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Background/Objective: Juvenile xanthogranuloma (JXG) is a rarely encountered skin disorder, which is characterized by the proliferation of non‐Langerhans cell histiocytes. As JXG primarily affects infants and young children, this study aims to describe the epidemiologic, clinical, and histopathologic characteristics of 44 children diagnosed with JXG at a tertiary health care center. Methods: Fourty‐four children with a histopathologic diagnosis of JXG between January 2003 and January 2017 were retrospectively reviewed. Data related to epidemiologic, clinical, and histopathologic features were extracted from hospital records. Results: The mean age of the affected patients was 4.6 years old (range: 0–17 years old) at the time of diagnosis. Twenty‐five patients (56.8%) were male, and 19 patients were female (43.2%). Thirty‐six children (81.8%) had solitary JXG, one of which was a giant congenital JXG; eight children (18.2%) had eruptive JXG. The heterozygote mutation associated with neurofibromatosis 1 gene was detected in one patient who had both eruptive JXG and numerous café‐au‐lait spots. Another patient with eruptive JXG was identified to have hypercholesterolemia. None of the children with eruptive JXG developed symptoms or signs of extracutaneous involvement during their clinical follow‐up. Conclusion: Since JXG is rarely encountered, there may be a tendency toward over‐treatment, given concerns for extracutaneous involvement. However, our review revealed no instances of extracutaneous involvement. [ABSTRACT FROM AUTHOR]

Objective: Alopecia areata (AA); is a sudden onset, non-scaring hair loss. Twenty percent of cases are children. Although it is thought to be related to genetic predisposition, inflammation, immunological processes or psychological triggers, its pathophysiology is still not fully understood. This study was planned to investigate the levels of serum 25-hydroxy vitamin D, vitamin B12, thyroid-stimulating hormone (TSH) and free T4 FT4) in children with AA and compare the results with age-matched healthy individuals. Methods: A retrospective medical record review was carried out in an outpatient dermatology clinic in a tertiary medical center between January 1,2013 and December 31, 2017. The study included 520 patients (ages 0-18 years) who received a clinical diagnosis of AA.106 patients with AA met the inclusion criteria. Patients in the control group (n=106) were selected among children aged 0-18 years without any medical and/or psychiatric diagnosis. Both past medical and family medical history were also noted. Results of laboratory tests including vitamin D, vitamin B12, TSH, FT4, and thyroid auto-antibodies were noted. Results: There was no significant difference between the patient and control groups in terms of mean age. Mean age of onset was 8.0 years. The number of boys and girls in both the patient and control groups were 55 and 51. Serum levels of FT4 and TSH in patients with AA were significantly higher than the control group. Both vitamin D and vitamin B12 levels of the patients with AA were significantly lower than the control group. Conclusion: Although its role in etiopathogenesis is not understood, the importance of monitoring both vitamins and thyroid functions in childhood AA cases is obvious. [ABSTRACT FROM AUTHOR]

Acquired Macular Hyperpigmentation: Ashy dermatosis (AD), lichen planus pigmentosus (LPP), erythema dyschromicum perstans (EDP), and idiopathic eruptive macular pigmentation (IEMP) are the spectrum of acquired macular pigmentation of unknown etiology (MPUE). The aim of this study is to investigate and reevaluate our pediatric patients who had clinically and histopathologically been diagnosed with aforementioned disorders, in consideration of the global consensus statement on acquired MPUE. Materials and Methods: A retrospective chart review of 23 pediatric cases that had applied to the dermatology unit between the years 2007 and 2017 and diagnosed with any of the acquired macular pigmentation was performed. Results: Of 23 patients, 16 were diagnosed with AD, 4 with LPP, and 3 with IEMP. In AD patients, major site of presentation at onset was the trunk (13/16) and brownish (15/16) were the most prominent coloring. Dermal melanophages (16/16), perivascular lymphohistiocytic infiltrate (14/16), and pigment incontinence (7/16) were the most prominent features. Upper limbs (3/4) were the most predilection area in LPP patients. Perivascular lymphohistiocytic (4/4), lichenoid infiltration (3/4), basal vacuolar degeneration (4/4), and dermal melanophages (4/4) were observed. The trunk was the major site of presentation (3/3) in IEMP patients. Brownish (2/3) and ashen-gray (1/3) was the coloring of lesions. Basal layer pigmentation (3/3) and dermal melanophages (3/3) were the most prominent findings. No basal vacuolar changes (0/3) were observed. Conclusion: Clinical and histopathological distinction between these conditions is challenging. We reevaluated our patients in this context. We predict that we have achieved more accurate terminology with the global consensus statement. Such a terminology might allow that these disorders may be compared with a collective terminology in the literature. [ABSTRACT FROM AUTHOR]

Background: Allergic contact dermatitis (ACD) has become more frequent in children. The prevalence of contact sensitization varies with respect to age, sex, and geographic localization. Objective: The aim of the study was to investigate the experience of a tertiary health center regarding the patch test results of contact sensitization in children without atopic dermatitis. Methods: This is a retrospective review of 89 children (30 boys and 59 girls) who were aged between 3 and 18 years and who were diagnosed with ACD between July 2013 and July 2017. Children with a known history of atopic dermatitis were excluded. All patients were tested with the TRUE (Thin-layer Rapid Use Epicutaneous) test series. Results: The most frequently determined allergens by TRUE test were methylchloroisothiazolinone (n = 7 [16.3%]), disperse blue 106 (n = 5 [11.6%]), and bacitracin (n = 5 [11.6%]). Formaldehyde-related allergens produced 15 positives. Conclusions: Preservatives, such as methylchloroisothiazolinone, formaldehyde, and formaldehyde releasers, emerge as the most frequent allergens in children who undergo patch testing because of ACD. This finding might be attributed to the increase in the utilization of these chemical compounds in personal hygiene products for children. [ABSTRACT FROM AUTHOR]

Stevens-Johnson syndrome and toxic epidermal necrolysis are severe cutaneous adverse reactions commonly caused by exposure to drugs and can end up with significant morbidity and mortality. We reported our experience with six patients who were diagnosed with Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis with a different clinical presentation. In patients, drugs and Mycoplasma pneumoniae infection were implicated as a trigger. Intravenous Immunoglobulin treatment was given to all patients, and intensive treatment was applied for skin and mucosal lesions. The median period of stay in hospital was 13.5 days. The most common long-term complication was ocular involvement. Among six patients, corneal epithelial defects occurred in one patient. Consequently, ophthalmological evaluation should be performed both at the time of diagnosis and before hospital discharge. [ABSTRACT FROM AUTHOR]

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Objective: Lichen nitidus (LN) is an uncommon inflammatory skin eruption. The present study aims to describe a case series of children with LN seen at a tertiary‐care health center. Methods: Retrospective study of 17 children with biopsy‐proven LN between January 2007 and March 2017. Data related with epidemiologic, clinical, and histopathologic characteristics were recorded. Results: The mean age for the onset of LN was 9 years (range: 5‐17 years), and the mean duration of the skin lesions was 13 months (range: 1‐48 months). Fifteen were boys (88.2%). Seven children had a generalized form of LN (41.1%) and of these, two children had severe pruritus (11.8%). Seven children had a history of co‐morbid skin conditions (41.1%), including lichen planus in one patient (5.9%), lichen striatus in one patient (5.9%), psoriasis and longitudinal ridges in the nails in one patient (5.9%), and cutaneous features of atopic skin in four patients (23.5%). All of the reviewed patients had lymphohistiocytic infiltration in the dermis and basal vacuolar degeneration. Multinucleated giant cells were present in 11 (64.7%). Conclusion: This case series found LN in a generalized form as well as other concurrent dermatologic conditions in nearly half of those reported. The boy predominance was also noteworthy. [ABSTRACT FROM AUTHOR]

Subcorneal pustular dermatosis (SPD) is a rare, chronic, recurrent dermatosis characterised by sterile pustules. It develops mainly in middle-aged or elder women, but is also rarely seen in children. The exact aetiology of the disease is unknown. In literature, cases associated with IgA gammopathy have been reported. In this article; we report a case of a five-year-old girl who was diagnosed as SPD by clinical features, histopathological characteristics, and direct immunofluorescence analysis results. IgA was high, and IgG-IgM and CD19+ B cell were low. We noticed that during IVIG treatment for immunodeficiency, dermatological symptoms were recovered rapidly. Clinical profile of SPD and its association with systemic diseases may provide early detection of immune dysfunction. [ABSTRACT FROM AUTHOR]

“Drug rash with eosinophilia and systemic symptoms” (DRESS) syndrome is a rare but life-threatening systemic severe adverse drug hypersensitive reaction. The syndrome is characterized by maculopapular rash, fever, lymphadenopathy and single or multiple organ involvement as liver, lung, heart and kidney. The pathogenesis of the syndrome is not clarified completely. It has been suggested that causative drug may induce hypersensitivity as a result of abnormalities in the production and detoxification of its active metabolites. In this report we aimed to present a 13 years old female with DRESS syndrome induced by sulfasalazine and amoxicillin. He had been taking sulfasalazine for seven weeks for treatment of seronegative spondylarthritis and taking amoxicillin for three days for tonsillopharyngitis. We want to remark to this syndrome because of its life-threatening course. Promt withdrawal of the offending drug/drugs following rapid diagnosis is only undisputed way to treat this syndrome. [ABSTRACT FROM AUTHOR]

Neonatal subcutaneous fat necrosis (NSFN) is a rare form of panniculitis that occurs in term infants who experience birth trauma, meconium aspiration or therapeutic cooling in the first week of life. Although most cases of NSFN resolve spontaneously, it may be associated with metabolic complications as hypercalsemia, hypoglycaemia, hypertriglyceridemia or with heamatological complications as anemia and thrombocytopenia. Because the disease is rarely seen, we want to report the case of term newborn who did not have any metabolic and heamatologic complications. [ABSTRACT FROM AUTHOR]

Objective: To examine family functioning, psychopathology, quality of life in children and adolescents diagnosed with alopecia areata (AA), and to investigate the relationship between sociodemographic and disease-related variables. Method: 45 patients from 2 to 18 years of age were examined retrospectively. The Family Assessment Device (FAD), the Pediatric Quality of Life Inventory (PedsQL), the Children Depression Inventory (CDI) and the sociodemographic data sheet were used. Statistical analyses were performed using SPSS 18.0 software. Results: Of the subjects assessed, the mean age was 9.22±3.79 and 55.6% were female. The FAD affective involvement and behaviour control subscales demonstrated impairment in the entire case group (>2). 42.2% of the cases received at least one psychiatric diagnosis. Presence of psychiatric comorbidity caused impairment in all the subscales of depression, FAD general functioning, parental quality of life psychosocial health, and pediatric quality of life. A psychosocial trigger incident was detected in 51.1% of the cases. In cases, however, where no trigger incident was detected, CDI and PedsQL showed significant impairment in all the subscales (p<0.05). Lesion intensity was found positively associated only with the number of attacks and duration of the disease. Conclusion: Family functioning in AA patients is impaired in the subscales of affective involvement and behaviour control. Although psychosocial trigger incidents are common in AA, they may not be associated with psychopathology, quality of life and family functioning. Psychiatric comorbidity emerged as the factor which impaired the quality of life most. [ABSTRACT FROM AUTHOR]

İnce D, Demirağ B, Özek G, Erbay A, Ortaç R, Oymak Y, Kamer S, Yaman Y, Kundak S, Vergin C. Pediatric langerhans cell histiocytosis: single center experience over a 17-year period. Turk J Pediatr 2016; 58: 349-355. This study aimed to analyze children with the diagnosis of Langerhans cell histiocytosis (LCH) who were diagnosed and treated between 1998-2015. Medical records were evaluated retrospectively for clinical and laboratory features, treatment details, and outcome. There were 20 patients, the median age of diagnosis was 37 months, M/F ratio: 1.5. Nine had single system (SS), 11 had multisystem (MS) LCH. Spontaneous regression occurred in three infants with skin limited LCH. Eight patients had risk organ involvement in MS-LCH group. The curettage alone was performed in only one case. Patients received LCH-II/ LCH-III based chemotherapy schema. Radiotherapy was performed to vertebral disease and residual craniofacial bone disease in four cases. The regression and relapse rates were 100% and 33% for SS-LCH. The regression and relapse rates were 73%, and 18% for MS-LCH. Two infants with MS-LCH died despite chemotherapy. Pulmonary and liver involvements affected outcome adversely in MS-LCH. Multidisciplinary treatment approaches are needed. [ABSTRACT FROM AUTHOR]

Lymphangioma circumscriptum is a rare hamartomatous condition characterized by clear vesicles which can be present at birth or soon after in localized areas of the skin. Lesions are often reminiscent of the frog spawn, grouped and in a herpetiform pattern. As vesicles of 3-4 mm in diameter may be clear, they consist of pink, red, black haemorrhage. The most common locations are proximal aspect of the limbs, buttock, groin, axillary folds,neck and oral mucosa especially the tongue. In addition to congenital lesions, acquired lesions may also occur. Such lesions are usually located vulvar and perianal area and can be seen after surgical procedures, radiation therapy and infection. In this article, three cases of congenital Lymphangioma circumscriptum which are in different locations and which shows different clinical progression are reported. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi is the property of Journal of Pediatric Infection / Cocuk Enfeksiyon Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)