Publications by authors named "Elizabeth Nieman"

Eruptive melanocytic nevi (EMN) have been reported in the setting of immunosuppression, chemotherapy, and bullous skin disease, including less commonly, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). This case report presents a 4-year-old girl who developed agminated EMN and nail changes after TEN. A systematic review of the literature supports clinically appropriate follow-up of EMN, as there is no reports of malignancy in EMN following SJS/TEN, nor reports of pediatric melanoma arising within EMN of any etiology.

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Hidradenitis suppurativa (HS) and ulcerative colitis (UC) are associated chronic inflammatory conditions with complex disease courses and potential for overlapping therapeutic management. We describe a case of severe pediatric HS and UC that were poorly controlled despite several standard-of-care therapies, including infliximab and ustekinumab. Transitioning the patient to upadacitinib monotherapy resulted in clinical improvement of both her UC and HS within 3 months, and she was then able to be weaned off her other systemic therapies.

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Article Synopsis
  • Cutaneous pyogenic granulomas (PGs) are benign tumors with unclear causes, but recent research indicates they may be linked to genetic changes in specific cellular pathways.
  • The authors discuss three cases of spontaneous multifocal PGs that began during infancy, lacking associated vascular issues or clear causes, and show genetic mutations in the Ras/Raf/MAPK pathway.
  • These PGs did not respond well to treatments like beta-blockers and mTOR inhibitors, but improved significantly with pulsed dye laser therapy; the authors suggest the term "spontaneous multifocal PGs" for this condition.
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  • - Alopecia areata (AA) has a lifetime incidence of about 2%, often starting in childhood, with ritlecitinib being the only FDA-approved treatment for those aged 12 and older.
  • - The review examines various treatment options for pediatric AA patients, including topical, injectable, and oral therapies, focusing on those that have been clinically studied.
  • - While existing treatments like corticosteroids and methotrexate are common, newer options like Janus kinase inhibitors show promise, though evidence remains limited and combination therapies are often necessary for better outcomes.
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"Corymbiform" is a term found in medical literature as early as 1876 to describe a central larger lesion with smaller surrounding lesions, leading to the appearance of an irregular border. While the term in current medical literature most often describes a possible morphology of secondary syphilis, the authors have noted this pattern presenting in other cutaneous conditions. We present a commentary on the corymbiform pattern in dermatology including a series of photographs of cutaneous disorders presenting in a corymbiform morphology in pediatric patients.

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  • Molluscum contagiosum (MC) is a common viral skin infection in children, marked by small, dome-shaped bumps that usually heal on their own over time.
  • The immune response to MC can trigger various inflammatory skin conditions, including molluscum dermatitis and granuloma annulare-like reactions.
  • A unique case is reported where a child developed a granuloma annulare-like reaction due to their immune system recognizing MC, which subsequently led to a quick resolution of the bumps.
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Vascular anomalies (VA) are developmental anomalies of veins, arteries, lymphatics or capillaries thought to be caused by mutations in genes that drive angiogenesis. Treatments targeting these genes are limited. We review the literature for conventional medications and products from traditional medicine cultures that have been found to have antiangiogenic activity.

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Purpose Of Review: The use of lasers in pediatric dermatology is well established, but recent literature has expanded the evidence for specific timelines of treatment. Additionally, new devices and combinations with medical therapy have improved outcomes and treatment options for various conditions.

Recent Findings: Pulsed dye laser remains the first-line laser for vascular lesions.

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Topical corticosteroids (TCS) are the most commonly prescribed treatment for children with atopic dermatitis and are supported by the American Academy of Dermatology (AAD) atopic dermatitis treatment guidelines with level I strength A evidence; however, fear regarding their use, coined "steroid phobia," is widespread. In this study, we analyzed steroid phobia-related content on popular social media platforms. We found much of this content consists of patients describing negative personal experiences with TCS and subsequently discouraging viewer use.

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Introduction: Onychomadesis occurs when the nail plate separates from the nail matrix and nail bed, eventually leading to shedding of the nail. This condition has been attributed to viral infections, autoimmune disorders, drug side effects, and physical trauma. A subset of patients has a recurrent form of onychomadesis without a clear trigger; this phenomenon is not well characterized in the literature.

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Sinus pericranii is a rare vascular anomaly characterized by an abnormal communication between the intra- and extracranial venous systems through a calvarial defect(s). We present three cases of congenital sinus pericranii with facial involvement, emphasizing its cutaneous presentation with diagnostic pitfalls and discuss the multidisciplinary management of this vascular anomaly.

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Article Synopsis
  • - Atopic dermatitis (AD) is a prevalent skin condition that often starts in childhood and can persist into later life, requiring more than just topical treatments for some patients.
  • - This review discusses systemic immunomodulating medications used for AD, including cyclosporine A, azathioprine, methotrexate, and mycophenolate mofetil, which are commonly prescribed off-label in the U.S., alongside dupilumab, an FDA-approved option.
  • - Additionally, the review highlights new systemic therapies that are currently being researched and may soon be available for treating AD.
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Article Synopsis
  • * The focus of this review is on topical treatments, as systemic medications are not commonly recommended for infants, highlighting emollients, topical corticosteroids, and other topical agents.
  • * The review will also cover new and promising therapies being researched for treating AD in children.
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Background: Cardiac tumors are uncommon in the pediatric population. When present, cardiac manifestations stem from the tumor causing inflow or outflow obstruction. While common in adults, cardiac myxomas presenting with generalized systemic illness or peripheral emboli especially with no cardiac or neurological symptoms are rare in children.

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Infantile haemangiomas (IHs) with functional or cosmetic concerns necessitate systemic treatment for which propranolol is the preferred treatment. However, the mechanism of action is unknown. Mouse models suggest the angiopoietin-2 (Ang2)/Tie-2 system is implicated.

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Background Aims: Delivery of cell-based therapies through the carotid artery with the use of an intra-arterial catheter could introduce aggregates and cause focal ischemia in the brain. We developed a pulse-width flow cytometry method for aggregate detection and quantification. The assay was designed to be used as a cell product release assay in a clinical trial seeking to treat ischemic stroke with sorted cells brightly expressing aldehyde dehydrogenase (ALDH(br) cells) delivered through intra-arterial catheters.

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Background: The body of research is rapidly growing regarding the use of telemedicine in patient care, including cost-effectiveness, patient access, patient outcomes, etc. Less has been done describing physician communication during different aspects of the clinical visit (i.e.

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