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A healthy 2-year-old girl presented with multiple asymptomatic subcutaneous nodules on both legs. Histologically demonstrated calcium deposition within the dermis and subcutaneous tissue consistent with calcinosis cutis. Laboratory abnormalities, underlying genetic conditions, and potential triggering factors were ruled out. The lesions resolved over an 18-month period without treatment, emphasizing the importance of the wait-and-see approach in idiopathic cases of calcinosis cutis., (© 2023 Wiley Periodicals LLC.)

Streptococcus dysgalactiae subspecies equisimilis infection is an emerging pathogen. Cutaneous and systemic manifestations resemble those of other pyogenic streptococci. However, the rapid group A antigen detection test used to diagnose Streptococcus pyogenes infection is usually negative, making the diagnosis difficult. If clinical suspicion of streptococcal infection is high, a tonsillar culture should be performed to confirm the diagnosis., (© 2021 Wiley Periodicals LLC.)

Anorexia nervosa is an eating disorder frequently associated with cutaneous manifestations. A rare type of purpura, known as diffuse reticulate purpura, has been described in patients with anorexia nervosa and severe malnutrition. Typical characteristics of this condition include a purpuric reticulate rash predominantly affecting the trunk that rapidly resolves with adequate feeding. We report two male adolescent patients with anorexia nervosa and severe malnutrition who developed diffuse reticulate purpura., (© 2021 Wiley Periodicals LLC.)

Sorafenib is a multikinase inhibitor increasingly used for the treatment of several solid tumors. Different types of keratotic lesions, such as squamous cell carcinoma, actinic keratosis, or infundibular cyst, have been reported in association with this therapy. We present a 15-year-old male diagnosed with desmoid fibromatosis who developed multiple penile and scrotal infundibular cysts while receiving treatment with sorafenib., (© 2021 Wiley Periodicals LLC.)

Background: Different skin manifestations of COVID-19 are being reported. Acral lesions on the hands and feet, closely resembling chilblains, have been recognized during the peak incidence of the COVID-19 pandemic., Material and Methods: A retrospective review of 22 children and adolescents with chilblain-like lesions seen over a short period of time in the Emergency Department of a children's hospital during the peak incidence of COVID-19 in Madrid, Spain., Results: All patients had lesions clinically consistent with chilblains of the toes or feet, with three also having lesions of the fingers. Pruritus and mild pain were the only skin symptoms elicited, and only 10 had mild respiratory and/or GI symptoms. None had fever. Coagulation tests, hemogram, serum chemistry, and lupus anticoagulant were normal in all patients tested. One out of 16 tested cases had elevated D-dimer results, but without systemic symptoms or other laboratory anomalies. SARS-CoV-2 PCR tested in 19 cases was positive in just one case. Skin biopsies obtained in six patients were consistent with chilblains. On follow-up, all cases showed spontaneous marked improvement or complete healing., Conclusion: Acute chilblains were observed during COVID-19 pandemic in children and teenagers. It is a mildly symptomatic condition with an excellent prognosis, usually requiring no therapy. Etiopathogenesis remains unknown., (© 2020 Wiley Periodicals LLC.)

During examination of cases of chilblains in children and adolescents, we identified four patients who also showed skin lesions similar to erythema multiforme (EM). They had no other known triggers for EM. One of them had a positive PCR for SARS-CoV-2, while the other three were negative. Skin biopsies from two patients showed features not typical of EM, such as deep perivascular and perieccrine infiltrate and absence of necrosis of keratinocytes. Immunohistochemistry for SARS-CoV/SARS-CoV-2 spike protein showed granular positivity in endothelial cells and epithelial cells of eccrine glands in both biopsies. All patients had an excellent outcome, and had minimal or no systemic symptoms. The coincidence of EM, a condition commonly related to viruses, and chilblains in the setting of COVID-19, and the positivity for SARS-CoV/SARS-CoV-2 spike protein by immunohistochemistry strongly suggest a link between EM-like lesions and SARS-CoV-2., (© 2020 Wiley Periodicals LLC.)

The term mid-face toddler excoriation syndrome (MiTES) has been proposed to describe a rare condition that arises in infancy as is characterized by self-inflicted excoriations. It is considered to be a milder variant of hereditary sensory-autonomic neuropathy (HSAN) type VIII. We present an 8-year-old boy with lesions on the mid-face that were admittedly self-induced and associated with an abnormally high pain threshold. The diagnosis and management of MiTES is reviewed., (© 2020 Wiley Periodicals, Inc.)

Background: Previous studies have linked low serum vitamin D (VD) or 25-hydroxyvitamin D (25(OH)D) levels with increased severity of atopic dermatitis (AD) in children., Objective: To investigate the association between serum VD (25(OH)D) levels and AD and AD severity, considering the influence of diet and sun exposure., Methods: We performed a prospective cross-sectional study of healthy controls and children diagnosed with AD. Participants were recruited between January 2011 and December 2012, and the following parameters were assessed: age, sex, body mass index (BMI), AD severity, Fitzpatrick skin type, asthma and rhinitis history, dietary VD intake, daily potential sun-induced VD production, sunscreen use, 25(OH)D and IgE serum levels, and results of the ImmunoCAP Phadiatop Infant test., Results: The study population consisted of 105 healthy controls and 134 AD patients. Serum 25(OH)D levels were significantly lower in moderate and severe AD than in mild AD, although this association was only significant for patients with light Fitzpatrick skin type (mean(SD) 36.7 (11.9) ng/mL; moderate 28.8 [11.5] ng/mL; and severe 27.6 [12.1] ng/mL, P = .045). Logistic regression analysis revealed a positive association between severe AD and both positive ImmunoCAP Phadiatop test and BMI., Conclusion: Our data support an association between VD deficiency and AD severity only in patients with light complexion., (© 2020 Wiley Periodicals, Inc.)

Papillary hemangioma (PH) is a rare, benign, vascular tumor that usually appears on the scalp and face and is reported most frequently in adults. We present a pediatric case of PH and provide sonographic features that may assist in establishing the diagnosis., (© 2019 Wiley Periodicals, Inc.)

Nevoid hyperkeratosis (NH) of the nipple and areola is an extremely uncommon condition in prepubertal children. We report on a prepubertal girl with NH and provide dermoscopic findings that helped to make the diagnosis., (© 2019 Wiley Periodicals, Inc.)

A 2-year-old girl presented with a 2-month history of an erythematous, indurated plaque with well-defined borders on the third toe of the right foot. Bedside high-resolution ultrasonography demonstrated a thickened epidermis overlying a hyperechoic focus within the dermis. Her clinical and sonographic presentation was in keeping with a foreign body causing hair-thread tourniquet syndrome. The foreign body was surgically extirpated without neurovascular sequelae. Ultrasonography expedited accurate diagnosis and is a promising adjunct to clinical evaluation for radiolucent foreign bodies., (© 2018 Wiley Periodicals, Inc.)

Bullous pemphigoid (BP) is an acquired autoimmune blistering disorder of unknown etiology uncommon in childhood. Unlike adult BP, infantile BP shows acral distribution and resolves rapidly with systemic steroids. We report three infants with infantile BP presenting shortly after vaccination for diphtheria, pertussis, tetanus, poliomyelitis, hepatitis B, Haemophilus influenzae B, and meningococcus C. Our cases further reinforce the causal association between childhood BP and vaccination., (© 2013 Wiley Periodicals, Inc.)

Propranolol has shown to be effective in the treatment of infantile hemangiomas (IH), but several cases of recurrences have been reported so far. We describe five cases of IH recurrence after propranolol treatment was stopped in 26 patients treated with propranolol all of whom were observed for at least 9 months after treatment was discontinued. Recurrence was present in 5 of 26 cases, yielding a recurrence rate of 19%. All cases were in females. Time from withdrawal to recurrence ranged from 0 to 6 months. In four of five cases, the lesion relapsed after the age of 11 months. Four of the five cases presented partial recurrences, whereas in one case, recurrence was complete. In the majority of cases, recurrence appeared in the deep component of the IH. Early treatment withdrawal or a long proliferative phase of IH are potential causes of hemangioma recurrence, although the exact mechanism remains unclear. The vascular endothelial growth factor receptor might be involved, as well as incomplete apoptosis during treatment., (© 2011 Wiley Periodicals, Inc.)