Publications by authors named "Lawrence A Schachner"

Article Synopsis
  • * A panel of pediatric dermatologists developed five consensus statements addressing the management of S. aureus-related AD exacerbations and current treatment challenges, emphasizing the need for improved patient care.
  • * The panel highlighted the need for a comprehensive topical therapy that targets multiple symptoms of AD, including itch, infections, and inflammation, while also advocating for prudent antibiotic use to prevent resistance.
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Background: Atopic dermatitis (AD) typically starts in infancy and early childhood. The chronic skin disorder is associated with recurrent flares, pruritus, and genetic predisposition. Daily use of moisturizers that contain lipids, such as ceramides, reduces the rate of AD flares and the need for topical steroid treatment.

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Mycobacterium avium-intracellulare (MAC) infection may have different skin manifestations, including cutaneous granulomas. Granulomatous skin reactions have distinct morphologic and histopathologic appearances. We present the case of an adolescent male with cutaneous MAC, misdiagnosed as sarcoidosis after initial biopsy results, demonstrated preservation of reticulin fibers and absence of organisms within granulomas.

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Introduction: Acne is a common, complex, multifactorial inflammatory skin disease associated with epidermal barrier dysfunction. Beginning in childhood, acne affects many adolescents and adults. Acne is associated with lower self-esteem, anxiety, and depression and may cause scars and pigmentary sequelae.

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Background: The skin of newborns and infants of all races/ethnicity is more susceptible to skin barrier disruption than adult skin. This consensus paper offers insights into potential skincare implications for using gentle cleansers and moisturizers for skin of color (SOC) newborns, infants, and children.

Methods: Six pediatric dermatologists and dermatologists used a Delphi communication technique to adopt 5 statements for SOC newborns, infants, and children on skin barrier integrity and the importance of skin care to promote a healthy skin barrier.

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Article Synopsis
  • The human skin barrier in newborns is underdeveloped, leading to increased vulnerability to conditions like atopic dermatitis (AD) and affecting skin hydration and resistance to irritants.
  • A panel of eight clinicians developed a skincare algorithm to promote healthy skin in infants, emphasizing non-prescription methods based on clinical research and expert opinions.
  • Recommended skincare practices include maintaining a cool environment, using gentle cleansers with a pH of 4-6, brief lukewarm baths, and applying hydrating moisturizers to strengthen the skin barrier from an early age.
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Background: Pediatric acne is a common, complex, multifactorial inflammatory skin disease with various expressions in childhood that can be categorized by age, severity, and pubertal status.

Methods: The Faces of Pediatric Acne Project (FoPAP) aims to improve patient outcomes. The FoPAP group developed an algorithm that follows a consensus paper and a clinical case series on pediatric acne by applying the selected literature and drawing from the clinical knowledge and experience of each group member.

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Atopic dermatitis (AD) is a chronic inflammatory skin disorder that affects a substantial number of children and has a significant negative impact on affected patients and their caregivers/families. Recent studies have led to significant evolutions in the understanding of AD pathogenesis, epidemiology, and treatment. The first point of contact for many patients with new-onset AD is usually with their primary care provider or pediatrician.

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Article Synopsis
  • Neonates and infants have delicate skin that is still developing, making it more prone to barrier disruptions, which is why proper skincare is essential.* -
  • A panel of eight clinicians created a consensus paper using the modified Delphi technique to emphasize the importance of ceramide-containing skincare products for maintaining skin barrier integrity in young patients.* -
  • Daily use of safe, non-irritating cleansers and moisturizers, particularly those with ceramides, is recommended from birth to support healthy skin and enhance moisture retention over time.*
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Article Synopsis
  • Accurate diagnosis of epidermolysis bullosa (EB) is crucial for effective treatment and counseling, as different types require different management strategies.
  • The study analyzed testing patterns among 771 patients, comparing results from transmission electron microscopy (TEM), immunofluorescence mapping (IFM), and genetic analysis to determine how often they produced consistent diagnoses.
  • Findings showed a preference for genetic analysis over traditional methods, but both TEM and IFM often yielded unclear or inconsistent results, indicating the need for a more definitive diagnostic approach.
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Background: Impetigo is a contagious bacterial infection that affects the superficial skin layers. Increasing worldwide antimicrobial resistance (AMR) to existing topical agents commonly prescribed to treat impetigo is central to treatment failure. The Worldwide Health Organization developed a global action plan on AMR, but omitted information about AMR stewardship programs for topical antibiotics.

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Article Synopsis
  • Impetigo is a contagious skin infection primarily affecting children, caused mainly by S. aureus and sometimes by S. pyogenes, with growing concerns about antibiotic resistance complicating treatment options.
  • An international group of specialists developed an evidence-based treatment algorithm using a modified Delphi technique to provide guidelines for managing impetigo in both children and adults.
  • The algorithm includes strategies for education, diagnosis, treatment, and follow-up care, emphasizing the importance of understanding local antibiotic resistance trends and recommending ozenoxacin cream 1% as a potential effective treatment option.
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Background: Neonates and infants are susceptible to skin barrier disruption as their skin anatomically and functionally is still developing. The process of skin acidification plays a vital role in barrier maturation and the activation of enzymes involved in the extracellular processing of stratum corneum lipids. The current consensus paper explores challenges, and current treatment approaches in neonatal and infant normal and sensitive skin and the role of ceramides containing moisturizers.

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Background: Acne vulgaris is the most common dermatological disorder. Pediatric acne may be a manifestation of the underlying pathology and can occur in the first weeks, months, or years of life. Acne in childhood can be categorized by age and pubertal status.

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Background: Impetigo is a common contagious superficial bacterial skin infection. Treatment of localized lesions can be achieved through topical antibiotics. Oral antibiotics are reserved for extensive disease.

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Objective: Children can have non-healing wounds due to a wide range of pathologies, including epidermolysis bullosa (EB), pilonidal disease and Stevens-Johnson syndrome, with some causes being iatrogenic, including extravasation injuries and medical device-related hospital-acquired pressure ulcers. Furthermore, paediatric wounds are vastly different from adult wounds and therefore require a different treatment approach. While there are numerous types of dressings, topical remedies, and matrices with high-tier evidence to support their use in adults, evidence is scarce in the neonatal and paediatric age groups.

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Background/objectives: Epidermolysis bullosa (EB) comprises a group of inherited skin blistering diseases. There is currently no cure, and management includes skin protection and prevention of infection. To date, there has been no systematic investigation of home skin care practices among EB patients on a multicenter scale.

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The majority of neonatal cutaneous conditions are benign and self-limited. However, some skin infections and specific birthmarks are serious and require proper management approaches. This study was a prospective survey of 1000 consecutive newborns at a tertiary care center in Northeast Thailand from September 2015 to 2016, which aimed to identify various cutaneous findings in newborns during their first 5 days of life.

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Article Synopsis
  • The study focuses on children with epidermolysis bullosa (EB), a rare skin condition that can lead to serious health issues, and aims to improve understanding of patient experiences and outcomes.
  • Researchers analyzed data from 644 EB patients across the U.S. and Canada to identify demographics, clinical characteristics, and significant medical events related to the disease.
  • The results showed variations in disease severity and initial signs of EB at birth among different types of EB, with most patients experiencing symptoms early in life, which highlights the need for better diagnostic approaches and treatment strategies.
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Background/objectives: Short anagen syndrome is a hair cycle disorder usually diagnosed in early childhood and characterized by short hair length due to short duration of the anagen phase. The objective was to review the presentation and demographic characteristics of short anagen syndrome and compare them with the most common differential diagnosis, loose anagen syndrome.

Methods: A retrospective review of eight children with short anagen syndrome was performed at the University of Miami Outpatient Dermatology Clinic.

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Poisoning through pediatric skin leading to acute systemic symptoms is a relatively uncommonly reported phenomenon. Systemic toxicity through the skin typically occurs by direct contact between therapeutic or non-therapeutic topical agents and the skin. Though uncommon, poisoning through pediatric skin can have significant consequences and must be recognized so the offending agent may be discontinued and appropriate treatment initiated.

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Background: Pityriasis lichenoides (PL) is a dermatologic disorder that manifests in either the acute (pityriasis lichenoides et varioliformis acuta) or the chronic form (pityriasis lichenoides chronica, also known as parapsoriasis chronica). Traditional first-line therapy consists of corticosteroids or antibiotics; however, these treatments are often accompanied with multiple side effects and may be ineffective.

Objective: The goal of this study was to review the use of phototherapy for treating PL in the pediatric population.

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Despite the current treatment options for different types of alopecia, there is a need for more effective management options. Recently, low-level laser therapy (LLLT) was evaluated for stimulating hair growth. Here, we reviewed the current evidence on the LLLT effects with an evidence-based approach, focusing more on randomized controlled studies by critically evaluating them.

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