Introduction: The use of postbiotics, which are defined as dead microorganisms and/or their components that provide health benefits to the target host, has been shown to reduce the severity of atopic dermatitis (AD) in several studies.
Methods: A systematic literature review was conducted in Pubmed, the Cochrane Library, Science Direct, Clinicaltrials.gov, and Google Scholar, covering the period from January 2012 to July 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. AD patients of all ages that received oral postbiotics or placebo as treatment were the focus of the study. The main study outcome was the scoring of atopic dermatitis (SCORAD) and other measures, such as extension area, disease intensity, and adverse events. The final data were pooled using a fixed-effect model.
Results: A meta-analysis of three studies found that, compared to placebo, SCORAD was lower in subjects that were given oral postbiotics from Lactobacillus sp. (mean difference: -2.90, 95% confidence interval [CI; -4.21, -1.59], p < 0.00001). From the comparison of two studies, the differences in disease extension (mean difference: -2.40, 95% CI [-7.67, 2.81], p = 0.37) and intensity (mean difference: -0.27, 95% CI [-0.84, 0.30], p = 0.36) were not significant.
Conclusions: The administration of oral postbiotics from Lactobacillus sp. has the potential to alleviate the severity of AD as indicated by a reduction in SCORAD scores.
Diagnosing and treating neonatal and infantile erythroderma can be challenging due to the wide variety of potential causes. Neonatal erythroderma is rare and is associated with a high mortality rate due to complications of erythroderma itself and potential life-threatening underlying diseases. Prolonged erythroderma should always be a warning sign and an indication for referral to a hospital where a multidisciplinary team approach is possible. The role of a pediatric dermatologist is to keep in mind the wide spectrum of differential diagnoses that could be causing the condition and the determination of the final diagnosis. To avert a delay in establishing the correct diagnosis, we suggest adhering to specific guidelines. We reviewed available guidelines and adapted a step-by-step approach for use in Slovenia. We also discuss a case of a neonate with erythroderma to illustrate the applicability of the proposed guidelines. Our patient presented with persistent erythroderma, pustules on the trunk and limbs, and intertriginous dermatitis. Despite local corticosteroid treatment, the skin redness persisted. After the exclusion of a systemic infection and additional tests, Omenn syndrome was diagnosed as the underlying cause.
Q fever is a rare worldwide zoonosis, caused by the rickettsial bacteria Coxiella burnetii. There are many clinical manifestations of infection, but the most common ones are fever, atypical pneumonia, and/or liver disease. Cutaneous involvement, however, is not a typical feature of Q fever, but it is nevertheless present in up to 20% of cases. We present a 42-year-old male patient with Q fever and erythema exudativum multiforme (EEM)-like parainfectious exanthema, which to the best of our knowledge has not been described before. We recommend considering Coxiella burnetii infection in the differential diagnosis of an EEM-like rash in a patient with an unexplained or "query" fever.
Lichen planus (LP) is a chronic inflammatory disease of the skin and mucous membranes. The disease usually affects adults and is only rarely encountered in children. Typically, skin lesions include violaceous, polygonal, flat papules and plaques, affecting predilection sites such as the wrists, ankles, and lower back. However, clinical presentation can be heterogeneous and is often atypical in children. Various precipitating factors are known to play an important role in the pathogenesis of lichen planus, some of which may also be coincidental. LP occurring after an infection with Mycoplasma pneumoniae is a rare occurrence. We present the case of a 13-year-old boy with pruritic papular skin lesions on the extremities and trunk. In view of the clinical and histopathological findings, LP exanthematicus was diagnosed. To the best of our knowledge, our case is the first of pediatric exanthematous LP after M. pneumoniae infection that has been reported so far.