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Background: Comedone extraction provides greater satisfaction for acne treatment than conventional treatment alone; however, post‐comedone extraction erythema (PCEE) remains a concern for patients. Objectives: To evaluate the efficacy of pulsed‐dye laser (PDL) in PCEE and comedone reduction. Methods: Mild‐to‐moderate acne patients were randomly allocated in split‐face fashion. Three comedones were extracted on each facial side. On the PDL‐treated side, 595‐nm PDL was delivered to the entire side with an additional shot on three comedone‐extracted sites. Erythema index (EI) and total acne lesion counts (TALC) were evaluated at baseline, week 2 and 4. The comprehensive acne severity scale (CASS) was assessed by three blinded independent pediatric dermatologists. Participant satisfaction surveys were completed at the end of the study. Results: Thirty‐five participants (age 12.9–24.2 years) showed no differences in the EI and TALC at baseline on both sides. At weeks 2 and 4, the EI on the PDL‐treated side was significantly lower (p < 0.001) with a greater EI reduction (p < 0.001) when compared to the control side regardless of gender and menstruation. There was significantly lower TALC on the PDL‐treated side at week 2 (p < 0.001) and week 4 (p = 0.02). No complications were noted with high participant satisfaction reported (median 8; IQR 7–9). PDL remained significantly associated with EI improvements after controlling for gender, menstruation cycle, and examination stress. Conclusion: PDL can be an adjunctive intervention for the treatment of PCEE and comedone reduction due to its effectiveness and high participant satisfaction. [ABSTRACT FROM AUTHOR]

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe adverse drug reaction involving multiple organs. Data on DRESS syndrome among children are currently limited. The purpose of this study was to determine the clinical features, causative drugs, systemic organ involvement, laboratory findings, disease severity score, and treatment outcomes in pediatric DRESS patients. The medical records of all pediatric DRESS patients, based on the RegiSCAR diagnostic criteria and admitted to King Chulalongkorn Memorial Hospital, Bangkok, Thailand from January 2010 to December 2021, were reviewed. Twenty‐two cases were identified (males 54.5%) with a median age of 9.5 years. Anticonvulsants (54.5%) and antibiotics (27.3%) were the leading culprit drugs. Skin rash was reported in all cases, followed closely by liver involvement (95.5%). Eosinophilia and atypical lymphocytosis were identified in 54.5% and 31.8% of cases, respectively. The median latency period was 17.5 days. Liver enzyme elevation was detected at an average onset of 20.0 days and hepatocellular type was the most common pattern of liver injury. Nineteen patients (86.4%) were treated with systemic corticosteroids with prednisolone being the most prescribed medication. One case developed Graves' disease after DRESS and multiple relapses of DRESS. One case (4.5%) died due to refractory status epilepticus that was unrelated to DRESS. Anticonvulsants were the major cause of DRESS in pediatric patients. High suspicion for DRESS is crucial in patients receiving these drugs and presenting with fever, rash, and internal organ involvement. [ABSTRACT FROM AUTHOR]

Background: Concerns about the use of topical corticosteroids (TCS) in pediatric eczematous dermatitis management often hinder effective treatment. Limited data exist regarding the prevalence of these concerns and the effectiveness of interventions. This study aimed to assess the prevalence of TCS concerns among caregivers and determine the effectiveness of video education in mitigating these concerns. Methods: A single‐center prospective study was conducted from 2022 to 2023, involving caregivers of children under 18 years with eczematous dermatitis. Baseline and post‐intervention questionnaires were administered after a 4‐week period. Caregivers received video education on TCS use, and the TOPICOP score was evaluated before and after viewing the video. Results: The study included 150 caregivers, 85.3% female and 74% had a child with atopic dermatitis. The prevalence of TCS concerns among Thai caregivers was 62%. Following video education, the prevalence of TCS concerns significantly decreased to 10.7%. Mean belief score decreased from 43.81 ± 13.45 to 31.85 ± 16.56, mean worry score decreased from 56.22 ± 18.27 to 40.41 ± 18.55 and mean total TOPICOP score decreased from 50.02 ± 12.65 to 36.13 ± 13.52 (p‐value <.001). The intervention also resulted in reduced disease exacerbations, duration of the rash, and duration of TCS use. The optimal TOPICOP cut‐off score to predict TCS concerns was identified as 43.06. Conclusion: Video education effectively alleviated TCS concerns among caregivers, addressing beliefs, worries, disease exacerbations, and side effects. Integration of this intervention into the management of pediatric eczematous dermatitis can yield optimal outcomes. [ABSTRACT FROM AUTHOR]

Steroid phobia is an increasing phenomenon that affects treatment adherence. The purpose of this study was to assess the prevalence and associated factors of steroid phobia among adolescents with eczema and the caregivers of children and adolescents with eczema by using questionnaires and TOPICOP© scale. The prevalence of steroid phobia is approximately 12% and 37% in the adolescent and caregiver groups, respectively. Caregivers who obtained information about topical corticosteroid (TCS) from dermatologists and whose children had fewer number of flares, demonstrated less concern about using TCS. [ABSTRACT FROM AUTHOR]

Byline: Therdpong. Tempark, Susheera. Chatproedprai, Siriwan. Wananukul Sir, The topical use of Ferula assa-foetida oleo-gum-resin essential oil, a traditional phyto-medicine believed to be effective in gastrointestinal disorders like flatulence and [...]

LT and HSCT are now potentially curative treatments for many medical conditions. Dermatologic manifestations are one of the sequelae after transplantation. To study the prevalence and associated risk factors of dermatologic manifestations after pediatric LT and HSCT. A 20‐year retrospective cohort study was conducted in children, aged ≤15 years, who received LT or HSCT from January 1, 1997, to December 31, 2017. Medical records were reviewed for data collection until December 31, 2018. A total of 70 LT and 51 HSCT recipients were included. The percentages of overall dermatologic manifestations after LT and HSCT were 64.3% and 64.7%, respectively. Viral infection was the most common manifestation in both groups, with mucocutaneous HSV infection as the most prevalent. One HSCT recipient developed leukemia cutis. GVHD was revealed in 27.5% of HSCT recipients. Impetigo and xerosis were significantly observed in patients using azathioprine and prednisolone. Approximately two‐thirds of pediatric LT and HSCT recipients experienced dermatologic manifestations, potentially associated with immunosuppressive agents. Thus, regular skin examination and optimized immunosuppression would be beneficial in these recipients. [ABSTRACT FROM AUTHOR]

Background: Xerosis is a common skin manifestation in chronic renal disease. Itching from dry skin causes skin discomfort, scratch marks, and compromises skin barrier function. Objective: To compare the efficacy of moisturizer containing 5% urea, natural moisturizing factors (NMFs), ceramide, and glyceryl glucoside (GG) with 5% urea lotion for treatment of xerosis in patients with underlying stable chronic kidney disease. Material and Method: We performed a randomized, double-blind, split-side, experimental study in 50 children with xerosis in stable chronic kidney disease. The patients were assigned sequentially by block randomization to use either moisturizing lotion containing 5% urea, NMFs, ceramide, and GG or 5% urea on opposite sides of the lower leg, twice daily for four weeks. The moisturizers were repacked in identical bottles. Clinical severity of xerosis, skin hydration, and transepidermal water loss (TEWL) were evaluated at baseline and at at one, two, and four weeks. Results: Forty-seven of 50 patients completed the study. The mean age was 13.43±2.3years. Both products significantly decreased clinical severity of scaling and roughness from baseline (p<0.001). Application of moisturizer containing 5% urea, NMFs, ceramide, and GG resulted in significantly higher skin hydration and lower TEWL compared with 5% urea lotion (both p<0.01), from week 1. Regarding the safety of using urea in chronic kidney disease, there were no significant differences in blood urea nitrogen (BUN) and creatinine levels between pre- and post-treatment (p = 0.627). No adverse effects were reported. Conclusion: Both moisturizing lotions containing 5% urea, NMFs, ceramide, and GG and 5% urea were effective in improving scaling and roughness, skin hydration, and skin barrier function in stable chronic pediatric kidney disease patients. Additional ingredients, such as NMFs, ceramide, and GG can significantly improve xerosis, skin hydration, and skin barrier function. Products containing 5% urea applied on the lower legs for four weeks do not increase BUN or creatinine levels. [ABSTRACT FROM AUTHOR]

Nail scabies is an interesting clinical presentation of scabies. Although it is usually found concomitant with characteristic dermatologic manifestations, it may present as an isolated finding in the immunocompromised host. This condition is commonly mistaken with other diseases such as nail dystrophy, nail psoriasis and onychomycosis. We report two cases of unusual nail presentations that provide clues to diagnosis. Also, literature on unusual nail and dermatologic presentations was reviewed to recognize dermatologist consideration for appropriate treatment options. [ABSTRACT FROM AUTHOR]