Pediatric Dermatology最新文献

Tumor necrosis factor-alpha inhibitors (TNFi) are used to treat various autoimmune diseases but can induce paradoxical psoriasiform dermatitis (PD) in a subset of patients. This retrospective chart review aimed to identify risk factors impacting PD severity in 70 pediatric patients at a single center. Forty patients (57.1%) discontinued their initial TNFi: 12/40 (30.0%) switched to another TNFi, with 4/12 (33.3%) experiencing PD recurrence, while 25/40 (62.5%) switched medication classes. Female sex was associated with increased use of high-potency topical steroids (p = 0.01), suggesting more severe disease. Juvenile idiopathic arthritis (p = 0.02), older age (p < 0.01), and concomitant immunomodulator use (p = 0.04) were associated with a longer latency period before PD development.

Very few cases of porokeratoma have been reported in the literature. We report a 14-year-old boy with porokeratoma presenting with multiple verrucous nodules and masses. Histopathology revealed significant hyperkeratosis of the epidermis, acanthosis, papillomatosis, hypogranulosis, and the epidermis formed large depressions filled with prominent broad cornoid lamellae. After excision of larger nodules, the patient was treated for 3 months with oral acitretin and topical retinoic acid, after which some nodules and masses subsided. Limitations include the unavailability of HPV virology and molecular genetic profiling, which would have been helpful, if not essential.

Jarisch-Herxheimer (JH) reaction is a known side effect involving the worsening of pre-existing skin lesions accompanied by systemic symptoms such as fever, chills, headache, and myalgias. This reaction typically occurs following the initiation of anti-syphilitic therapy but has also been reported with other antimicrobial therapies, such as those for leptospirosis. This case describes the occurrence of a JH-like reaction after the first intake of griseofulvin for the treatment of tinea capitis in a 14-year-old patient. Due to the rarity of the case, the purpose of this report is to raise awareness of the potential for such reactions with systemic antifungal therapies and to provide guidance on their management.

A 14-year-old boy was initially diagnosed with erosive oral lichen planus based on clinical and histopathological findings. However, the atypical clinical course and resistance to immunosuppressive therapy raised suspicion for an autoinflammatory disorder or inborn error of immunity. Genetic testing revealed a pathogenic SH2D1A mutation, confirming X-linked lymphoproliferative disease type 1 (XLP-1) in the absence of Epstein-Barr virus exposure. This case highlights oral mucosal lesions as a potential early, EBV-independent manifestation of XLP-1 and emphasizes the importance of considering monogenic immune disorders in persistent, treatment-refractory mucosal disease.

Social media are increasingly being used as a source of health information. We conducted an online, anonymous survey to learn how caregivers are interacting with social media and how this may impact their child's dermatologic care. There were 136 participants who started the survey and 97 who completed it (71.3% completion rate). The most common skin conditions participants sought information for were atopic dermatitis, 48% (47); acne, 40% (39); and dry skin care, 35% (34). Our results also found that participants of lower socioeconomic status use social media for skin care management more often (p < 0.01), highlighting the importance of providing reliable content on social media.

We report a child presenting with pigmentary skin lesions and spinal neurofibromas who was diagnosed molecularly with KRAS mosaicism. We review the previous literature of two cases of congenital skin lesions and neurofibromas and spinal nerve root hypertrophy caused by KRAS variants and highlight this presentation as an important differential diagnosis for neurofibromatosis.

Integrating First Nations knowledge systems and Western research methodologies recognizes the strength, experience, and insight of First Nations peoples in addressing health issues in their communities. In research, this includes projects being led by First Nations Elders and peoples, including First Nations researchers in the team, and collecting data in ways that reflect First Nations ways of knowing, being, and doing. In this paper, we reflect upon the Koolungar (children) Moorditj (strong) Healthy Skin Project; operational in Perth and Bunbury, Western Australia, Australia, where the traditional custodians are the Noongar Aboriginal people. This Aboriginal Elder co-designed project is presented as a case study to illustrate the practical use of The Kids Research Institute Australia Standards for the Conduct of Aboriginal Health Research, in striving towards best practice in Aboriginal pediatric dermatology research. It leads into The Koolungar (children) Moorditj (strong) Healthy Skin Project Part II manuscript, in which we present cross-sectional studies of Aboriginal children attending community skin screening weeks.

Trichotillomania (TTM) is a condition characterized by recurrent hair pulling, often resulting in hair loss and functional impairment. The disorder remains underreported in the pediatric population, despite high rates of psychiatric comorbidities. Moreover, diagnosing and treating TTM among children remains challenging due to a lack of standardized guidelines. Hence, this systematic review aims to evaluate the current treatment approaches for pediatric TTM. A comprehensive search was conducted of five databases, using the search concepts of trichotillomania, pediatric populations, and treatments/interventions. Studies were included if they (1) directly addressed the topic, (2) were of an appropriate study type (e.g., clinical trials, case-control studies, cohort studies, cross-sectional studies, or interview studies), (3) were published within the past 10 years, and (4) appeared in peer-reviewed journals published in English. Ultimately, 10 studies met our inclusion criteria, from which data were extracted and synthesized following formal quality assessment. Our results indicate that behavioral interventions, particularly habit reversal training, consistently demonstrated the greatest therapeutic benefit. Pharmacological treatments, including selective serotonin reuptake inhibitors, have been explored in various case series. Although some individuals have shown improvement, overall evidence remains insufficient to support pharmacotherapy as first-line. Alternative therapies, such as N-acetylcysteine, have also been studied, though findings are variable and require further investigation in pediatric cohorts. Our review underscores the importance of early behavioral intervention and the need for larger, controlled studies to inform standardized treatment protocols. Given the functional and psychosocial burden of TTM in youth, comprehensive management strategies are essential.

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in school-aged children. Various cutaneous reactions to M. pneumonia have been described, including reactive infectious mucocutaneous eruption, morbilliform eruptions, and vasculitis. This study highlights two cases of Mycoplasma infection that presented with a morbilliform eruption and had clinical and laboratory findings similar to drug reaction with eosinophilia and systemic symptoms (DRESS), a pattern not well documented in the literature, and emphasizes the clinical manifestations that help distinguish between these conditions.