Publications by authors named "Kalyani Marathe"

Effective communication in pediatric dermatology is critical for accurate diagnosis and treatment, particularly in sensitive areas such as the anogenital region. Unfortunately, children and their families often use euphemisms or incorrect terms when referring to this area, and many adults lack knowledge of anogenital terminology. Pediatric dermatologists can play a unique role in educating children and their families on correct anatomical language, which enhances body awareness, empowers young patients, improves safety, and contributes to accurate medical assessments and treatment adherence.

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Article Synopsis
  • Lichen sclerosus (LS) is a chronic condition in children that requires ongoing monitoring due to scarring risks, but doctors lack clear long-term management strategies for pediatric vulvar and perianal lichen sclerosus (PVPLS).
  • A survey of pediatric dermatologists and gynecologists revealed that while 85% felt confident in diagnosing PVPLS, 86% wanted more guidance on treatment and follow-up.
  • Initial treatment approaches were similar, but maintenance and follow-up recommendations varied greatly, with only 42% advocating for lifelong monitoring despite the condition's potential persistence into adulthood.
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Purpose Of Review: Vulvar skin disease is an underrecognized pediatric condition encompassing a wide range of conditions, from isolated vulvar disease to vulvar manifestations of systemic illnesses. This review highlights the most current research discussing clinical features, risk factors, and treatments.

Recent Findings: Recent studies confirm that labial adhesions resolve more quickly with estrogen treatment.

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Article Synopsis
  • * Initial treatment strategies focus on nonpharmaceutical methods like moisturizers, trigger avoidance, and psychological support, with further medical intervention if necessary.
  • * A "therapeutic ladder" approach is used for managing pruritus, starting with topical agents (like glucocorticoids), moving to systemic medications, and potentially including phototherapy for effective relief.
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  • When evaluating pediatric patients of color, healthcare providers must recognize unique dermatologic conditions that are more prevalent, such as keloids and postinflammatory hyperpigmentation.* -
  • Conditions like vitiligo can significantly impact quality of life and may be harder to identify in darker skin due to inflammation being less visible.* -
  • Treatment approaches should take into account cultural norms and lifestyle factors, including preferences for sunscreen and hair care practices, to ensure effective care.*
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  • The Phase 2b CONTROL study analyzed the safety and effects of a new topical isotretinoin formulation, TMB-001, on laboratory values in patients with congenital ichthyosis, specifically focusing on X-linked and autosomal recessive types over 12 weeks.
  • Participants aged 9 and older were randomly assigned to receive either TMB-001 or a vehicle, with laboratory tests conducted at the beginning and end of the study to monitor for adverse effects.
  • Results indicated that while some minor laboratory abnormalities were noted, none were clinically significant, suggesting that TMB-001 may be a safer alternative to traditional oral retinoids for treating congenital ichthyosis.
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Background: Emollients and keratolytics are frequently used to manage symptoms of congenital ichthyosis (CI). Systemic retinoid treatment is complicated by teratogenicity and dose-limiting adverse effects.

Objectives: This analysis from the randomized Phase IIb CONTROL study investigated the characteristics of participants who responded to treatment with TMB-001, a novel topical isotretinoin ointment formulation.

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Article Synopsis
  • - Epidermolytic ichthyosis leads to redness and blistering from birth, making it a complex skin condition in newborns.
  • - A hospitalized neonate with this condition exhibited increased fussiness, changes in skin color, and odor, indicating a superinfection by staphylococcal scalded skin syndrome.
  • - This case underscores the difficulty in identifying infections in newborns with blistering skin disorders and stresses the need for vigilance regarding potential superinfections.
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Background: In two severe congenital ichthyosis subtypes, autosomal recessive lamellar ichthyosis (ARCI-LI) and X-linked recessive ichthyosis (XLRI), cutaneous manifestations include widespread scaling. Approved topical treatment options are limited to emollients and keratolytics.

Aim: This analysis from the randomized phase IIb CONTROL study assessed whether the efficacy and safety of TMB-001, a novel topical isotretinoin ointment formulation, differed between ARCI-LI and XLRI subtypes.

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Background: Epidermolysis bullosa (EB) is a group of rare genetic skin conditions that result in skin fragility. EB can be quite severe with chronic inflammation and malnutrition impairing growth and pubertal development. These factors have potential consequences for skeletal health.

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Background: Amorphous calcifications noted on mammograms (i.e., small and indistinct calcifications that are difficult to characterize) are associated with high diagnostic uncertainty, often leading to biopsies.

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Autosomal recessive congenital ichthyosis (ARCI) is a group of hereditary, nonsyndromic disorders of keratinization. ARCI encompasses several different clinical presentations and is caused by various genetic mutations. Commonly, ARCI presents with a taut, thick, shiny stratum corneum called a collodion membrane, but patients with mutations in CYP4F22 frequently present only with erythroderma.

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This Clinical Opinion replaces the NASPAG Clinical Recommendation: Pediatric Lichen Sclerosus published in 2014. The objective of this document is to provide guidance in the diagnosis and management of vulvar lichen sclerosus (LS) in the pediatric and adolescent patient in order to treat patient symptoms and reduce long-term sequelae. LS is a chronic inflammatory condition affecting the anogenital region that may present in the prepubertal or adolescent patient.

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X-linked agammaglobulinemia (XLA) is a primary immunodeficiency caused by mutations in the gene for Bruton's tyrosine kinase , with affected males most commonly presenting with recurrent bacterial infections during the first few years of life. Here we present a 17-month-old male with a chief complaint of worsening rash and fever, whose history of streptococcal pneumonia meningitis at 5 months of age prompted suspicion for an underlying immunodeficiency and subsequent diagnosis of XLA. Bacterial meningitis is a rare initial presentation of XLA, and therefore physicians may easily overlook any underlying immunodeficiency.

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A better understanding of what skin conditions are most commonly diagnosed in different pediatric racial and ethnic groups in outpatient dermatology clinics could help guide the development of pediatric dermatology educational initiatives for primary care providers and general dermatologists who have limited access to pediatric dermatologists. Using a nationally representative dataset, we evaluated the most common diagnoses in patients younger than 15 years of age (children) and 15-24 years of age (youth) who present to outpatient dermatology clinics, stratified by race and ethnicity. While acne and dermatitis were among the top ten most common diagnoses in all racial and ethnic groups studied, Black children were also commonly diagnosed with dermatophytosis and impetigo, and Black and Hispanic children were often diagnosed with seborrheic dermatitis; pigmentary disorders were among the top three most common diagnoses in Black, Asian, and Hispanic youth.

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Guidelines for neonatal skin care are scarce, and there is no consensus on the best management practices for neonatal skin breakdown. This review presents the pathology and phases of wound healing, reasons for neonatal skin fragility, and approaches to recognition of commonly encountered neonatal wounds. This review also provides general strategies for neonatal wound prevention, care, dressing, and management to avoid further damage to the fragile neonatal skin.

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Epidermolysis bullosa (EB) is a group of rare genetic disorders that are characterized by fragile skin. Because of its rarity, many neonatologists may not be familiar with the current diagnosis and treatment recommendations for EB. The classification of EB was updated in 2020.

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Acne vulgaris is a common skin condition encountered in specialties outside of dermatology, including obstetrics and gynecology. The pathophysiology of acne is complex and includes disruption of the cutaneous microbiome, abnormal keratinization, inflammation, and hormonal influences. Various topical and systemic treatment modalities target each component of acne pathophysiology.

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Article Synopsis
  • The study investigates the unclear causes of vulvar lichen sclerosus (LS) and examines the potential role of skin and gut microbiota in its development.
  • Researchers collected skin and stool samples from 13 prepubertal girls divided into three groups: those with LS, those with nonspecific vulvovaginitis, and healthy controls.
  • Results showed significant differences in microbial communities, with girls with LS having higher levels of certain bacteria on their skin and in their gut compared to controls, suggesting a link between microbiota imbalances and vulvar LS that needs further exploration.
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Background/objectives: To determine whether iron was being enterally absorbed in anemic patients with recessive dystrophic epidermolysis bullosa (RDEB).

Methods: Anemic patients with RDEB who were refractory or had poor adherence to oral or gastrostomy-given iron underwent enteral iron absorption challenges. Subjects were given 2 mg/kg of elemental iron.

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