Pediatric dermatology workforce shortage: perspectives from academia.

Background: The pediatric dermatology workforce has not been systematically evaluated since recent changes in board certification requirements.

Objective: To quantify and characterize the workforce of academic pediatric dermatologists and examine issues related to training, hiring, and retention.

Methods: Dermatology chairpersons and residency directors in the United States and Canada completed a 30-question survey.

Skin signs of sexually transmitted diseases in adolescents.

Sexually transmitted diseases (STDs) continue to be a significant and prevalent problem among adolescents. One in four sexually active teenagers are infected with one or more STDs. Certain STDs, including gonorrhea, chlamydia, and possibly human papillomavirus infections have the highest prevalence in this age group.

Congenital erosive and vesicular dermatosis healing with reticulated supple scarring: report of three new cases and review of the literature.

Congenital erosive and vesicular dermatosis healing with reticulated, supple scarring is a rare disease with seven reported cases in the literature. This congenital cutaneous defect of unknown etiology presents with patchy or generalized erosions and vesicles at birth that heal with striking reticulated scarring. We report three new cases of this rare disease and review the literature.

Hypophosphatemic vitamin D-resistant rickets, precocious puberty, and the epidermal nevus syndrome.

Background: The association of multisystem pathologic conditions and epidermal nevi, known as the epidermal nevus syndrome, includes disorders of bone, central nervous system, eye, kidney, vasculature, body symmetry, and skin. Rarely, vitamin D-resistant rickets has been observed in association with this syndrome. Precocious puberty is another rare finding associated with epidermal nevus syndrome, having been observed in 3 patients.

New aspects of exanthematous diseases of childhood.

The childhood exanthems include a spectrum of common and uncommon disorders caused by a variety of pathogens. In this article, timely issues relating to immunization for measles and varicella are discussed. Recently reported exanthematous illnesses, including papular-purpuric gloves and socks syndrome, unilateral laterothoracic exanthem, and eruptive pseudo-angiomatosis, are described.

A comparison of dermatologists and generalists. Management of childhood atopic dermatitis.

Background And Design: To compare the approaches of generalist physicians and dermatologists in the management of childhood atopic dermatitis (AD), a 6-page questionnaire was developed to assess specific practice characteristics and therapeutic preferences. Surveys were mailed to all board-certified dermatologists in North Carolina (n = 173) and to a sample of pediatricians (n = 200) and family medicine physicians (n = 300) randomly selected from the North Carolina Health Professions Database. There were 307 eligible respondents, defined as those who see children with AD, and 112 ineligible respondents.

Upper extremity atrophy associated with a giant congenital melanocytic nevus.

Persistent limb atrophy in association with a giant congenital melanocytic nevus is described. This association has not been reported previously.

Porphyria in childhood.

Porphyria in childhood is an uncommon problem but the recognition of these disorders is vitally important for affected children. Of the cutaneous porphyrias, erythropoietic protoporphyria, congenital erythropoietic porphyria, hepatoerythropoietic porphyria, and the hereditary form of porphyria cutanea tarda (PCT) can present in infancy or childhood. This article focuses on the porphyrias that present in infants and children along with a brief discussion of pathogenesis, cutaneous histopathology, and genetics of these metabolic disorders.

Dyskeratosis congenita or chronic graft-versus-host disease? A diagnostic dilemma in a child eight years after bone marrow transplantation for aplastic anemia.

A 12-year-old boy had striking reticulate hyperpigmentation of the neck and upper chest, dystrophic nails, patchy alopecia, and a white streak on the buccal mucosa. He was diagnosed as having chronic graft-versus-host disease (GVHD) based on clinical findings, skin biopsy findings, and his history of a bone marrow transplantation for aplastic anemia eight years earlier. Dyskeratosis congenita (DC) was not a diagnostic consideration, although the clinical findings and history of aplastic anemia made it a compelling possibility.

Hemorrhagic complications in a rapidly growing, congenital hemangiopericytoma.

A 3-week-old infant had a massive hemangioma-like vascular neoplasm that had enlarged rapidly since being noted at birth. Less than a day after this initial evaluation the tumor underwent spontaneous ulceration and the infant had a near-fatal hemorrhage. Histologically, the tumor was a spindle cell neoplasm most consistent with the diagnosis of congenital hemangiopericytoma.

Pulsed dye laser therapy for port-wine stains in children: psychosocial and ethical issues.

The port-wine stain is a disfiguring vascular birthmark that commonly occurs on the face. Amelioration of this condition in children was difficult or impossible until the introduction of the flashlamp-pumped pulsed dye laser in the late 1980s. This article provides an interdisciplinary social and ethical examination of pulsed dye laser therapy for port-wine stain in childhood.

Staphylococcal toxin-mediated syndromes in childhood.

Staphylococcal toxic shock syndrome (TSS) and staphylococcal scalded skin syndrome (SSSS) are two distinct toxin-mediated syndromes with prominent cutaneous features. The exanthematous presentation of these syndromes places them in the broad category of childhood exanthems, and the ability to recognize these potentially devastating illnesses is essential for pediatricians and dermatologists who may encounter children with fever and rash. Recent advances in the understanding of the pathogenesis of these entities has helped to explain the distinctive clinical presentations of TSS and SSSS.

Childhood exanthems. Old and new.

Exanthems are a common cause of rashes in children. Several recent developments have sparked a renewed interest in this group of diseases, including the identification of parvovirus B19 and human herpesvirus 6 as the causative agents of erythema infectiosum and roseola infantum. The resurgence of measles as a childhood exanthem has caused a re-examination of current immunization practices.

Dermatophytosis mimicking Kaposi's sarcoma in human immunodeficiency virus disease.

Kaposi's sarcoma (KS) is an important finding in patients infected with human immunodeficiency virus (HIV), with a distinctive spectrum of clinical presentations. Three cases of dermatophytosis in HIV-infected patients are presented which clinically mimic the appearance of KS. This new observation underscores the importance of histopathologic examination in the evaluation of skin lesions suspicious for the diagnosis of KS.

Giant juvenile xanthogranuloma: exophytic and endophytic variants.

Xanthogranulomas larger than 2 cm are rarely reported variants of this otherwise common, benign lesion usually measuring 1 mm to 1 cm in diameter. The natural history of such macronodular xanthogranulomas is uncertain, but appears to parallel the generally predictable course toward involution seen in micronodular lesions. Two patients with macronodular xanthogranuloma illustrate exophytic and endophytic variants, as well as the problems of managing this unusual tumor.