An infant with LUMBAR syndrome complicated by severe perineal ulceration managed with diverting colostomy.

Infantile hemangiomas are the most common childhood vascular lesions. LUMBAR syndrome (lower body hemangioma, urogenital abnormalities/ulceration, myelopathy, bony deformities, anorectal malformations/arterial anomalies, and rectal anomalies) warrants special treatment considerations. Here we describe a case of an infant with LUMBAR syndrome who presented with severe perineal ulceration refractory to standard medical therapy and was managed with a temporary diverting sigmoid colostomy.

Multidisciplinary management of a previously unreported presentation of severe aplasia cutis congenita.

Aplasia cutis congenita (ACC) is characterized by the complete or partial absence of skin at birth, with 85% of cases of ACC involving the scalp vertex. The etiology of ACC is unclear and appears to be multifactorial. We present the case of a 3-month-old boy who presented with a diagnosis of non-scalp ACC affecting approximately 80% of his total body surface area at birth.

Clinical and histologic presentation of pediatric reactive granulomatous dermatitis.

Objective: To characterize the clinical and histologic presentation of reactive granulomatous dermatitis (RGD) in the pediatric population.

Methods: In this multicenter retrospective chart review, 7 pediatric patients with biopsy-proven RGD were identified. Photographs, histology reports, and clinical course were reviewed to discover patterns in demographics, comorbid conditions, autoimmune sequelae, drug exposures, infections, morphology, and histologic features.

Classic pseudoxanthoma elasticum in a girl with sickle cell disease.

A pseudoxanthoma elasticum (PXE)-like phenotype develops in a subset of patients with inherited hemoglobinopathies. Although PXE tissue changes are thought to develop in the absence of ABCC6 mutations in patients with beta-thalassemia, ABCC6 mutations have not been well evaluated among sickle cell disease patients with PXE-like disease. To our knowledge, we describe the first patient with sickle cell disease, PXE skin findings, and two confirmed pathogenic ABCC6 mutations.

Bumps in the Road: Panniculitis in Children and Adolescents Treated with Vemurafenib.

Vemurafenib is increasingly being used to treat nonmelanoma tumors that are positive for the BRAF V600E mutation. We report three children who presented with panniculitis induced by vemurafenib while undergoing treatment for central nervous system tumors and review the literature.

Itching to learn: school chair allergic contact dermatitis on the posterior thighs.

A 10-year-old girl with a history suggestive of nickel allergy presented with pruritic, eczematous plaques on her posterior thighs. Patch testing revealed sensitivities to nickel, cobalt, and chromium. The pattern of her involvement suggested an "outside job," and subsequent investigations confirmed that the exposed metal fasteners on her school chair were the likely source of her focal contact dermatitis.

Genital melanocytic nevi in children: Experience in a pediatric dermatology practice.

Background: Little is known about the prevalence and clinical characteristics of genital melanocytic nevi in children.

Objective: We sought to describe the epidemiology, clinical and dermoscopic features, and natural history of genital nevi in pediatric patients.

Methods: We reviewed charts of 1159 children given the diagnosis of melanocytic nevi over 11 years.

Ulcerative sarcoidosis.

Sarcoidosis is a multi-system, granulomatous disease, which affects the skin in approximately 20 to 30 percent of cases. Recognition of cutaneous sarcoidosis can be challenging because of the wide range of skin lesion morphologies. Ulcerative sarcoidosis is uncommon.

Antiphospholipid-antibody-associated panniculitis.

A 60-year-old man presented with intermittent, tender, erythematous nodules on the legs that were associated with mild arthralgias. He was otherwise asymptomatic but reported a history of lupus anticoagulant antibodies that were discovered incidentally on laboratory screening at the approximate time that his lesions first occurred. A biopsy specimen showed a septal and lobular panniculitis with neutrophils, histiocytes, numerous eosinophils, foci of fibrosis, and fat necrosis but no vascular pathology.