European Journal of Pediatric Dermatology

Contents, issue 2, vol. 35, 2025

STAFF STAFF — 2025-05-11

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Gorlin Goltz syndrome in childhood: report of two cases.

C.V. Procel — 2025-05-11

Gorlin Goltz syndrome (GGS), also known as nevoid basal cell carcinoma syndrome, is a rare autosomal dominant disorder with variable expressivity. It is characterized by a predisposition to the development of multiple basal cell carcinomas (BCC), skeletal abnormalities, odontogenic keratocysts, and developmental delay. The aim of this article, which reports two pediatric cases, is to highlight the importance of knowing the particularities of the syndrome in this age group. Although the syndrome is more frequently diagnosed in adulthood, signs such as the sudden appearance of nevoid lesions in photo-exposed and non-photo-exposed areas should suggest this syndrome. Dermoscopic signs are also important, such as the presence of blue-gray globules in the lesions; in larger lesions, arboriform telangiectasias may also be present. It is essential that dermatologists and pediatricians recognize the characteristics of the syndrome for early diagnosis and adequate therapy.

Perianal erosive papulonodular dermatosis secondary to surgery for Hirschsprung disease.

O. Hormi — 2025-05-11

Hirschsprung’s disease is a congenital disorder characterized by the absence of ganglion cells in the distal colon, leading to functional obstruction. Surgical intervention is often required to alleviate symptoms. We present a rare case of erosive papulo-nodular perianal dermatitis mimicking condyloma as a postoperative complication of Hirschsprung’s disease in a 19-month-old boy. Although rare, awareness of this entity is crucial to avoid misdiagnosis and ensure appropriate management.

Genital ulcerated nodules revealing primary Epstein-Barr virus infection.

L.E. Marhraoui — 2025-05-11

Epstein-Barr virus (EBV) is a ubiquitous herpesvirus that infects more than 90% of adults worldwide. While primary EBV infection is often asymptomatic in children, cutaneous manifestations can occur; however, genital lesions remain rare.

A 1-year-old infant presented with a sudden painful ulcerated genital nodules, fever, and diarrhea. Clinical examination showed erythematous necrotic nodules, cervical lymphadenopathy, erythematous angina, and splenomegaly. EBV serology confirmed a primary infection. Treatment with antibiotics and symptomatic care led to complete recovery in three weeks.

This case highlights an unusual presentation of primary EBV infection with ulcerated genital nodules without mucosal involvement, distinct from the more commonly reported Lipschütz ulcer. Further research is needed to understand the pathophysiology of mucocutaneous EBV manifestations.

Cutaneous larva migrans in a 4-month-old child.

V.B. Hunashikatti — 2025-05-11

Cutaneous larva migrans (CLM) is a skin infestation caused by a nematode larva, Ancylostoma brasiliensis. The infective larvae hatched from parasite eggs enter human skin when encountered with infested soil. Linear erythematous itchy lesions occur along the path of the larva within skin. Generally seen between 2-5 years of age with peak incidence around 5-14 years, it rarely occurs in early infancy. And here we report one such case affected at 4 months of age.

European Journal of Pediatric Dermatology, issue 2, vol. 35, 2025

STAFF STAFF — 2025-05-11

none

Treatment of Spitz nevus and spitzoid lesions in children.

V. Coppola — 2025-05-11

Purpose. Spitzoid lesions are classified into Spitz nevi, Spitz tumors, and spitzoid melanomas. While the understanding of Spitz nevi has improved, the malignant potential of Spitz tumors remains uncertain, leading to diagnostic and management challenges. This study evaluates the surgical management of pediatric patients with suspected Spitz lesions.
Methods. Fifty-eight pediatric cases of suspected Spitz lesions were analyzed. Demographics, lesion characteristics, surgical indications, histopathology, and follow-up were collected. Histopathologic groups included Spitz nevus (G1), Spitz nevus/tumor with mild atypia (G2), Spitz tumor with moderate atypia (G3), and spitzoid melanoma (G4). Subgroups were based on the need for additional procedures (A) or follow-up only (B).
Results. The mean age of the patients was 14.6 years, with a female predominance (58%). The lesions were commonly located on the limbs (51%), chest (35%), and head (9%). Histopathological findings included: 37 (64%) Spitz nevi (G1), 9 (15%) Spitz nevi/tumor (G2), 11 (19%) Spitz tumors (G3), and 1 case of spitzoid melanoma (G4). Additional procedures were required in 5/9 (55%) in G2, 10/11 (91%) in G3, and 1/1 in G4, mostly involving margin widening. In all G2 cases (5/5) and most G3 cases (8/10), margin widening was unnecessary.
Conclusion. The diagnosis of suspected Spitz tumors in children often lacks clarity, leading to treatment decisions influenced by the physicians’ experience rather than by standardized guidelines. Margin widening should be limited to cases with high-grade atypical Spitz tumors. In addition, other factors, such as cosmetic considerations and potential complications, especially in visible areas, should always be taken into account.

Transient abdominal telangiectasia of the newborn: two new cases and review of the literature.

F. van Erp — 2025-05-11

Two neonates with transient abdominal telangiectasia are presented. This relatively unknown condition is usually benign, as demonstrated by previous literature. Clinical monitoring to confirm spontaneous regression is advisable, unless other symptoms require careful pediatric evaluation and possibly abdominal imaging.

Urticaria multiforme in a 3-year-old child and review of the literature.

L. Abelha — 2025-05-12

Urticaria multiforme is a variant of parainfectious urticaria characterized by annular aspects, ecchymotic sequelae, acral edema without pitting. These aspects may give rise to some problems of differential diagnosis with other conditions, especially erythema multiforme and neonatal hemorrhagic edema. In literature it is most often described with the questionable name of urticaria multiforme, but also with other terms such as annular, giant, ecchymotic urticaria that emphasize its different morphological aspects. A clinical case in a 3-year-old child was described and a complete review of the literature was performed.

Capillary malformations: clinical review.

U. Wollina — 2025-05-11

Capillary malformations (CM) are congenital vascular anomalies that occur in up to 2% of newborns without gender differences. They are the result of somatic mutations, most often in the GNAQ gene. While isolated CM have a good prognosis, syndromic CM can have a significant negative impact on quality of life. Careful clinical examination of cutaneous CM highlights the possible risk of neurological and ocular complications. In the current work, frequent and less frequent syndromic CM are described and their clinical and laboratory data are discussed. After discussing the differential diagnosis of CM, the available treatment options are reviewed, which include laser, photodynamic therapy, topical immunosuppressants, surgery and new targeted therapies. Finally, the need for a multidisciplinary approach in syndromic CM is emphasized.

Transient multiple neonatal onychodystrophy. Case report and review of the literature.

B. Rodriguez-Lechtig — 2025-05-12

Neonatal onychodystrophy is a rare condition, usually associated with congenital candidiasis. We report a case of severe dystrophy of multiple nails in a newborn, which resolves spontaneously in a few months. The pregnancy history did not show any noteworthy problems. The perinatal history showed prolonged dystocic labor, clavicle fracture and jaundice due to blood group incompatibility. The negativity of the mycological examination, the absence of significant causal factors and the rapid spontaneous resolution, despite the apparent severity of the clinical picture, make this case unique and we propose the name of transient multiple neonatal onychodystrophy (TMNO). All the articles in the literature related to this condition are reviewed.

Acquired auricular cauliflower deformity in a child.

A. Diaconeasa — 2025-05-11

Cauliflower ears are a permanent deformation of the auricle after blunt or cutting trauma with hematoma. The disease is a consequence of inflammation and fibrocartilaginous growth. It is rare among infants and children. We present the case of a 7-year-old boy with bilateral auricular deformation. After exclusion of other possible causes, the diagnosis of cauliflower ears type IA was confirmed. The parents were advised to prevent trauma. Surgical correction was not accepted.

Erythrodermic sebopsoriasis in a 15-month-old child.

N. Rana — 2025-05-11

Erythroderma is rare in the pediatric population and poses significant diagnostic and therapeutic challenges due to the numerous causes that can provoke it. We report a case of erythrodermic sebopsoriasis in a 15-month-old boy, who presented with generalized erythema, thick and adherent scales, ectropion, and nail changes. Histopathological examination revealed intermediate features of seborrheic dermatitis and psoriasis, speaking in favor of the diagnosis of sebopsoriasis, a rarely reported cause of erythroderma in this age group. The child was successfully treated with extemporaneously prepared isotretinoin.

Rothmund-Thomson syndrome in a 6-year-old little girl.

A. Mun — 2025-05-11

Rothmund-Thomson syndrome (RTS) is a rare and severe autosomal recessive disorder characterized by dermatological lesions prevalent in photoexposed areas, associated with alterations of other organs, especially the skeletal system, and neoplastic complications. Dermatological lesions are early and allow to suspect the diagnosis, but RTS is a multisystem disease that requires a multidisciplinary approach, starting from genetic investigation. A case is presented in a 6-year-old girl, in whom genetic investigation showed a compound heterozygosity on the RECQL4 gene.

Importance of skin lesions in diagnosing kwashiorkor.

A. Widiawaty — 2025-05-11

Kwashiorkor is a form of severe acute malnutrition caused by extreme protein deficiency, often underdiagnosed since it is characterized by edema, which masks the decrease of muscle mass. Dermatologic manifestation can present as a diagnostic clue for kwashiorkor. This report discusses the case of a 15-month-old girl with desquamated skin and swelling over a large area of her body. She had a history of poor diet with low protein intake, was irritable, underweight, severely stunted, and had generalized pitting edema. Dermatological findings were dry skin and hyperpigmented lesions with erythema in the area where the skin had desquamated, leaving hypopigmented lesions with white-brownish scales over them in an irregular pattern, resembling flaky paint dermatosis. The hair appeared thin and dull, and angular cheilitis was present. Treatment involved therapeutic feeding with WHO formula (F-75 and F-100), antibiotics, and micronutrient supplements. Moisturizer with zinc oxide and vaseline were used to maintain the skin barrier, resulting in improved skin lesions within 7 days. This case report highlights the cutaneous manifestations as a clinical clue to diagnose kwashiorkor and its management.