Cutaneous coronavirus disease 2019 in children: a clinical primer for diagnosis and treatment.

Purpose Of Review: This review examines the global literature regarding rashes encountered in children and adults infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and aims to provide practicing pediatricians with an understanding of the relationship between instances of rashes and coronavirus disease 2019 (COVID-19) in children in order to effectively evaluate and treat patients.

Recent Findings: The true incidence of cutaneous reactions in children infected with SARS-CoV-2 is not known. Children's immune systems differ from those of adults and rashes as a manifestation of immune responses, in turn, differ in morphology and distribution.

New science and treatment paradigms for atopic dermatitis.

Purpose Of The Review: The prevalence of atopic dermatitis is increasing in industrialized countries for unclear reasons. One theory centers on reduced exposure to microbes during infancy and childhood. Alterations in the epidermal permeability barrier, place certain patients at risk for the immunological dysfunction seen in atopic dermatitis.

Cutaneous manifestations of systemic viral diseases in neonates: an update.

Purpose Of Review: Dermatologic findings may be the first signs of a neonatal viral infection. This review provides an update of the diagnostic features and therapies for selected viral illnesses [herpes simplex virus (HSV), varicella zoster virus, enterovirus, and Zika virus] that present with cutaneous manifestations in the neonate.

Recent Findings: HSV DNA polymerase chain reaction of plasma and cerebrospinal fluid, routinely used in the diagnosis of neonatal HSV, may have expanded utility in assessing prognosis and acyclovir therapeutic efficacy.

Childhood skin and soft tissue infections: new discoveries and guidelines regarding the management of bacterial soft tissue infections, molluscum contagiosum, and warts.

Purpose Of Review: Pediatric skin and soft tissue infections (SSTIs) constitute a significant number of office-based pediatric visits. With SSTIs on the rise, it is not only important to effectively treat the individual, but to do so appropriately and cost-consciously. In this article, we highlight new research related to the treatment of bacterial skin infections, molluscum contagiosum, and cutaneous warts, with the goal of guiding pediatricians in their practice against these common skin conditions.

Dermal melanocytosis and associated disorders.

Purpose Of Review: Dermal melanocytosis is commonly seen in the newborn period and is frequently a concern to parents and providers. Four clinically distinct entities are recognized: nevus of Ota, nevus of Ito, Mongolian spots, and dermal melanocyte hamartoma. This article reviews these disorders, with special emphasis on melanocyte biology and important associated systemic disorders such as rare malignant transformations and inborn errors of metabolism.

What's new with common, uncommon and rare rashes in childhood.

Purpose Of Review: Children with rashes account for many of the outpatient visits to a general pediatrician. As such, pediatricians are often the first to identify and treat these rashes. Establishing an approach to common, uncommon and rare pediatric rashes assists in accurate assessment.

Cosmeceuticals for children: should you care?

Purpose Of Review: Cosmeceuticals are substances that exert physiologic changes to the skin for aesthetic purposes and are popular alternatives to invasive cosmetic procedures for antiaging. Cosmeceuticals are being used on children; yet studies of cosmeceuticals in the pediatric population are limited.

Recent Findings: Cosmeceuticals remain an unrecognized category by the US Food and Drug Administration, and therefore stringent regulatory pathways do not exist to guide research and marketing.

Core concepts in congenital melanocytic nevi and infantile hemangiomas.

Purpose Of Review: Congenital melanocytic nevi (CMN) and infantile hemangiomas are commonly encountered in newborns and may present diagnostic and therapeutic dilemmas for medical practitioners. Herein, we review and discuss these two important clinical entities and focus on core issues and recent advances.

Recent Findings: Melanoma risk for patients with CMN is greatest in infants with large CMN located on the trunk, CMN greater than 40 cm, and multiple satellite nevi.

Current principles of sunscreen use in children.

Purpose Of Review: Physicians need to be prepared to counsel patients on why and how to protect themselves from damaging ultraviolet (UV) radiation, including the proper use of sunscreens. In this article, we review the interplay between UV radiation, sunscreens and the skin, highlighting current controversies and recommendations surrounding sunscreen use.

Recent Findings: An important concept is that excessive UV exposure has long-term damaging effects on the skin beyond the immediate sunburn.

Effect of cat and daycare exposures on the risk of asthma in children with atopic dermatitis.

Atopic dermatitis (AD) in young children is often followed by the development of asthma (atopic march). The role of environmental exposures is unclear in this high-risk population. We aimed to determine the predictive relationship between indoor allergen exposures, particularly pets, rodents, and cockroaches, to the development of asthma in a prospective pediatric cohort.

Update on topical glucocorticoid use in children.

Purpose Of Review: This monograph reviews recent studies, examining topical glucocorticoid use in children. Emphasis is placed on mechanism of action, relative potency, cutaneous absorption, adverse affects, steroid phobia, and treatment compliance.

Recent Findings: Recent literature has shown that over 80% of patients prescribed topical glucocorticoids are fearful of side effects and fail to use them appropriately.

Cosmetic procedures in children.

Purpose Of Review: Cosmetic procedures are being performed with increased frequency in the United States and worldwide. Many of these procedures are being performed on children for aesthetic reasons and for the management of dermatological conditions such as psoriasis and vitiligo. This review serves as an overview of selected cosmetic procedures with pediatric applications.

Spitz nevi arising in speckled lentiginous nevus: clinical, histologic, and molecular evaluation of two cases.

Spitz nevi are small dome-shaped nodules that sometimes arise in areas of preexisting hyperpigmentation, such as a speckled lentiginous nevus (nevus spilus), where they present a diagnostic dilemma. We report clinical, histopathological, and molecular findings of two cases of multiple Spitz nevi arising in a speckled lentiginous nevus. We used immunohistochemistry to assess expression of Ki-67, epidermal growth factor receptor, vascular endothelial growth factor, and RelA in two cases of Spitz nevi arising in a speckled lentiginous nevus.

Changing the topography of acne with topical medications.

Purpose Of Review: Acne vulgaris is a common skin condition that affects approximately 40-50 million Americans annually. The peak incidence of acne occurs during adolescence and young adulthood, with approximately 80% of persons aged 11-30 years having at least minor acne. Because the onset of acne is typically in early adolescence, pediatricians are often at the front-lines in terms of caring for patients with this chief complaint.

Cultural practices affecting the skin of children.

Purpose Of Review: Cultural practices that present with dermatologic manifestations in the pediatric population are common. However, such skin manifestations are often poorly understood in western medicine and lesions are misdiagnosed, with child abuse being a common misdiagnosis.

Recent Findings: The 2000 Census counted approximately 28 million first-generation immigrants in the United States.

Multiple granular cell tumors in a child with Noonan syndrome.

Granular cell tumors are benign neurally derived neoplasms, involving cutaneous and subcutaneous tissues; and typically occur as solitary lesions. Multiple granular cell tumors occur in 10% of affected individuals, but are in children. Children with underlying somatic and genetic syndromes, including neurofibromatosis and Noonan syndrome, appear to be at higher risk of developing multiple granular cell tumors.

Ichthyotic-appearing skin changes associated with childhood morphea, systemic sclerosis, and systemic lupus erythematosus/scleroderma overlap.

Ichthyotic-appearing skin changes have been associated with autoimmune disorders, including systemic lupus erythematosus and systemic sclerosis in adults. We report three children with ichthyotic-appearing skin changes that may be an early feature reflecting underlying dermal sclerosis. Detection of these subtle skin changes may be predictive of more widespread cutaneous involvement, ultimately prompting earlier treatment.

A business case for shared medical appointments in dermatology: improving access and the bottom line.

Objectives: To evaluate the economic viability of shared medical appointments (SMAs) in dermatology. Secondary objectives include a comparison of the hourly adjusted census levels generated by SMAs compared with regular clinic appointments (RCAs), as well as a comparison between the economic viability of dermatology SMAs and SMAs in other fields of medicine.

Design: Cost-benefit analysis.