Pediatric Dermatology最新文献

This study evaluated the feasibility, reproducibility, validity, and responsiveness of the Chromameter CR-400 for assessing erythema in infantile hemangiomas (IHs). Results demonstrated high inter- and intra-rater reliability and consistent measurement accuracy, outperforming a subjective visual analog scale (VAS) in detecting subtle changes. While limited by a small sample size, the chromameter CR-400 shows promise as an objective tool for monitoring IH progression and potentially treatment response.

Alopecia areata (AA) is a nonscarring, autoimmune hair disorder affecting approximately one in 1000 children and leads to considerable psychosocial distress. This pilot study evaluated the impact of "Hair Heroes," a 30-min educational curriculum aimed at enhancing middle school students' knowledge of and attitudes toward AA. Following the intervention, students demonstrated statistically significant improvements in understanding of AA (p < 0.001) and increased willingness to befriend a bald peer (p = 0.024), with over 75% reporting that the lesson was a meaningful addition to their education. These findings support the integration of targeted inclusivity curricula in school settings to reduce stigma and promote the psychosocial well-being of children affected by AA.

Epidermolysis bullosa simplex (EBS) is a genetic condition characterized by skin fragility and blistering due to minimal mechanical trauma. EBS-KLHL24, a rare subtype, arises from pathogenic variants in the KLHL24 gene and has unique clinical features, including systemic involvement. We present a case of a 16-year-old patient with EBS-KLHL24 exhibiting novel clinical findings, including significant oral blistering, hyperkeratotic papules, ocular involvement, and lichenified reticulate flexural scarring. This case expands the EBS-KLHL24 phenotype and highlights the importance of accurate diagnosis, early genetic confirmation, and multidisciplinary care to improve understanding of this disorder.

Juvenile xanthogranulomas (JXGs) are benign solitary or multiple lesions that present as yellow-red nodules on the skin or other organs, with histology demonstrating normolipidemic, non-Langerhans cell histiocytosis. We present a case of a clinically atypical lesion shown to be of the JXG family of lesions following pathologic review. Next-generation sequencing (NGS) analysis revealed a MRC1::PDGFRB gene fusion. This is the third report of the MRC1::PDGFRB gene fusion identified in JXG, and the first case of an isolated cutaneous lesion, which highlights the spectrum of the MRC1::PDGFRB gene fusion in JXG.

An 8-year-old female developed fever, dyspnea, and cough 1 week after starting ustekinumab for psoriasis. She was noted to have recurrent left lower lobe consolidation and subsequent obstructing eosinophilic casts and was diagnosed with eosinophilic plastic bronchitis. Her respiratory symptoms improved with systemic steroids, mepolizumab for 10 months, and discontinuing ustekinumab. Eosinophilic pneumonia/eosinophilic plastic bronchitis has been rarely reported as an adverse effect of ustekinumab in adults; to our knowledge, it has not previously been reported in children on ustekinumab for a dermatologic indication.

In January 2021, the Centers for Medicare and Medicaid Services (CMS) implemented changes that increased work relative-value units (wRVUs) for outpatient evaluation and management (E/M) services, potentially benefiting cognitive specialties such as pediatric dermatology. This cross-sectional study analyzed 230,524 dermatology outpatient encounters across pediatric, general adult, and micrographic surgery and dermatologic oncology (MSDO) providers at a large academic health system in 2019 and 2021 to assess the impact of these changes. We found that mean wRVUs per encounter increased in pediatric and adult dermatology and decreased for micrographic surgery after the CMS revision (pediatric: 1.3-1.9, p < 0.01; adult: 1.8-2.2, p < 0.01; MSDO: 12.9-12.6, p = 0.048). Both pediatric and adult dermatologists shifted toward billing higher-level E/M codes after the 2021 reforms. These findings suggest that the 2021 CMS reforms modestly narrowed, but did not eliminate-longstanding reimbursement disparities between cognitive and procedural dermatology practices.

Psoriasis is a skin disease characterized by erythematous and scaly lesions, influenced by genetic and environmental factors. Hirschsprung disease (HD) is a congenital disorder associated with gut microbiome dysbiosis, which can trigger inflammatory skin conditions. We report a case of psoriasis vulgaris in a male infant with HD whose skin lesions completely resolved after HD treatment. This case highlights a potential link between HD-related gut dysbiosis and psoriasis.