European Journal of Pediatric Dermatology

European Journal of Pediatric Dermatology, issue 1, vol. 34, 2024

STAFF STAFF — 2024-01-29

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The effect of early systemic propranolol treatment on color improvement of infantile hemangiomas. A retrospective cohort study.

S. Hosseini — 2024-01-29

Introduction. Infantile hemangioma (IH) is a benign vascular tumor that primarily affects infants. Thus, this study aimed to evaluate the overall efficacy of propranolol treatment and compare the outcomes of early and late treatment initiation in infants under one year of age.
Methods. Data was collected from patients treated at Ryhov Hospital, Sweden, between 2018 and 2021. Treatment effect was evaluated based on clinical criteria and overall lesion appearance using images.
Results. The mean age of the patients at the time of drug initiation was 141.9 days (SD±111.9). On average, propranolol treatment resulted in an 85% improvement (SD±28.8) in the overall appearance of IH. Early initiation of treatment (under 3 months of age) was associated with a 92.3% (SD±25.0) higher likelihood of an excellent response compared to late initiation of treatment (79.4%, SD±30.9, p=0.09). In terms of color improvement, early treatment showed a significant response in 67.3% (SD±22.5) of cases compared to 47.9% (SD±30.6) in the late treatment group (p<0.01).
Conclusion. The study results suggest that early initiation of propranolol treatment in infants under three months of age is significantly associated with better color improvement of IH.

Dermal melanocytosis as a sign of GM1 gangliosidosis.

H. Macedo de Moura — 2024-01-29

GM1 gangliosidosis is an autosomal recessive hereditary disease resulting from deficiency of the enzyme β-galactosidase, which leads to massive accumulation of GM1 gangliosides in various tissues. Dermal melanocytosis is the persistence of dendritic melanocytes in the dermis: usually present as a Mongolian spot in the sacral region, it tends to spontaneously regress. A very extensive dermal melanocytosis both in the dorsal and ventral region and in the limbs, persistent and with an extensive tendency, is sometimes associated with gangliosidosis and can be a revealing sign of the disease. We describe the case of a 7-month-old girl in whom extensive dermal melanocytosis led to the early diagnosis of GM1 gangliosidosis.

Pyogenic granuloma-like “de novo” melanoma in a 3-year-old child.

H. Chagraoui — 2024-01-29

Melanoma is one of the rarest tumors in children. Its diagnosis is generally late, due to its misleading morphology and low level of suspicion. The diagnosis of pediatric melanoma remains extremely challenging due to the existence of neoformations that present clinical and histological overlaps and therefore requires great experience of the dermatologist and pathologist. We present the case of a rare pediatric melanoma, occurred on healthy skin with a pyogenic granuloma-like appearance in a 3-year-old girl, which benefited from multidisciplinary management.

Hematohidrosis - A rare entity.

T. Jayakar — 2024-01-29

Hematohidrosis is a rare disease characterized by blood exudation from the intact skin or mucosa. It occurs mostly in healthy adolescents as an unusual reaction to anxiety. It has a benign course but must be known to avoid unnecessary family concerns and laboratory tests. A case was reported in a 14-year-old boy, its differential diagnosis was discussed and a diagnostic algorithm was proposed.

Lethal prematurity ichthyosis syndrome in a newborn.

Y. Akkus — 2024-01-29

Ichthyosis prematurity syndrome (IPS) is a rare condition characterized by prematurity, thickened epidermis, vernix caseosa-like scaling and neonatal asphyxia. A neonatal case of IPS was here reported. Despite all the attention aimed at dealing with respiratory distress, possible infections, dehydration and nutritional deficit, fatal sepsis could not be avoided.

Erythema migrans with secondary lymphangitis in a non-endemic area.

P. Minardi — 2024-01-29

The early diagnosis of Lyme disease is more difficult to suspect in non-endemic areas such as Southern Italy. Erythema migrans, which constitutes its primary manifestation, is not always typical and, even when it is typical, i.e. when it has the classic annular shape with central resolution, it can be confused with non-infectious lesions due to hypersensitivity to arthropods. An atypical case with secondary lymphangitis in a 7-year-old girl of the Southern Italy was described.

Molluscum contagiosum in a girl with HIV infection. Case report and literature review.

R. Lomelí Valdez — 2024-01-29

Molluscum contagiosum (MC) is a common viral disease in the pediatric population characterized by smooth, shiny papules measuring a few millimeters. In immunosuppressed patients, these lesions can appear atypically, with multiple, extensive and verruciform appearance. We describe the case of a 7-year-old child diagnosed with human immunodeficiency virus (HIV) infection who, after stopping antiretroviral treatment, presented with multiple verruciform lesions on the scalp dating back a few months. Histological examination confirmed the diagnosis of MC. A topical treatment with 10% potassium hydroxide reduced the lesions which were then removed with curettage. A literature review is also performed including pathogenesis, clinical manifestations and treatment options in children with HIV infection.

Black hairy tongue caused by linezolid.

N. Saraswat — 2024-01-29

Black hairy tongue (BHT) is a self-limiting condition that presents as brown or black discoloration of the dorsal part of the tongue, associated with elongation and hypertrophy of the filiform papillae. Among the various etiopathogenetic factors that can cause BHT there is linezolid, an antibiotic used for infections resistant to other drugs. A case of BHT in a 5-year-old girl is described.

Linear porokeratosis in a 13-year-old girl.

Can Kuru Burce — 2024-01-29

Porokeratosis is a rare, acquired or inherited disorder of keratinization characterized by one or more atrophic macules or patches, each surrounded by a characteristic ridge-like hyperkeratotic border. Linear porokeratosis (LP) is a variant of porokeratosis in which the lesions are distributed in a linear way. The skin lesions of linear porokeratosis typically present in infancy or early childhood. However, sometimes they occur in adults. The current work talks about a 13-year-old girl suffering from linear porokeratosis since the age of 2 months.

Alopecia areata incognita – An underrecognized entity masquerading as female pattern hair loss.

S. Soundarya — 2024-01-29

Alopecia areata incognita is a particular variant of alopecia areata that presents with widespread hair loss without the classic patchy pattern. It is more frequent in the third and fourth decades and must be differentiated from female pattern hair loss and telogen effluvium. A case of diffuse alopecia areata in a 12-year-old girl simulating androgenetic alopecia and treated with tofacitinib was presented.

Terra firma-forme dermatosis: an often underdiagnosed benign condition.

S. Poço Miranda — 2024-01-29

Terra firma-forme dermatosis is an idiopathic acquired condition characterized by asymptomatic brown plaques that are easily removed by rubbing alcohol. It manifests as slightly raised, brownish or blackish, hyperkeratotic and asymptomatic plaques. Lesions are typically located on the neck, face, and trunk, unilaterally or bilaterally. This skin disorder affects people with good hygiene habits and the lesions are not removed with soap and water. Terra firma-forme dermatosis must be differentiated from dermatitis neglecta due to inadequate frictional cleansing, confluent and reticulated papillomatosis, acanthosis nigricans, and “dirty neck syndrome” of atopic dermatitis. The diagnosis is clinical and is confirmed by the disappearance of the lesions following vigorous rubbing with a gauze soaked in alcohol. While a benign condition, misdiagnosis can lead to unnecessary endocrinological tests and social disapproval due to the dirty appearance.

Adalimumab induced alopecia areata in a patient with arthritis.

A.T. Aydemir — 2024-01-29

The use of biologic agents such as anti-TNF alpha inhibitors in chronic inflammatory diseases is increasing. Consequently, skin side effects such as infusion reactions, psoriasis and alopecia have been observed. Knowing how to recognize these side effects is necessary to reach the correct diagnosis and treatment.

Position Paper on the use of sunscreens.

A. Moschetti — 2024-01-29

This document is a position taken by expert operators on the need for correct use of sunscreens. These filters, which had been created to counteract sunburn caused by irrational exposure to the sun, were later attributed purposes, such as prevention of skin tumors, which they have not really achieved, given the continuous increase in such tumors despite their presence on the market and their widespread use. We believe that this purpose has not been achieved due to the incorrect use of these filters and for this reason we propose a meeting and discussion between all the scientific personalities interested in the topic, in order to make them use consciously thanks also to the intervention of professional figures that guide their prescription and improve their composition, eliminating substances potentially harmful to the human body, especially in pediatric age, such as endocrine disruptors.

Unilateral ciliary and superciliary madarosis.

S. Patankar — 2024-01-29

Madarosis is the loss of eyebrow or eyelashes. Alopecia of eyelashes is termed as ciliary madarosis (CM) and that of eyebrows is termed as superciliary madarosis. Madarosis has varied etiologies, alopecia areata being one of them. Differential diagnoses include trichotillomania, infections and telogen effluvium. Investigations are directed towards identifying the underlying cause with dermoscopy being a non-invasive tool. Treatment for alopecia areata in pediatric population includes mid-potency topical steroids which is safer, and bimatoprost. We present a 9-year-old female with a patch of hair loss over left eyebrow and upper eyelid since 6 months. Dermoscopic findings were vellus hair at periphery of eyebrow patch and complete loss of hair over eyelid. An excellent response was seen with only topical mid-potent steroids applied for 2 months without any adverse effects noted in skin or eyes. A rare and unique case of unilateral simultaneous presentation of alopecia areata in eyebrow and eyelashes not reported from India so far is highlighted.

Efficacy of secukinumab in an adolescent with generalized pustular psoriasis.

Z. Karaca Ural — 2024-01-29

Treatment protocols in generalized pustular psoriasis have not been clearly defined because it is a rare type of psoriasis. In the pediatric age group, the data are even less. Our knowledge about the use of biological agents is increasing day by day. Sekukinumab appears to be an effective agent in the rapid and complete remission of psoriasis.

Tinea faciei mimicking neonatal lupus erythematosus in a newborn.

J.P. Ribeiro Jr — 2024-01-29

Tineas constitute prevalent superficial fungal infections in the fields of pediatrics and dermatology, primarily caused by dermatophytes - fungi that intrude upon keratinized tissues, provoking inflammatory responses. Despite their confinement to the superficial epidermal layers, these pathogens engender substantial morbidity by symptomatic manifestations, susceptibility to secondary bacterial infections, and stigmatization. The differential diagnosis for these infections is broad, potentially mimicking more severe conditions such as lupus erythematosus (LE). LE may manifest either with exclusive cutaneous involvement or contribute to a systemic presentation, with its subacute variant assuming significance as a crucial differential diagnosis for dermatophytoses. Within this study, we report a rare case of facial tinea in a newborn and emphasize its distinctive features from neonatal lupus.

Contents, issue 1, vol. 34, 2024

STAFF STAFF — 2024-01-29

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