalia, Eveie W Schwartz, Dana Hosseini, Sasan Amini, Lawrence F Eichenfield
BACKGROUND/OBJECTIVES: The pathogenesis of preadolescent acne has not been well studied, and it is uncertain if Cutibacterium acnes is a predominant organism in the microbiome in this age group. The aim of this study was to analyze the microbiome of preadolescent females and to assess whether benzoyl peroxide impacts the microbiome. METHODS: The study enrolled girls, aged 7-12 years, with evidence of at least six acne lesions who had not been previously treated...
January 18, 2019: Pediatric Dermatology
Maria Estela Martinez-Escala, Sapna Modi Amin, Kimberly Anne Sable, Pedram Gerami, Joan Guitart
We described the development of multiple melanocytic nevi within long-standing MF patches in four young patients. Mycosis fungoides (MF) patches are characterized by a regulatory-like cytokine profile leading to local immune suppression. The proliferation of nevomelanocytes is regulated by cellular senescence mechanisms mediated by immune system. The immunosuppressive effect of MF infiltrate in conjunction with the systemic effect of treatments may play a specific role in the nevomelanogenesis of the patients herein described...
January 18, 2019: Pediatric Dermatology
Emily A Weig, Gretchen M Roth, Nkanyezi N Ferguson
Subepidermal calcified nodules are lesions that primarily affect children and are most commonly located on the head. The current standard of treatment for these is surgical excision. However, surgical excision is not always possible and may not be cosmetically favorable. We describe the use of a CO2 laser as a successful treatment for a subepidermal calcified nodule of the finger.
January 18, 2019: Pediatric Dermatology
Aikaterini Patsatsi, Aikaterini Kyriakou, Victoria P Werth
Bullous pemphigoid (BP) is the most common autoimmune blistering disease affecting the elderly but is quite rare in childhood. The majority of pediatric cases have been reported during early childhood. Adolescence is divided into three phases: early (10-13 years), middle (14-17), and late (18-21). This review aimed to identify BP cases in adolescence and demonstrate their clinical features and course. Our literature search was performed in Medline with the terms "bullous pemphigoid in childhood and adolescence," "childhood bullous pemphigoid," "juvenile bullous pemphigoid," and "autoimmune blistering and autoimmune bullous diseases in childhood...
December 19, 2018: Pediatric Dermatology
Angela Mauro, Salvatore Mauro, Roberto Rega, Luigi Martemucci, Rita Sottile
Henoch-Schonlein purpura (HSP) is the most common systemic vasculitis in childhood. There is no consensus about the management for isolated cutaneous manifestations in HSP. We describe a case of HSP presenting with severe skin lesions that did not respond to standard therapy with corticosteroids. The 11-year-old child was treated with intravenous immunoglobulins, which induced rapid and persistent resolution of symptomatology.
December 18, 2018: Pediatric Dermatology
Mohammed D Saleem
Melanocyte development is orchestrated by a complex interconnecting regulatory network of genes and synergistic interactions. Piebaldism and Waardenburg syndrome are neurocristopathies that arise from mutations in genes involved in this complex network. Our understanding of melanocyte development, Piebaldism, and Waardenburg syndrome has improved dramatically over the past decade. The diagnosis and classification of Waardenburg syndrome, first proposed in 1992 and based on phenotype, have expanded over the past three decades to include genotype...
December 18, 2018: Pediatric Dermatology
Sarah Helen Mehrtens, Sonal Shankar
We present a rare case of focal facial dermal dysplasia type 4 (FFDD4) in an otherwise healthy boy infant, presenting as bilateral preauricular scarlike defects surrounded by a hair collar, resembling membranous aplasia cutis congenita. The presence of a hair collar supports the hypothesis that FFDD is caused by abnormal closure at facial embryonic fusion lines, but unlike midline scalp defects is not associated with neurological compromise. Other types of FFDD occur at different sites and can be associated with cranial dysgraphism...
December 18, 2018: Pediatric Dermatology
Eric J Yang, Kristen M Beck, Sahil Sekhon, Tina Bhutani, John Koo
BACKGROUND: Atopic dermatitis (AD) is an extremely common childhood disease, with considerable impact on the quality of life of affected children and their families. While pruritus is the hallmark symptom of this disease, AD has been well-documented to impact patients beyond physical symptoms, resulting in behavior problems, mood disorders, and sleep disturbance. OBJECTIVE: This literature review outlines how atopic dermatitis impacts the quality of life of families of children affected by AD...
December 16, 2018: Pediatric Dermatology
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