An unusual cluster of circumscribed juvenile pityriasis rubra pilaris cases.

Circumscribed juvenile pityriasis rubra pilaris (PRP) is an uncommon dermatosis. We describe the unusual clustering of circumscribed juvenile PRP cases in our pediatric dermatology clinic in 2011. A retrospective chart review was done of patients presenting during the summer of 2011 with classic findings of circumscribed juvenile PRP.

Serum 25-hydroxyvitamin D concentration does not correlate with atopic dermatitis severity.

Background: An inverse correlation between serum 25-hydroxyvitamin D concentration and atopic dermatitis (AD) severity has been suggested.

Objective: To determine if a statistically significant relationship exists between serum 25-hydroxyvitamin D concentration and AD severity.

Methods: A cross-sectional study was conducted of patients with AD who were 1 to 18 years of age.

Cutaneous and disseminated blastomycosis: a pediatric case series.

Blastomycosis is a rare fungal infection that most often initially infects the lungs and can progress to disseminated involvement of the skin, bones, and central nervous system (CNS). Pediatric blastomycosis constitutes a small portion of total cases, but delay in diagnosis may result in significant morbidity. Seventeen pediatric cases of blastomycosis were identified at Children's Hospital of Wisconsin from 1999 to 2009 through retrospective chart review; 53% had evidence of dissemination (bone, skin, or CNS) confirmed by culture.

Psoriasiform eruption and oral ulcerations as adverse effects of topical 5% imiquimod treatment in children: a report of four cases.

Imiquimod 5% cream is a topical immune-response modifier indicated in the treatment of multiple cutaneous conditions including actinic keratoses, superficial basal cell carcinoma, and condylomata acuminata. In children, it has been approved only for ages 12 and older in the treatment of external genital and perianal warts. It has also been used off label for a variety of pediatric skin disorders, including molluscum contagiosum (MC), trichoepitheliomas, verrucae plana, and verrucae vulgaris.

Inverse Gottron's papules: an unusual cutaneous manifestation of juvenile dermatomyositis.

Dermatomyositis is an autoimmune inflammatory myopathy characterized by unique cutaneous features. Gottron's papules are pathognomonic, lichenoid papules that can be found overlying the joints of the dorsal hand. Papules on the palms of the hand are less commonly seen, especially in the pediatric age group.

Microcystic adnexal carcinoma: the first reported congenital case.

Microcystic adenexal carcinoma is a rare, locally aggressive, malignant appendage tumor also known as sclerosing sweat duct carcinoma. Since widespread recognition of microcystic adenexal carcinoma as a distinct clinicopathologic entity, approximately 300 total cases have been reported in the literature, with only eight previous cases reported in children under the age of 18, with no reported cases in patients younger than 6 years old. Our patient is unique in that the lesion was present at birth, making this the youngest case of microcystic adenexal carcinoma reported.

Congenital melanocytic nevi.

The relative risk for melanoma arising within a congenital nevus is related to the size of the lesion. The timing of and clinical presentation of development of melanoma is also related to the size of the lesion. Medical decisions are individualized taking into account the perceived risk of malignancy, psychosocial impact, and anticipated treatment outcome.

More evidence confirming the safety of general anesthesia in pediatric dermatologic surgery.

Outpatient surgical procedures performed in medicine have been increasing, as has the use of general anesthesia. Children are more likely to require general anesthesia for procedures because of developmental constraints limiting their cooperation. Dermatology procedures are typically painful and can require time to perform and thus necessitating the use of general anesthesia.

The spitz nevus: review and update.

The Spitz nevus is a relatively common skin lesion in children and is less commonly seen in adults. The lesion is defined by the presence of distinctive-appearing spindle or epithelioid cells on light microscopy in a recognizable nevus-like pattern. Spitz lesions share features with melanoma on light microscopic examination.

Store-and-forward teledermatology versus in-person visits: a comparison in pediatric teledermatology clinic.

Background: The role of teledermatology in the diagnosis of pediatric skin conditions has not been studied exclusively.

Objective: To determine the ability of a pediatric dermatologist to correctly diagnose rashes by history and digital images.

Methods: Consecutive, new referrals to the pediatric dermatology clinic with a rash were enrolled in the study.

One-year experience with candida antigen immunotherapy for warts and molluscum.

Molluscum contagiosum and warts are two very common viral-induced diseases of childhood. We report our 1-year experience with intralesional candida antigen therapy for both warts and molluscum contagiosum. A retrospective chart review was performed and a total of 217 patients were identified.

Toddler wrap for abdominal biopsy or excision.

Young children, especially toddlers, are anxious and uncooperative during skin procedures. Wrapping a sheet or blanket around the child is an effective way to restrain the child to maintain a sterile field. The wrap can be used for skin biopsies and small excisions on the midsection of the body, arms, and legs.

Approach to procedures in neonates.

Physical constraints and metabolic differences in neonates require that special attention is given to performing procedures in this patient group. Neonates have a thinner dermis and a greater surface-to-weight ratio, allowing for easier invasion through the skin barrier. The enzymes for metabolism of agents and defense against organisms inside the body are not fully developed in infants.

Lumps and bumps in children-when to worry: recent trends in recognition and pathology of hemangiomas of infancy and Spitz nevi.

Purpose Of Review: Hemangiomas are common, and most lesions are benign. Careful attention needs to be paid to these lesions; however, because their growth can be unpredictable, they can have important complications and can serve as markers of underlying malformations. The consequences of hemangiomas are extensive and can be challenging to recognize.

Necrotic facial papules in an adolescent: C2 deficiency with eventual development of lupus erythematosus.

A 14-year-old girl was admitted to the hospital because of persistent throat pain, fever, fatigue, 25 pound weight loss, and leukopenia. On physical examination she was thin, ill-appearing, and had necrotic papules on the face and palpable cervical lymph nodes. Presumptive differential diagnosis included occult malignancy and infection.