Pediatric Dermatology最新文献

Congenital erosive and vesicular dermatosis (CEVD) is a rare condition that typically presents at birth with erosions and vesicles that heal with distinctive reticulate and supple scarring. We report two cases of CEVD in term infants, both of which exhibited unique features. The first patient presented with linear erosions that healed without vesiculation, and the second with stellate scarring and milia. As there was no clear history of vesiculation in both our patients, we suggest the term congenital erosive and scarring eruption (CEASE) may better reflect this subset of CEVD.

Reactive infectious mucocutaneous eruption (RIME) is a clinical syndrome characterized by mucosal and cutaneous manifestations triggered by various infectious agents. Herein, we describe a case of an 11-year-old girl who presented with RIME, with significant genital involvement, associated with a urinary tract infection caused by Klebsiella pneumoniae. This case highlights the importance of examining the genital mucosa in RIME and the need for increased awareness of RIME among physicians.

Trichophyton indotineae is a fungus that is often antifungal-resistant and presents with exuberant infection. It has been increasingly reported across the world, posing significant diagnostic challenges. We describe a case of a toddler with a history of travel to Bangladesh, presenting with persistent annular scaling plaques of dermatophytosis that were unresponsive to standard antifungal treatments. Misidentification of the Trichophyton species on fungal culture delayed appropriate treatment, with resolution of the rash with a course of itraconazole. This case underscores the need for heightened clinical suspicion and the value of empiric therapy in managing pediatric T. indotineae infection.

This study sought to evaluate narrowband UVB phototherapy in pediatric vitiligo through an online patient and caregiver survey to better understand patient experiences and barriers to care in this population. In a survey of 111 respondents, 51.4% were offered nbUVB and 45.1% utilized nbUVB for treatment of vitiligo before age 18 years. The primary reasons for not pursuing nbUVB included it not being offered (36.1%), difficulty attending appointments (11.5%), and satisfaction with the current skin condition (11.5%). Our results suggest nbUVB may be underutilized in pediatric vitiligo; addressing obstacles to access is crucial for improving treatment outcomes and quality of life.

This study aims to assess perspectives on pediatric dermatology care in an underserved, rural region of California using semi-structured interviews with 13 PCPs with experience in the Central Valley of California. Most participants reported a high need for pediatric dermatologists in this rural region and had differing strategies for addressing gaps resulting from this workforce shortage. Participants also noted numerous barriers and challenges facing patient families, including lack of adequate transportation, language barriers, knowledge gaps, and financial burden. The findings of our study demonstrate strategies most useful to rural PCPs in caring for pediatric dermatology patients, which can inform efforts to enhance health equity given the near absence of pediatric dermatologists practicing in these regions.

Anagen effluvium is a rare adverse effect of methotrexate therapy, generally associated with high-dose regimens. We report a 12-year-old girl who developed abrupt hair loss 1 week after inadvertently taking methotrexate 15 mg daily for five consecutive days (total 75 mg), without other signs of systemic toxicity. Trichoscopic examination and trichogram findings confirmed methotrexate-induced anagen effluvium, and spontaneous hair regrowth occurred after 2 months. This case underlines the importance of careful methotrexate dose monitoring and awareness that methotrexate toxicity can be associated with anagen effluvium even in the absence of other signs of toxicity.

Cutaneous myiasis is most commonly seen in travelers returning to the United States. There are rare reports of US-acquired human myiasis, with Cuterebra larvae being the most common causative organism. Gasterophilus, also known as the horse botfly, however, rarely infests human hosts and typically presents as cutaneous migratory myiasis, unlike this case. We report a cutaneous furuncular myiasis due to Gasterophilus larvae in the neck and cheek of a 4-year-old female after visiting a campground in northern New York.

We report a patient with neuroichthyosis with an ELOVL1 variant associated with severe pruritus who responded well to dupilumab therapy. Our case is the third known patient reported with this de novo heterozygous dominant variant. The feature of severe progressive pruritus greatly impairing quality of life is unique among these reports. After multiple treatment failures, he responded well clinically and subjectively to the monoclonal antibody dupilumab.