Publications by authors named "Lucia Z Diaz"

Article Synopsis
  • The study focused on the challenges of transitioning patients with epidermolysis bullosa (EB) from pediatric to adult care, revealing that provider support is crucial during this process.
  • A survey conducted with members of the Epidermolysis Bullosa Clinical Research Consortium found that 88% of providers were concerned about this transition, while only 38% had formal transition of care (TOC) programs.
  • The results highlighted the importance of establishing formal TOC programs and a team-based approach, emphasizing the need to identify adult care providers to facilitate better transitions for patients.
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Pediatric procedure-related pain management is often incompletely understood, inadequately addressed, and critical in influencing a child's lifelong relationship with the larger healthcare community. We present a comprehensive review of infiltrative anesthetics, including a comparison of their mechanisms of action and relative safety and efficacy data to help guide clinical selection. We also describe the multimodal utilization of adjunct therapies-in series and in parallel-to support the optimization of pediatric periprocedural pain management, enhance the patient experience, and provide alternatives to sedation medication and general anesthesia.

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Article Synopsis
  • Pediatric atopic dermatitis has seen a rise in emergency visits and healthcare costs over the last 20 years, highlighting a need for better clinician education on this condition.
  • A quality improvement initiative recruited 56 clinicians in Travis County, Texas, aiming to enhance their knowledge and confidence in diagnosing and managing pediatric atopic dermatitis through surveys, quizzes, and multimodal education.
  • Results showed significant improvements in quiz scores (average increase of 10% overall and 37% for treatment-specific knowledge) and clinician confidence, indicating that the program is an effective resource for training healthcare providers in both emergency and outpatient settings.
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Pediatric procedure-related pain management is often incompletely understood, inadequately addressed, and critical in influencing a child's lifelong relationship with the larger health care community. We highlight the evolution of ethics and expectations around optimizing periprocedural pain management as a fundamental human right. We investigate the state-of-the-art of topical anesthetics, reviewing their mechanisms of action and providing comparisons of their relative safety and efficacy data to help guide clinical selection.

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Background: The study aimed to compare barriers perceived by medical students and resident physicians identifying as of underrepresented groups in medicine (UIM) and/or as sexual and gender minorities (SGM) to individuals not identifying with these groups, especially for trainees with an interest in dermatology.

Methods: Cross-sectional survey of medical students and resident physicians based in the United States from February 2021 to July 2021, with subgroup analysis of trainees with interest in dermatology.

Findings: Among trainees interested in dermatology, the most notable barriers for the UIM group were 1) lack of home program in specialty/fellowship of interest (4.

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Article Synopsis
  • Medical procedures can cause significant pain and anxiety in patients, potentially leading to long-term negative effects if not managed properly.
  • A study aimed to compare the effectiveness of virtual reality (VR) headsets and noise-canceling headphones (HP) against standard treatment (TAU) in alleviating pain and anxiety for children undergoing dermatology procedures.
  • Results showed that both VR and HP significantly reduced anxiety levels from before to after the procedures, whereas the TAU group did not experience the same reduction, highlighting the potential benefits of technology-based interventions in pediatric care.
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Background: Hidradenitis suppurativa (HS) is a chronic, debilitating, inflammatory disease. Contemporaneous real-world data can be used to elucidate the clinical treatment of pediatric patients and how treatment strategies compare with adult hidradenitis suppurativa patients.

Objective: The objective of this study is to evaluate clinical and treatment characteristics of pediatric and adult HS patients.

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Background/objectives: The primary objective was to assess pain catastrophizing and functional disability in pediatric patients with epidermolysis bullosa (EB) and their parents/guardians. Secondary objectives included examining relationships between pain catastrophizing, functional disability, and correlations with other factors (e.g.

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A Becker's nevus typically appears as a single unilateral, well-demarcated, hyperpigmented patch over the upper trunk during adolescence. It uncommonly presents as multiple and bilateral patches and rarely involves a lower extremity. We describe the unusual case of a child with multiple, bilateral Becker's nevi of the trunk and lower extremities present since birth.

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Gaucher disease is a rare lysosomal storage disorder caused by a deficiency in glucocerebrosidase. This enzyme deficiency leads to the accumulation of toxic metabolites in various organs. Multiple subtypes of this disease have been described; however, the perinatal-lethal form is extremely rare and challenging to diagnose.

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We report the case of a 13-year-old female who presented with punctate, erythematous macules coalescing into patches on the upper extremities and left thigh. A skin biopsy demonstrated dilated capillary-sized blood vessels in the papillary dermis consistent with a diagnosis of cutaneous collagenous vasculopathy (CCV). To our knowledge, this is the youngest patient to present with CCV and will represent the third pediatric case in the literature.

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Article Synopsis
  • Atopic dermatitis (AD) is a widespread chronic condition in children, often managed by primary care providers, but sometimes requiring dermatology specialists.
  • A survey of 50 caregivers revealed that while they felt both PCPs and specialists listened to their concerns, many believed that specialists offered better care for managing AD.
  • The study suggests that earlier and more frequent referrals to dermatology specialists might benefit children with AD, indicating a need for further research on access to care based on race and ethnicity.
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  • The study aimed to evaluate how reliable and valid remote assessments of atopic dermatitis severity are, using caregiver-provided photos (p-EASI) and videos (v-EASI) compared to traditional in-person evaluations.
  • A group of 50 children with varying severity of atopic dermatitis had their skin condition assessed by caregivers through photos and videos, and by clinicians using in-person ratings.
  • Results showed that p-EASI demonstrated strong reliability and validity, while v-EASI had moderate reliability, indicating both methods could be useful for assessing atopic dermatitis remotely.
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Article Synopsis
  • Dermatologists are skilled in treating complex skin conditions but may lack expertise in addressing the psychosocial aspects of care for pediatric patients with epidermolysis bullosa (EB).
  • The article highlights the importance of recognizing various types of trauma—social, psychological, and medical—that children with EB may face.
  • It provides recommendations for trauma-informed care and emphasizes the need for a patient-centered approach in managing anxiety and trauma in these patients, involving both dermatologists and multidisciplinary teams.
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Hidradenitis suppurativa (HS) is a chronic, inflammatory follicular disorder that most commonly involves the intertriginous areas. It is characterized by recurrent nodules that may progress into deeper abscesses and sinus tracts. Treatment is challenging and often involves a combination of lifestyle modifications, medical therapies, and procedures to control symptoms.

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Behҫet disease is a multisystem inflammatory disease and variable vessel vasculitis involving primarily the oral and genital mucosa, skin, and eyes. Diagnosis is challenging due to the lack of a specific diagnostic test and overlap with other autoinflammatory diseases. Treatment of pediatric Behҫet disease aims to reduce inflammation and prevent future flares.

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Prolidase deficiency is an extremely rare, autosomal recessive disorder resulting in defective collagen formation. We report a case of prolidase deficiency in a male child, highlighting the dermatologic features. Early diagnosis is important as these patients encounter significant multisystem comorbidities requiring multispecialty care.

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Common polygenic skin disorders, such as atopic dermatitis, may rarely present in a segmental or linear distribution due to cutaneous mosaicism. Only seven cases of superimposed linear atopic dermatitis have been reported to date. Here, we present a child with severe superimposed linear atopic dermatitis and highlight the first successful use of dupilumab in its treatment.

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Hidradenitis suppurativa (HS) is a chronic and recurrent inflammatory skin condition resulting in the formation of nodules, sinus tracts, and abscesses in intertriginous areas. We provide recommendations for the management of children presenting to the emergency department with acute HS flares, based on a review of literature and insights from our own clinical experience. The purpose of the recommendations is to educate clinicians on specific considerations that should be made when caring for children with HS.

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Background: Coccidioides immitis is a dimorphic fungus endemic to the arid climates of the Southwest United States, Mexico and parts of Central and South America. Human infection occurs through inhalation of spores with less than half of exposures progressing to a symptomatic state that primarily consists of pulmonary manifestations. Disseminated coccidioidomycosis is exceedingly rare, occurring in fewer than 1 % of symptomatic infections.

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