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Lichen sclerosus (LS) is a chronic inflammatory dermatosis primarily affecting the genitalia, commonly characterized by pearly-white papules and plaques. Although predominantly affecting females, LS can manifest across all age groups, with a bimodal distribution observed in prepubescent girls and postmenopausal women. This case report presents an unusual instance of exclusive extragenital LS in a 10-year-old girl, showcasing hyperpigmented patches and wrinkled plaques resembling lichen planus on her forearms and lower legs. Histopathological analysis confirmed LS, revealing distinctive epidermal changes and lymphocytic infiltrates. The absence of mucosal involvement and unique clinical presentation differentiated this case from typical LS manifestations. Treatment with topical clobetasol propionate demonstrated significant improvement in pruritus. Extragenital LS is infrequent, particularly among children, and its diagnosis necessitates a comprehensive clinicopathological correlation. The reported case contributes valuable insights into this uncommon variant, emphasizing the importance of accurate diagnosis and tailored treatment strategies. Additionally, it highlights the efficacy of high-potency topical corticosteroids in managing this condition.

Reactive infectious mucocutaneous eruption (RIME) is a newly defined condition characterized by mucocutaneous blistering secondary to upper respiratory infections and encompasses Mycoplasma pneumoniae‐induced rash and mucositis, broadening the disease spectrum to include various infectious etiologies. We present a severe RIME case involving a 5‐year‐old female with concurrent coronavirus NL63 and group A streptococcus infections. Diagnosis complexity stemmed from overlapping clinical features with other severe mucocutaneous eruptions such as Stevens‐Johnson syndrome/toxic epidermal necrolysis/drug‐induced necrolysis. This case underscores the need for comprehensive infectious workup and emphasizes the clinical diagnostic spectrum of drug‐induced and infection‐induced desquamative skin and mucosal disease. [ABSTRACT FROM AUTHOR]

The characteristics of epidermolysis bullosa (EB) demand higher than average provider support for transition from pediatric to adult care. We administered an online Qualtrics survey to members of the Epidermolysis Bullosa Clinical Research Consortium (EBCRC), a group of providers who care for patients with EB, in order to examine their practices and perspectives on transition of care (TOC) and identify barriers to successful implementation. Sixteen of eighteen medical centers completed the survey. Eighty‐eight percent of center representatives expressed concerns about their patients transitioning/transferring from the pediatric to adult‐centered care. Thirty‐eight percent of providers reported having a formal TOC program in place. Our findings support the desire for formal TOC programs, the need for a team‐based approach and, in particular, identification of adult providers to participate in the transition to improve this often challenging time. [ABSTRACT FROM AUTHOR]

This study explores referral patterns in pediatric dermatology and assesses the diagnostic concordance between referring and dermatology providers. This retrospective cross-sectional study utilized referrals to an outpatient pediatric dermatology clinic. The review included patients referred between July 1, 2018 and June 30, 2019. Only patients who completed a clinic visit were included in the diagnostic concordance. Referral and first visit diagnoses were compared to determine concordance. A total of 8,682 charts were reviewed, and 3,738 completed a clinic visit. The most common referral diagnoses included atopic dermatitis, rash, lesion, melanocytic nevus, and warts. Physicians (78.5%) and APRNs (18.1%) most frequently referred patients. The diagnostic concordance of physicians was 67.1% vs 66.3% for APRNs. Physicians and APRNs showed similar rates of diagnostic concordance, yet a large proportion of diagnoses were discordant. Primary care providers may benefit from focused education around the most commonly referred and missed diagnoses. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate the characteristics and treatment response of patients with pityriasis lichenoides seen in the last 43 years in a pediatric dermatology service. Methods: This was a retrospective, analytical, longitudinal study of patients under 15 years of age. The medical records were reviewed and data were presented as frequencies, means and variances. Student’s t-test, Mann-Whitney test, Fisher’s exact test, Pearson/Yates chi-square test and multivariate logistic regression model were used, with p < 0.05 considered. Results: 41 patients were included, 32 (78.0%) with pityriasis lichenoides chronica (PLC), five (12.2%) with pityriasis lichenoides et varioliformis acuta (PLEVA) and four (9.8%) with clinical PLC without biopsy. The age range of school children and adolescents was 19 (46.3%) and 13 (31.7%) respectively and 27 (65.8%) were male. Two peaks of the highest frequency were observed between 2004 and 2006 (10 patients - 24.4%) and another between 2019 and 2021 (6 patients - 14.7%). There was remission in 71.9% (n = 23), with 56.6% (n = 17) of those who used antibiotic therapy and 80% (n = 4) of those who had phototherapy. The chance of remission was 13 times greater in patients with disease onset after 5 years of age. Conclusions: The clinical form most commonly found was PLC mainly in school children and adolescents. The frequency peaks coincided with infectious outbreaks. The remission rate was satisfactory with antibiotic therapy, but higher with phototherapy. Remission was greater in patients with disease onset after 5 years of age. [ABSTRACT FROM AUTHOR]

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Background Methods Results Conclusions Dystrophic epidermolysis bullosa (DEB) describes a rare genetic blistering disorder characterized by fragile skin. This study aimed to classify the frequency, demographics, cost, and comorbidities associated with emergency department (ED) visits due to DEB.The Nationwide Emergency Department Sample (NEDS) was analyzed for pediatric (age <18) ED visits from 2015 to 2019. DEB was identified with ICD‐10‐CM code Q81.2. Weighted frequency, prevalence, and 95% confidence intervals (CIs) of comorbidities were determined among ED visits with and without a DEB diagnosis.From 2015 to 2019, 53 (weighted 242) cases of DEB among 27,223,220 pediatric ED visits were captured. Patients with DEB were more likely to visit the ED in summer compared with those without a diagnosis of DEB (35.7% vs. 21.4%, P < .05). More than half of patients with DEB were admitted to the hospital (56.2%, 95% CI: 39.3–72.5, P < .001) versus only 3.4% (95% CI: 3.1–3.7) of other patients.For ED visits with a secondary DEB diagnosis, the top three primary diagnoses were fever, constipation, and bone marrow transplant aftercare. Patients with DEB had higher rates of hypertension, cellulitis, sepsis, acute and chronic kidney injury, esophageal obstruction, gastroesophageal reflux disease, cardiomyopathy, and anxiety, compared to patients without DEB (all P < .001).DEB is a complex blistering disorder with multisystemic manifestations. Patients with DEB have significantly higher admission rates and commonly present with infectious or gastrointestinal complications. Understanding the features of ED visits due to DEB can better prepare healthcare teams and improve patient outcomes. [ABSTRACT FROM AUTHOR]

The skin of newborns is classified as sensitive, with a higher risk of skin barrier disruption and irritation of a diapered area. Despite dermatologist recommendations to use only water and a cloth for cleaning, most of the population still relies on the comforts of modern parenting, which includes intensive daily usage of baby wet wipes. Novel baby formulations are designed following the concept of infant skin health, containing a gentle cleanser, suitable emollient, and buffer system enabling a slightly acidic pH value and they are free of ethyl alcohol. Thus, it is important to understand the chemical background of such a complex liquid formulation, with emphasis on its safety. In line with this, the present paper discusses the scientific background of various chemical compounds found in baby wipe formulations to improve the understanding of wet wipe designs and direct them toward more skin‐friendly solutions. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Artificial intelligence (AI) tools have the potential to revolutionize many facets of medicine and medical sciences research. Numerous AI tools have been developed and are in continuous states of iterative improvement in their functionality.This study aimed to assess the performance of three AI tools: The Literature, Microsoft's Copilot and Google's Gemini in performing literature reviews on a range of dermatology topics.Each tool was asked to write a literature review on five topics. The topics chosen have recently had peer‐reviewed systematic reviews published. The outputs of each took were graded on their evidence and analysis, conclusions and references on a 5‐point Likert scale by three dermatologists who are working in clinical practice, have completed the UK dermatology postgraduate training examination and are partaking in continued professional development.Across all five topics chosen, the literature reviews written by Gemini scored the highest. The mean score for Gemini for each review was 10.53, significantly higher than the mean scores achieved by The Literature (7.73) and Copilot (7.4) (p < 0.001).This paper shows that AI‐generated literature reviews can provide real‐time summaries of medical literature across a range of dermatology topics, but limitations to their comprehensiveness and accuracy are apparent. [ABSTRACT FROM AUTHOR]

PSTPIP1‐associated myeloid‐related proteinemia inflammatory (PAMI) syndrome is a rare autoinflammatory disorder often arising in pediatric patients. We present a case of an 18‐year‐old female with a past medical history of growth failure, immunoglobulin A nephropathy, and inflammatory arthritis who presented to a pediatric dermatology clinic with findings of acne, psoriasiform dermatitis, and hidradenitis suppurativa, whose clinical, genetic, and laboratory findings were most consistent with PAMI syndrome. We conducted a literature review to better characterize this rare condition in the context of dermatologic findings. Recognition of the distinctive skin findings seen in PAMI syndrome can help distinguish it from other inflammatory disorders, enabling expedited diagnosis and treatment. [ABSTRACT FROM AUTHOR]

The European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized its bi‐annual forum EUFOREUM in Berlin in November 2023. The aim of EUFOREUM 2023 was to highlight pediatric action plans for prevention and optimizing care for type 2 inflammatory conditions starting in childhood, with a focus on early‐stage diagnosis, ensuring neither under‐ nor overdiagnosis, optimal care, and suggestions for improvement of care. EUFOREA is an international not‐for‐profit organization forming an alliance of all stakeholders dedicated to reducing the prevalence and burden of chronic respiratory diseases through the implementation of optimal patient care via educational, research, and advocacy activities. The inclusive and multidisciplinary approach of EUFOREA was reflected in the keynote lectures and faculty of the virtual EUFOREUM 2023 (www.euforea.eu/euforeum) coming from the pediatric, allergology, pulmonology, ENT, dermatology, primary health care fields and patients around the central theme of type 2 inflammation. As most type 2 inflammatory conditions may start in childhood or adolescence, and most children have type 2 inflammation when suffering from a respiratory or skin disease, the moment has come to raise the bar of ambitions of care, including prevention, remission and disease modification at an early stage. The current report provides a comprehensive overview of key statements by the faculty of the EUFOREUM 2023 and the ambitions of EUFOREA allowing all stakeholders in the respiratory field to be updated and ready to join forces in Europe and beyond. [ABSTRACT FROM AUTHOR]

Background: Pediatric longitudinal melanonychia (LM) can exhibit atypical features that mimic red‐flag signs for subungual melanoma in adults and lead to diagnostic uncertainty. Nail biopsy may be unnecessary if clinical inspection and dermoscopy suggest a benign nature. Methods: We searched PubMed and Embase from inception to February 2023 for studies of any design reporting either the number or proportion of clinical and dermoscopic features in at least five children (≤18 years) with LM. Non‐English articles, reviews, and abstracts were excluded. We performed a systematic review and meta‐analysis to collate all existing data. Results: A total of 1218 articles were screened and 24 studies with 1391 pediatric patients were included. Nevus was the most common diagnosis (86.3%). The most prevalent sites were fingernails (76.2%) and first digits (45.4%). Pooled proportions of common features were: dark‐color bands (69.8%), multi‐colored bands (47.6%), broad bandwidth (41.1%), pseudo‐Hutchinson sign (41.0%), irregular patterns (38.1%), Hutchinson sign (23.7%), dots and globules (22.5%), nail dystrophy (18.2%), and triangular sign (10.9%). Outcomes included progression (widening or darkening, 29.9%), stability (23.3%), and spontaneous regression (narrowing or fading, 19.9%). Only eight cases of subungual melanoma in situ were reported, and no invasive melanomas were identified. Conclusion: Although atypical characteristics are common in pediatric LM, the probability of malignant transformation is exceedingly low. Appropriate evaluation and management of pediatric LM includes careful clinical and dermoscopic inspection with attention to benign features followed by long‐term interval follow‐up. [ABSTRACT FROM AUTHOR]

This article is a systematic review of studies that explore the use of game-based learning (GBL) in dermatology education. The review found that GBL can be an effective approach to teaching dermatology, with positive attitudes and favorable learning outcomes reported. However, the study quality of the reviewed articles was generally low, and there is a need for high-quality studies with objective outcomes. The authors suggest that GBL could play an important role in future dermatology training, but more research is needed to support its effectiveness. The study was funded by the Copenhagen Capital Region Postdoctorate Research Fund and the authors declare no conflicts of interest. [Extracted from the article]

Acquired generalized lipodystrophy (AGL) is a rare disease characterized by variable loss of adipose tissue and concurrent metabolic derangements, typically with childhood or adolescent onset. AGL has three subclassifications: panniculitis (type 1), autoimmune disease (type 2), and idiopathic (type 3). This report highlights a rare case of AGL type 1 in a previously healthy 3‐year‐old female who presented with diffuse erythematous subcutaneous nodules, progressive lipoatrophy, and histopathological findings of a lobular panniculitis. [ABSTRACT FROM AUTHOR]

A current shortage of pediatric dermatologists limits access to dermatologic care among the pediatric population, yet comprehensive and updated data are lacking regarding access among the pediatric Medicaid population. This cross‐sectional study characterized Medicaid acceptance among actively practicing board‐certified pediatric dermatologists in the United States and revealed that of the 352 physicians compiled, 275 (78.1%) accept Medicaid. Significant differences in Medicaid acceptance status were observed based on practice type, region of practice, practice county median household income, and density of pediatric dermatologists. While the majority of practicing board‐certified pediatric dermatologists accept Medicaid, our findings suggest that differences in access to Medicaid‐accepting pediatric dermatologists exist based on practice type, geographic location, and density of pediatric dermatologists per county. [ABSTRACT FROM AUTHOR]

Background: Recent years have seen significant exploration into the potential link between allergic contact dermatitis and atopic dermatitis, yielding contradictory findings. Methods: A retrospective cohort analysis of children aged 2 to 18 who underwent patch testing at the pediatric dermatology clinic at a tertiary medical center in Israel was conducted. Results: Overall, 367 patients were included in the study, 31.6% of whom were diagnosed with atopic dermatitis. 160 children (43.6%) exhibited a positive reaction to at least one compound in the European baseline series. There was no statistically significant difference in reactivity between children with atopic dermatitis and those without (P = 0.848). Sub‐analyses based on ethnicity, gender, and age did not reveal significant differences in overall European baseline series reactivity (P = 0.612, P = 0.446, P = 0.488, respectively). Sensitivity was notably higher when patch readings were conducted 72 h after application compared to 48 h [0.95 (CI: 0.91–0.97) vs. 0.60 (CI: 0.55–0.66)]. Conclusions: Patch testing is imperative for suspected cases of allergic contact dermatitis in all children, regardless of their atopic background. Further research is warranted to potentially replace the traditional 48‐h reading with a single 72‐h reading in future guidelines, contributing to enhanced efficiency and cost‐effectiveness in clinical practice. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Pediatric pemphigus is a rare bullous disease that represents a diagnostic and therapeutic challenge;  evidence on patients' response to various treatments and long‐term surveillance data are lacking. We aimed to investigate pediatric pemphigus patients' characteristics, diagnosis, therapeutics, response, and long‐term follow‐up.This is a retrospective study of all pemphigus patients aged <18 years, diagnosed between 2000 and 2023, from three tertiary medical centers in Israel. The diagnosis was confirmed by positive immunofluorescence.Twelve pediatric pemphigus patients were included (mean age 10.7 ± 4.3 years, male:female ratio 1:1). Mean diagnostic delay was 11.1 ± 12.6 months (range 1.8–36 months). Most patients had pemphigus vulgaris with mucosal involvement (58.3%). First‐line treatment for all patients included systemic corticosteroids (sCS), with a treatment duration (including tapering down) of 28 ± 18.4 months. Hospitalization did not yield better outcomes. Only three patients achieved sustained complete response with sCS treatment (25.0%), and the rest required additional therapeutics, most commonly rituximab. Rituximab showed a good safety profile and therapeutic response. Follow‐up was recorded up to 18.1 years after diagnosis (mean: 5.6 years). Three of five patients with information available more than 5 years after the pemphigus diagnosis still exhibited disease symptoms.Pediatric pemphigus is associated with a significant diagnostic delay. While sCS can induce remission in most patients as a first‐line treatment, long‐term disease control requires additional immunomodulators. Long‐term follow‐up reveals a chronic yet mostly benign disease course in this population and advocates for the use of rituximab in pediatric pemphigus patients. [ABSTRACT FROM AUTHOR]

Objective: Pediatric dermatology patients constitues one of the most frequently encountered patient group in daily clinical practice. The present survey-based study aimed to evaluate the proficiency of pediatric dermatology training during dermatology and venereology residency in Türkiye. Material and Methods: An online Google questionnaire form (docs.google.com/forms) consisting of 55 questions, was carried out among 201 participants who were 3rd and 4th year dermatology research assistants, specialists and academicians between December 2022 and March 2023. Results: A total number of 201 participants were included in the study. Fifty six were research assistants, 107 were specialists and 38 were academicians. Only 74 (37%) participants had received pediatric dermatology training. Seventy two (97.3%) had pediatric dermatology training in their own residency clinic, whereas 2 (2.7%) had their training in another hospital by designation. In the management of pediatric patients, 46 (16.9%) dermatology research assistants were the primary attendants, 113 (41.5%) were under the supervision of a specialist or academician whereas 36 (13.2%) did not take any place in the management of pediatric patients. One hundred sixteen (58.9%) participants declared that they had received lectures related to pediatric dermatology during their residency training. If we were to look at the pediatric dermatology training satisfaction rates, the highest rate of satisfaction was observed among academicians with a rate of 44.8%. Conclusion: There is no pediatric dermatology subspeciality in our country. However, having a separate subspeciality in the new planning may contribute to its development. [ABSTRACT FROM AUTHOR]

This document is a collection of summaries of various articles from the Australasian Journal of Dermatology. The first article discusses "pool palms," a common condition in children caused by frictional dermatitis from rubbing against rough pool surfaces. The second article presents a case of a delayed bullous drug eruption caused by Trikafta, a drug used to treat cystic fibrosis. The third article describes a case of a neonatal neurocristic cutaneous hamartoma, a rare developmental abnormality. The fourth article examines the efficacy of combination oral antifungal therapy in pediatric patients with cutaneous fungal infections. The fifth article analyzes dermatological presentations in a pediatric emergency department. The sixth article reviews plant-based therapies for treating pediculosis capitis. The seventh article explores the experiences and needs of families with children diagnosed with xeroderma pigmentosum, a skin cancer predisposition syndrome. These summaries provide a brief overview of each article's topic and findings, offering valuable information for library patrons conducting research on specific dermatological topics. [Extracted from the article]

Cutaneous lymphoproliferative diseases in childhood are rare and they are clinically and pathologically heterogeneous, which makes their diagnosis challenging. Although there is limited long-term data and guidance on management, evidence suggests these to be different conditions from cutaneous lymphoma in adults, highlighting the need for age-appropriate patient information. We present clinical outcomes for our paediatric cohort of five patients with mycosis fungoides, emphasizing that despite diagnostic delays, mycosis fungoides in this age group tends to yield a good prognosis. It remains uncommon to provide clinical expertise together with psychological support in a dermatology paediatric service. Here, we provide our experience in offering this combined service. In conjunction with these patients, we have co-produced an accessible patient information leaflet targeted at a younger audience for support and to clarify potential misconceptions from a diagnosis of cutaneous lymphoma. [ABSTRACT FROM AUTHOR]

Unwanted hair is a common concern among patients presenting to pediatric dermatology clinics, and parents and patients alike inquire about the safety of methods employed for elective removal. Various methods of hair removal exist with different levels of invasiveness and permanence, from simple mechanical depilation to light‐based therapies. All methods of hair removal appear to be safe and generally well tolerated in children, and there are no age restrictions to any modality. In this review, we aim to address the available literature on the safety and efficacy of hair removal modalities in pediatric patients and propose guidance on how to manage requests for at‐home and in‐office therapies within an ethical framework. [ABSTRACT FROM AUTHOR]

Background: The presence of a vascular, blue linear discoloration on the nasal root of infants and young children is a frequent incidental feature, rarely reported in the medical literature. It is related to the trajectory of the transverse nasal root vein (TNRV). Objective: To study the frequency and clinical characteristics of the vascular discoloration of the nasal root in children. Methods: A prospective study was performed to address the presence or absence of vascular discoloration of the nasal root in all children under 6 years of age attending a pediatric dermatology clinic from November 2022 to November 2023. Data on age and skin phototype (Fitzpatrick classification I–VI) were also collected. Results: Of 701 patients examined, 345 (49.2%) presented with a vascular discoloration of the nasal root. This was present in 97 of 193 (50.3%), 127 of 261 (48.7%), and 121 of 247 (49.0%) patients for the age groups 0–1, 1–3, and 3–6 years, respectively. The presence of vascular discoloration of the nasal root was more frequent in patients with lighter Fitzpatrick skin phototypes: 49 of 69 (71.0%) phototype II, 157 of 290 (54.1%) phototype III, and 137 of 337 (40.7%) phototype IV. Conclusions: A vascular discoloration of the nasal root is a frequent skin feature in infants and children, persisting at least until the age of 6. It does not constitute any medical problem aside from cosmetic concern and parents can be reassured of its benign nature. We propose the medical term "prominent TNRV" to describe this condition. [ABSTRACT FROM AUTHOR]

Background/Objectives: Tree canopies have dermatologic and environmental benefits, especially on school campuses. However, inequities likely exist, and tree planting initiatives may further exacerbate disparities. We sought to identify any relationship between tree canopy shade on public school campuses in Austin, TX and the socioeconomic makeup of the student population, as well as whether current initiatives appropriately address any inequities. Methods: In this cross‐sectional study, we used ArcGIS, a publicly available geographic information system (GIS), to calculate the percentage of tree canopy on campuses within the Austin Independent School District (AISD) for the years 2006 and 2022. We compared this with the percentage of students eligible for free and reduced meals (FRM) at each school. The percentages of FRM‐eligible students were also compared for "low priority" versus "high priority" neighborhoods, as assigned by Austin's Tree Priority Map. Results: Among 112 schools analyzed, schools with minority FRM‐eligible students had significantly more tree canopy compared to schools with majority FRM‐eligible students (19.9% vs. 12.4%, p <.001). When comparing tree priorities, there was a significant difference between the percentage of FRM‐eligible students in "low priority" schools compared to "high priority" schools (23.8% vs. 62.2%, p <.001). Conclusions: Additional work is needed to rectify inequities in tree canopy access for public school students. Designations such as those used in Austin's Tree Priority Map would likely help direct such efforts. We hope this study encourages future research with GIS by both dermatologists and other health care professionals to promote interdisciplinary work with urban planners. [ABSTRACT FROM AUTHOR]

Background: Retronychia is characterized by proximal ingrowing of the nail plate into the proximal nail fold. It is always associated with the presence of two or more overlapping nail plates under the proximal nail fold, clinical signs of chronic proximal paronychia refractory to antimicrobial treatment, and a yellowish nail that does not grow. It mainly affects young female adults, with less than 30 pediatric cases described in the literature so far. Methods: Retrospective and observational study of patients between 0 and 18 years with a clinical and/or ultrasound diagnosis of retronychia attending a pediatric dermatology service between December 2020 and January 2022. Results: We identified 9 patients with retronychia, 7 girls and 2 boys. In all cases, the hallux nails were affected with 5 unilateral and 4 bilateral cases. On physical examination we observed the following signs: thickened and opaque nail plate (one patient), yellowish nail plate (7 patients), double nail plate (6 patients), and erythema with edema, pain, and suppuration of the proximal nail fold (7 patients). Ultrasound was performed in 7 patients and specific findings of retronychia were found in 5 of them. All patients received topical treatment and were referred for the appropriate surgical treatment. To date, only one patient underwent nail avulsion, which was followed by complete recovery. Conclusions: Retronychia is underdiagnosed, particularly in the pediatric population. We present a series of 9 cases of retronychia in children, with clinical and ultrasonographic findings consistent with those of adults. We emphasize the importance of recognizing this entity, which will allow early and adequate treatment. [ABSTRACT FROM AUTHOR]

Background Materials and methods Results Conclusion There are a limited number of studies evaluating the effects of alopecia areata (AA) on the health‐related quality of life (HRQoL) of pediatric patients and their families. This study aimed to assess the HRQoL of pediatric patients with AA and their parents.This single‐center cross‐sectional cohort study included 72 pediatric patients diagnosed with AA. The study was conducted between December 2020 and December 2021 in the dermatology department of a single tertiary center in Turkey. The HRQoL index of the pediatric patients was assessed with the Children's Dermatology Life Quality Index (CDLQI). At the same time, their parents, who were primarily involved in the disease process, were evaluated using the Dermatological Family Impact Scale (DeFIS). An ordinal logistic regression model was used to detect predictors for CDLQI severity.The mean ± SD CDLQI of the pediatric patients who participated in our study was 8.4 ± 5.3, corresponding to moderate impairment. The highest impairment in CDLQI was observed in the symptoms and feelings domain, while the slightest impairment was observed in the domain of personal relationships (P < 0.001). There was a statistically significant positive correlation between the Severity of Alopecia Tool (SALT) score and all CDLQI domains, and the most substantial relationship was with the leisure domain (r = 0.78, P < 0.001). DeFIS scores of female patients were substantially higher than males (25.3 ± 8.6 vs. 17.6 ± 9, P = 0.001).Our study supports that AA is a disease that significantly impacts the HRQoL of affected children and their families. [ABSTRACT FROM AUTHOR]

This document contains several abstracts from a pediatric dermatology conference. The first abstract discusses the use of biologic therapies in children with epidermolysis bullosa and ichthyoses, showing improvements in quality of life and symptoms. The second abstract presents a case of a rare skin disease called Ichthyosis with confetti. The third abstract reports on the successful treatment of a patient with PTEN tumor hamartoma syndrome. The fourth abstract evaluates the long-term outcomes of bleomycin sclerotherapy for lymphatic malformations in children, showing positive results. The final abstract discusses the use of trametinib in a pediatric patient with an arteriovenous malformation, leading to significant improvement. [Extracted from the article]

Molluscum contagiosum (MC) is a common viral infection that affects the skin of children. In this study, treatment regimens and demographic information for MC patients across US medical specialties were compared. We discovered an average of 471,383 pediatric MC visits annually using the National Ambulatory Medical Care Survey database from 2000 to 2016. Non-Hispanics (82.9%) and Caucasians (91.0%) made up the majority of the visitors. The majority of cases were handled by pediatricians (46.5%), family medicine doctors (10.6%), and dermatologists (36.7%). Compared to pediatricians, dermatologists saw a higher percentage of Caucasian patients (95% vs.84%) and patients with private insurance (83% vs. 73%). Patients were more likely to see family medicine doctors (55.0%) in non-metropolitan areas than pediatricians (26.4%) or dermatologists (16.3%). Dermatologists were less likely than pediatricians (38%) to favor spontaneous resolution (70%). Dermatologists favored terpenoids (20%), imiquimod (12%), and curettage (10%), while pediatricians primarily used terpenoids (12%), steroids (4%), and imiquimod (4%). The majority of MC cases are managed by pediatricians; however, treatment approaches deviate markedly from recommended best practices. [ABSTRACT FROM AUTHOR]

Background: There are few studies focusing on pediatric teledermatology, and the impact of a large-scale pediatric teledermatology program on the accessibility and efficiency of dermatology care remains unclear. This study evaluated the impact of a state-wide implementation of a store-and-forward teledermatology program augmented by the incorporation of dermoscopy in pediatric patients visiting community health centers. Methods: It was a descriptive, retrospective cohort study of 876 pediatric dermatology referrals. Results: In the traditional referral system, only 60 patients (17.6%) were seen by dermatologists with average waiting times of 75 days due to limited access. In comparison, with an implementation of dermoscopy-aided teledermatology, all 536 teledermatology referrals received dermatological care within 24 h, of which only 64 (12%) patients requires face-to-face (F2F) consultation. Patients referred for F2F consultation via eConsults had a much lower no-show rate as compared to the traditional referral system (39% vs. 71%). Side by side comparison between general population and pediatric population has demonstrated shared features in efficiency and access improvement but revealed specific characteristics of pediatric teledermatology in terms of diagnosis and treatment. Conclusion: Coordinated store-and-forward teledermatology platform with incorporation of dermoscopy between large community care network and dermatology provider can greatly improve access to pediatric dermatology care especially in underserved population. The efficiency of teledermatology in access improvement for pediatric population is comparable with adult population in eConsults. There are also unique features and challenges in pediatric teledermatology that require further research. [ABSTRACT FROM AUTHOR]

Pediatric melanoma presents with distinct clinical features compared to adult disease. Characterize risk factors and negative outcomes in pediatric melanoma. Multicenter retrospective study of patients under 20 years diagnosed with melanoma between January 1, 1995 and June 30, 2015 from 11 academic medical centers. Melanoma was diagnosed in 317 patients, 73% of whom were diagnosed in adolescence (age ≥11). Spitzoid (31%) and superficial spreading (26%) subtypes were most common and 11% of cases arose from congenital nevi. Sentinel lymph node biopsy was performed in 68% of cases and positive in 46%. Fatality was observed in 7% of cases. Adolescent patients with melanoma were more likely to have family history of melanoma (P =.046) compared to controls. Retrospective nature, cohort size, control selection, and potential referral bias. Pediatric melanoma has diverse clinical presentations. Better understanding of these cases and outcomes may facilitate improved risk stratification of pediatric melanoma. [ABSTRACT FROM AUTHOR]

Molluscum contagiosum is a common skin infection affecting different body areas, including the face. Previous data have shown cases of atypical lesions, notably on the face, and it was thought relevant to further examine differences between facial and non-facial lesions. All cases of children (0–18) diagnosed with molluscum contagiosum from 2013–2022 at the paediatric dermatology clinic of Soroka University Medical Center were retrospectively reviewed, and 615 children were included in the study. Facial lesions tended to be found in younger children (p = 0.018). Non-facial lesions were more erythematous (p

This article, published in the International Journal of Dermatology, discusses a case of juvenile xanthogranuloma (JXG) in a 3-year-old boy. The boy presented with a lesion on the sole of his left foot that was initially misdiagnosed as a plantar wart. A biopsy revealed the presence of JXG, a relatively common benign histiocytic proliferation in the skin. The article emphasizes the importance of considering JXG as a differential diagnosis for solitary palmoplantar nodules and highlights the need for clinical monitoring and potential surgical excision in certain cases. [Extracted from the article]

This article discusses a rare autoinflammatory syndrome called STING-associated vasculopathy with onset in infancy (SAVI). The article presents a case study of a 7-year-old Chinese girl with SAVI who had a somatic mosaic mutation in the TMEM137 gene. The girl exhibited various clinical manifestations, including cutaneous vasculitis, thrombocytopenia, hypothyroidism, and other complications. The article highlights the importance of genetic mutations in the TMEM173 gene, which lead to the activation of the interferon and NF-jb pathways. The authors also mention the potential use of JAK inhibitors for treating SAVI. [Extracted from the article]

Dermatologic manifestations of cystic fibrosis (CF) include nutrient deficiency dermatoses, vasculitis, transient reactive papulotranslucent acrokeratodema, digital clubbing, and increased rates of atopy and drug reactions. Few cases of a characteristic eruption in patients with episodic arthritis of CF have been described with prior reports primarily occurring outside of the dermatology literature. We report four cases consistent with this presentation to add to the literature and propose a new and unifying name to recognize this entity as cystic fibrosis dermatitis arthritis syndrome (CF‐DAS). Clinical suspicion should remain high in young female patients with cystic fibrosis presenting with episodic joint pain and rash, independent of pulmonary exacerbations. [ABSTRACT FROM AUTHOR]

Provider‐to‐provider outpatient pediatric dermatology eConsultation services increase access to care, but barriers exist that may prevent eConsult implementation and survival. We deployed cross‐sectional surveys to referring pediatric primary care physicians and consulting pediatric dermatologists participating in our eConsult program to identify barriers to utilization and sustainability. Our data suggest that eConsultation increases access to care and offers iterative educational opportunities for primary care providers, which may ultimately reduce office referrals for common outpatient skin issues. Sustainability of eConsult services requires simple order templates, clear representative photos, concise submission reports, and provider reimbursement. [ABSTRACT FROM AUTHOR]

The article discusses the use of line-field confocal optical coherence tomography (LC-OCT) as a noninvasive imaging device for diagnosing and differentiating between cutaneous mastocytoma (CM) and juvenile xanthogranuloma (JXG), which are benign skin tumors in children. LC-OCT can help avoid unnecessary skin biopsies, especially in aesthetically sensitive areas. The article presents three cases of CM and three cases of JXG that were evaluated using LC-OCT, highlighting the key features of each disease. The authors recommend acquiring 3D images in patients over 20 months of age and capturing numerous 2D images in younger children to confirm the presence or absence of specific structures. [Extracted from the article]

A 9‐year‐old premenarchal female presented to pediatric dermatology with a 6‐month history of periodically tender, bilateral and symmetric axillary masses. Magnetic resonance imaging and subsequent surgical excision confirmed the diagnosis of bilateral accessory axillary breast tissue. Accessory axillary breast tissue is a rare condition seen most in pubertal, pregnant and breastfeeding women. However, it can arise in pre‐adolescent patients and should be added to the differential diagnosis of an axillary mass. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVES: The primary objective was to assess pain catastrophizing and functional disability in pediatric patients with epidermolysis bullosa (EB) and their parents/guardians. Secondary objectives included examining relationships between pain catastrophizing, functional disability, and correlations with other factors (e.g., age, disease severity, and percent of body surface area (BSA) involved). METHODS: Patients with EB ages 8-16 and their parents/guardians who were English or Spanish speaking completed a one-time online survey. Parent measures included: demographics questionnaire, Pain Catastrophizing Scale-Parent (PCS), and Parent Functional Disability Inventory (FDI). Child measures included: PCS child and child FDI. Higher scores on both scales indicate higher levels of catastrophizing and functional disability. RESULTS: Of 31 children, the mean age was 11.47 years and the majority (70.97%) had dystrophic EB. Mean scores were: 35.84 = PCS parent; 34.58 = PCS child; 30.87 = parent FDI; 29.77 = child FDI. Total scores for PCS parent, parent FDI, and child FDI increased significantly with disease severity and percentage of involved BSA (p

Subepidermal calcified nodules are an uncommon subtype of idiopathic calcinosis cutis. Morphologically, this entity typically present as a single, well-circumscribed, white-yellow nodule. Based on clinical appearance alone, subepidermal calcified nodules are frequently misdiagnosed and often requires histological confirmation. We describe two cases of subepidermal calcified nodules presenting atypically as cutaneous horns. Subepidermal calcified nodules presenting as a cutaneous horn has rarely been reported; on review, there are fewer than 10 such cases have been described within the past 30 years. The cases described here illustrate the clinical variety and should increase awareness of subepidermal calcified nodules presented.

Introduction: Scabies is a common parasitic infestation caused by the mite Sarcoptes scabiei. Scabies can mimic other entities clinically, resulting in misdiagnosis. The presence of a mite in the stratum corneum on biopsy specimens is diagnostic of scabies. However, there are instances when mites are not visible, and immunohistochemical (IHC) staining may be misleading. An example is when IHC demonstrates Cluster of Differentiation 1a and S100 positivity. The main differential diagnosis for this finding is Langerhans cell histiocytosis, a group of idiopathic disorders of bone marrow-derived Langerhans cells, with manifestations ranging from isolated to life-threatening multisystem disease. Case Presentation: We present a case of a patient who was diagnosed with Langerhans cell histiocytosis based on histological findings, further review with a repeat reading and deeper sectioning of her biopsy revealed a mite in the stratum corneum, altering the diagnosis, course, and management. She subsequently developed persistent post-scabietic nodules, an underreported entity that may occur following infestation and persist for up to a year. These lesions are self-limiting and do not require repeated courses of treatment. Conclusion: Langerhans cell hyperplasia may be seen in a multitude of entities, including scabies. Familiarity with this phenomenon is crucial to avoid unnecessary invasive investigations, aggressive management and alleviate patients’ concerns.

Background: Plexiform neurofibromas (pNFs) are benign neoplasms, primarily originating from Schwann cells, posing challenges in patients with type 1 neurofibromatosis (NF1) due to pain, disfigurement, compression of vital structures and potential for malignancy. Selumetinib, a MEK1/2 inhibitor, has shown promising results in treating inoperable pNFs, with clinical trials demonstrating tumor volume reduction and improved patient-reported outcomes. Despite its efficacy, dermatologic toxicities may impact the quality of life and treatment adherence. Evaluating the frequency and spectrum of such effects is crucial for effective management. Methods: In a four-year retrospective and prospective study, pediatric NF1 patients with symptomatic, inoperable plexiform neurofibromas (pNFs) were treated with selumetinib. Eligibility criteria included significant morbidity, pNF size exceeding 3 cm or surgical inoperability, and performance status >70%. Hematological, liver, lung and cardiac assessments established baseline health. Selumetinib, orally administered at 25 mg/m2 twice, was administered for two years unless a response warranting extension occurred. Cutaneous AEs were documented and graded by severity according to CTCAE v5.0, with evaluations every three to six months. The impact on symptoms and pNF size was systematically recorded, and biopsies characterized histopathological features in those patients requiring surgery. Results: Twenty patients were enrolled, with an average age at therapy initiation of 11.6 years. Cutaneous side effects were common, with all patients experiencing at least one and a median of two per patient. Xerosis, paronychia and acneiform rash were prevalent. Notably, pre-pubertal individuals were more susceptible to xerosis. Acneiform rash had a higher incidence in older patients and those with skin phototypes II and III. Successful management involved tailored approaches, such as clindamycin for acneiform rash and topical agents for paronychia. Hair abnormalities, including color changes and thinning, occurred, with female patients at higher risk for the latter. Paronychia presented challenges, necessitating various interventions, including surgical approaches. AEs led to treatment suspension in 20% of patients, with tumor rebound observed in 75%. Conclusions: According to our experience, successful management of selumetinib-induced cutaneous AEs requires tailored strategies including surgery. AEs might indirectly determine pNF regrowth due to therapy suspension. We thus emphasize the pivotal role of addressing cutaneous reactions for effective selumetinib management in pediatric patients. [ABSTRACT FROM AUTHOR]

Juvenile xanthogranuloma (JXG) with extensive cutaneous or visceral organ involvement is often associated with high morbidity and treatment commonly involves surgical excision, radiotherapy, systemic steroids, or chemotherapy. Sirolimus, a mammalian target of rapamycin (mTOR) inhibitor, is an oral antitumor and immunosuppressive therapy used to treat various neoplastic disorders, including histiocytic disorders. We report two pediatric cases of JXG successfully treated with oral sirolimus monotherapy, and postulate that sirolimus may induce rapid disease resolution and long‐term remission for patients with both skin‐limited and multisystemic JXG. Our findings warrant further investigation of the relationship between the mTOR pathway and JXG. [ABSTRACT FROM AUTHOR]

Background: Despite studies of dermatologic manifestations in adults with inflammatory bowel disease (IBD), little is known about the prevalence of IBD‐associated skin lesions and their correlation with IBD severity in children. We aimed to address these knowledge gaps in our single‐center cohort of children with IBD. Methods: Retrospective chart review of 528 children and adolescents (≤18 years old) with IBD and seen at Mayo Clinic (Rochester, MN) between 1999 and 2017 was conducted. The Chi‐Square/Fischer's exact test (with p ≤.05 to signify statistical significance) was applied to compare categorical outcomes between Crohn's disease (CD) and ulcerative colitis (UC) patients. Results: In total, 425 IBD patients (64.9% CD, 53% males) and ≥1 dermatologic diagnosis were included. Presence of ≥1 cutaneous infection was recorded in 42.8% of participants. Acne was the most common non‐infectious dermatologic condition (30.8%), followed by eczema (15.8%) and perianal skin tags (14.6%). Angular cheilitis (p =.024), keratosis pilaris (KP, p =.003), and perianal skin complications (i.e., skin tags, fistula, and abscesses; all p <.001) were more frequently diagnosed among children with CD, while fungal skin infections (p =.017) were more frequently diagnosed in UC patients. Severity of IBD correlated with higher prevalence of perianal fistula (p =.003), perianal abscess (p =.041), psoriasis (p <.001), and pyoderma gangrenosum (PG, p =.003). Conclusions: Both IBD‐specific and IBD‐nonspecific dermatologic conditions are very prevalent in childhood IBD, the most common being infectious. Children with CD are more likely to experience angular cheilitis, KP, and perianal skin findings than those with UC. Perianal disease, psoriasis, and PG are associated with more severe IBD. [ABSTRACT FROM AUTHOR]

The rate of pediatric hospitalization for cutaneous pathology has been increasing in recent years, often requiring the expertise of consulting pediatric dermatologists; however, the infrastructure of inpatient pediatric dermatology consultative services remains poorly characterized. We sought to assess the structure, consult volume, physician compensation, and utilization of teledermatology in pediatric dermatology inpatient services to better understand the current care model. Our survey of 118 pediatric dermatologists revealed that 89% of respondents see between 1 and 10 new consults per week, 39% perform all inpatient consults including evening and weekends without assistance from other providers, 71% do not have protected time during the week to provide inpatient consultations, and only 10% receive financial compensation via stipend. By highlighting both the high demand for pediatric consultative dermatology as well as the significant burden placed on these providers by existing practice models, we hope to encourage a reappraisal of the current infrastructure of pediatric inpatient dermatology to increase structural and financial support for this vital service. [ABSTRACT FROM AUTHOR]

Poliosis is defined as the absence of melanin in hair, and hair graying typically occurs with hair melanin reduction. Poliosis can occur at any age but presents in childhood in certain genetic and acquired conditions, with many families seeking evaluation from a pediatric dermatologist. Poliosis presents as white hair typically restricted to a certain location of the scalp. Children may also present with a reduction of expected hair pigmentation, referred to as pigment dilution, or the development of hair graying. This review aims to provide a streamlined diagnostic approach for pediatric dermatologists when presented with these hair findings. Poliosis should be recognized as a potential diagnostic feature or initial sign in many syndromes and thus can guide clinicians in diagnosing and managing conditions earlier in a patient's care. Since many of the genetic and acquired conditions that present with poliosis or hair pigment dilution have extracutaneous manifestations, early diagnosis is vital in establishing multidisciplinary care. [ABSTRACT FROM AUTHOR]