Pediatric Dermatology最新文献

Psychiatric comorbidities associated with dermatological diseases, particularly in pediatric populations, are relatively understudied compared to psychiatric comorbidities of other chronic diseases. Research suggests that skin conditions in adolescence often co-occur with mental health difficulties, including heightened risk for suicide. Dermatologists play a vital role as early identifiers of suicidal thoughts and behaviors (STB) for their adolescent patients. Currently, there are no recommendations for screenings or assessments related to suicide risk in dermatologic settings. We provide evidence-based tools that can be helpful for STB assessment and highlight clinical pearls for increasing comfort when suicidal thoughts or behaviors occur in the pediatric dermatologist's office.

Giant cell fibroblastoma (GCF) is a rare predominantly pediatric tumor with frequent local recurrence that has clinical and histological similarities with DFSP. We conducted a literature review of published pediatric GCF cases to review demographics, management and outcomes. We identified 104 pediatric GCF cases from 52 articles, of which 81 were treated with excision of unspecified margins (EUM), 17 with wide local excision (WLE), two with Mohs micrographic surgery (MMS), and one with chemotherapy. Local recurrence was noted in 38/104 (36.5%); given the high recurrence rates of GCF following excision, and the advantages of MMS in treating DFSP, MMS is an important consideration for GCF when logistically possible.

Epidermolytic ichthyosis (EI) is a rare autosomal dominant keratinization disorder characterized by blistering at birth followed by progressive hyperkeratosis. Treatment is primarily supportive, involving emollients, keratolytics, and occasionally systemic agents. We report a pediatric case of clinically and histologically confirmed linear EI that showed marked improvement with topical urea 30% cream. Therapy led to substantial reduction in scaling, smoother skin texture, and improved comfort, with no adverse effects. This case highlights the potential role of high-concentration urea as a safe and effective monotherapy in pediatric EI.

Elexacaftor/tezacaftor/ivacaftor is a novel "triple therapy" drug which has been shown in clinical trials to reduce morbidity and mortality in cystic fibrosis patients. Few reports of serious cutaneous adverse reactions to elexacaftor/tezacaftor/ivacaftor leading to drug discontinuation have been previously documented, all occurring within 1 month of drug initiation. Herein we present a novel case of delayed bullous drug eruption, arising 2 years after elexacaftor/tezacaftor/ivacaftor initiation, with subsequent successful drug re-introduction. Documentation of the possible serious cutaneous adverse effects of elexacaftor/tezacaftor/ivacaftor will importantly aid understanding of the potential for drug re-challenge in these cases.

Hidradenitis suppurativa (HS) is an inflammatory skin condition increasingly diagnosed in pediatric populations; however, data on treatment practices in this group remains limited. In this retrospective study of 163 patients diagnosed with HS ≤ 18 years of age, we found that treatment patterns varied significantly by disease severity. As compared to patients with Hurley stage I (HSI) disease, those with Hurley stage III (HSIII) were more likely to receive: biologics (11.8% versus 58.3%, p < 0.001), chlorhexidine (47.1% versus 75.0%, p = 0.009), intralesional steroid injections (20.0% versus 58.3%, p < 0.001), metformin (3.53% versus 22.2%, p = 0.006), oral steroids (0%, versus 19.4%, p < 0.001), and spironolactone (10.6% versus 38.9%, p = 0.001). Higher Hurley stage was also associated with higher odds of receiving pain management prescriptions (NSAIDs [10.6% HSI versus 26.2% Hurley stage II (HSII) versus 52.8% HSIII; p < 0.001] and opioids [3.6% HSI versus 9.3% HSII versus 31.0% HSIII; p < 0.001]).

Cutaneous graft-versus-host disease (GVHD) is a significant complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). This review offers a clinically focused update on the diagnosis and management of acute and chronic cutaneous GVHD in pediatric patients. We highlight recent advances in clinical classification systems and therapeutic options, including newly FDA-approved treatments for steroid-refractory disease. Given the risk of long-term morbidity, multidisciplinary care and consistent dermatologic follow-up are essential. Future research should focus on pediatric-specific diagnosis and treatment to address age-specific presentation, drug response, and safety, as well as the potential of less immunosuppressive therapies for select cutaneous GVHD phenotypes.

Entomophthoromycosis is a rare skin and subcutaneous fungal infection predominantly common in the tropical regions with diagnostic challenges in the pediatric population. Herein, we report a case of a 2-year-old boy with an asymptomatic slowly progressive unilateral swelling of the face and upper chest over a 9-month period who presented to us with atypical shiny dome-shaped, hard swelling with loss of skin pinchability and cervical lymphadenopathy. Fine needle aspiration cytology from one of the lymph nodes demonstrated necrotizing granulomatous inflammation and histology from one of the swellings over the chest revealed necrotizing granuloma in the dermis, multinucleated giant cells, intracytoplasmic hyphae, and positive PAS staining. Subsequently, he was started on a supersaturated solution of potassium iodide and Itraconazole following which there was complete resolution.