Pediatric Dermatology最新文献

Background: Infantile hemangiomas (IH) affect 2%-10% of the pediatric population. The current standard treatment for complicated IH is oral propranolol. Propranolol initiation protocols vary depending on institution and may occur in an inpatient setting for patients <5-week-corrected-age, with a history of premature birth, and or with low weight to allow for heart rate (HR), blood pressure (BP), and glucose monitoring.

Objective: Our study aimed to determine the clinical outcomes of monitoring inpatient propranolol initiation and to evaluate if complications occurred during admission.

Methods: Retrospective chart review of patients seen at the University of Minnesota Department of Dermatology between January 01, 2012 and July 31, 2022 was completed. Inclusion criteria include less than 1 year of age at time of admission, a diagnosis of IH and or PHACE syndrome, and admission for propranolol initiation and monitoring.

Results: Admissions for 78 pediatric patients were reviewed. After initiation of propranolol, significant decreases in BP (systolic p = .005; diastolic p = .002) and HR (p = .004) were noted; however, average BPs and HRs remained above the lower limit of normal. No patients experienced symptomatic hypoglycemia. No statistically significant or clinically meaningful differences in vital sign alterations were observed between patients <5 versus >5 kg; preterm vs term gestation; or <5-week-corrected-age versus >5-week-corrected-age.

Discussion: Our findings complement current literature confirming that propranolol initiation is safe in pediatric patients. Propranolol initiation likely requires less laboratory and vital sign monitoring than currently performed for these patient populations.

Hair follicle nevus is a rare benign follicular hamartoma that is characterized histologically by the proliferation of vellus hair follicles with peri-follicular fibrous thickening. Clinically, hair follicle nevus is most commonly reported as an asymptomatic papule or nodule on the head and neck. Here, we describe an unusual presentation of hair follicle nevus presenting as an atrophic plaque on the cheek of a male infant.

PLACK syndrome is an autosomal recessively inherited genodermatosis characterized by peeling skin, leukonychia, acral keratoses, cheilitis, and knuckle pads caused by variants in CAST gene. This report describe two unrelated Indian children with typical features of PLACK syndrome and homozygous novel variants in the CAST gene.

Rates of childhood obesity are rising, making it a public health concern due to its link to numerous poor health outcomes over the lifespan. In adults, obesity is associated with various inflammatory skin conditions; however, this is not well-studied in children with obesity. A retrospective cohort study was conducted using the TrinetX Research Network Database, evaluating children under 18 with and without obesity and various dermatologic conditions and comorbidities. Childhood obesity was associated with increased rates of all dermatologic conditions and associated comorbidities evaluated (p < 0.05). This study highlights associations between various dermatologic conditions and comorbidities in children with obesity, compared with those without, emphasizing the need for early intervention and management strategies to mitigate obesity related health complications in pediatric populations.

The rise in the use of cosmeceuticals among children and adolescents has created a new challenge for dermatologists, who are confronted with the task of advising young patients on the risks that these products can carry and the often questionable efficacy of these products. While some cosmeceuticals can be beneficial for this population when used correctly, such as broad-spectrum sunscreen or specific anti-acne agents, other products may not carry benefits for young skin and could even cause complications, particularly in young consumers who have skin conditions such as acne or atopic dermatitis. Many of the common ingredients in cosmeceutical products have had very limited (if any) studies conducted in pediatric populations, and much of the data regarding the efficacy claims and risks of these products must be inferred from studies in adult patients.

Acquired digital fibrokeratoma (ADF) is a rare, benign tumor most commonly seen in adults aged 30-60, with pediatric cases being exceedingly rare. We report a case of ADF in a 6-year-old male, the youngest documented patient to date, who presented with a persistent 6-mm papule on the right first finger misdiagnosed as a verruca. Histopathological examination confirmed the diagnosis, and the lesion was successfully treated with surgical excision without recurrence. This case expands the demographic understanding of ADF and underscores the importance of including it in the differential diagnosis of atypical skin lesions in pediatric patients.

Background: Alopecia areata (AA) is an autoimmune disease characterized by hair loss that can negatively impact quality of life. AA has a significant pediatric prevalence; however, no systemic treatments are approved for AA in patients aged < 12 years. Ritlecitinib, a JAK3/TEC family kinase inhibitor, is approved to treat adults and adolescents with severe AA aged ≥ 12 years. This study evaluated ritlecitinib pharmacokinetic (PK) parameters and safety in pediatric patients with AA aged 6 to < 12 years.

Methods: In this single-group, uncontrolled, open-label study, participants received ritlecitinib 20 mg once daily for 7 days. PK parameters of ritlecitinib on Day 7 were measured and summarized descriptively. Safety outcomes, including incidence of adverse events (AEs), were evaluated.

Results: Fifteen participants were enrolled and 14 (93.3%) completed the study. The median time to maximum concentration (T_max) for plasma concentrations of ritlecitinib on Day 7 was ~0.5 h. The mean half-life of ritlecitinib was ~1.19 h. Geometric means (% coefficient of variation) for area under the curve from 0 to 24 h (AUC₂₄) and maximum concentration (C_max) were 437.5 ng·h/mL (30%) and 208.7 ng/mL (38%), respectively. Four AEs were experienced by 3 participants, with 1 AE of urticaria resulting in permanent discontinuation. No severe AEs, serious AEs, or clinically meaningful laboratory abnormalities were reported.

Conclusions: Ritlecitinib PK parameters in pediatric patients were successfully characterized in the present study. Ritlecitinib 20 mg once daily was generally well tolerated in pediatric patients with AA.

Trial registration: NCT05650333.

Understanding the potential racial differences in presentation, severity, and outcomes of pediatric hidradenitis suppurativa (HS) can help deliver equitable and individualized care, especially as this condition is increasingly being acknowledged in this population. We conducted a single-center retrospective analysis of 70 pediatric patients diagnosed with HS who were seen at our institution. There was no statistically significant difference in biologic treatments between non-Hispanic Black (NHB) patients when compared to non-Hispanic White (NHW) patients, although NHW patients overall received biologic therapy more frequently (17.4%) than NHB patients (12.8%). The observed racial differences in pediatric HS highlight the need for further investigation of possible underlying factors contributing to disease heterogeneity and treatment response to optimize the care provided and patient outcomes.