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Background: Guidelines and expert recommendations on infantile hemangiomas (IH) are aimed at increasing homogeneity in clinical decisions based on the risk of sequelae. Objective: The objective was to analyze the inter‐ and intra‐observer agreement among pediatric dermatologists in the choice of treatment for IH. Methods: We performed a cross‐sectional inter‐rater and intra‐rater agreement study within the Spanish infantile hemangioma registry. Twenty‐seven pediatric dermatologists were invited to participate in a survey with 50 clinical vignettes randomly selected within the registry. Each vignette contained a picture of an infantile hemangioma with a clinical description. Raters chose therapy among observation, topical timolol, or oral propranolol. The same survey reordered was completed 1 month later to assess intra‐rater agreement. Vignettes were stratified into hemangioma risk categories following the Spanish consensus on IH. The agreement was measured using kappa statistics appropriate for the type of data (Gwet's AC1 coefficient and Gwet's paired t test). Results: Twenty‐four dermatologists completed the survey. Vignettes represented 7.8% of the Spanish hemangioma registry. The inter‐rater agreement on the treatment decision was fair (AC1 = 0.39, 95% confidence interval [CI]: 0.30–0.47). When stratified by risk category, good agreement was reached for high‐risk hemangiomas (AC1 = 0.77, 95% CI: 0.51–1.00), whereas for intermediate‐ and low‐risk categories, the agreement was only fair (AC1 0.31, 95% CI: 0.16–0.46 and AC1 = 0.38, 95% CI: 0.27–0.48, respectively). Propranolol was the main option for high‐risk hemangiomas (86.4%), timolol for intermediate‐risk (36.8%), and observation for low‐risk ones (55.9%). The intra‐rater agreement was good. The inter‐rater agreement between pediatric dermatologists on the treatment of IH is only fair. Variability was most significant with intermediate‐ and low‐risk hemangiomas. [ABSTRACT FROM AUTHOR]

Background: Recent reports indicate that tufted angioma is a rare vascular neoplasm that manifests more frequently at birth than previously thought. Few studies specifically address congenital presentation. Objectives: We analyzed the clinicopathological characteristics, clinical course, and treatment of congenital tufted angioma (cTA) and evaluated variables that were indicative of problematic lesions. Methods: We performed an observational retrospective study of 30 patients with cTA in 9 Spanish hospitals over a 14‐year period. Histopathology and immunohistochemistry studies were performed. Results: Congenital tufted angioma mainly affected the limbs (56.67%), followed by the face and/or neck (23.33%). Almost three‐quarters of facial cTA were located over the mandibular area. Immunohistochemically, proliferating cells expressed markers of endothelial cells, with some clusters of cells, especially at the periphery of the aggregates, showing positivity for podoplanin. As no associated complications were observed in 66.67% of cases, no treatment was started. Limitations: Data were collected retrospectively. Conclusions: Our findings emphasize the clinical features and course of cTA. The possibility of cTA should be considered when a poorly defined congenital infiltrative vascular tumor with(out) overlying hirsutism appears over the mandibular area. Location on the face and/or neck requires a more comprehensive workup, since potentially severe complications often appear early. [ABSTRACT FROM AUTHOR]

Abstract: Omeprazole significantly increases duodenal prostaglandin E2 synthesis. Prostaglandins are involved in hair growth regulation: prostaglandin E2 and prostaglandin F2 alpha stimulate hair growth, and prostaglandin D2 has an inhibitory effect. The use of omeprazole can cause acquired generalized hypertrichosis by increasing prostaglandin E2 levels. [ABSTRACT FROM AUTHOR]

We report the case of a 6-month-old Hispanic boy with a 4-month history of widespread pruritic hypopigmented papules mimicking lichen nitidus. The final diagnosis was multisystem non-risk-organ Langerhans cell histiocytosis ( LCH), with cutaneous and multiple bone involvement. With this patient and others previously reported in the literature, we suggest an early biopsy of the hypopigmented rash in children. [ABSTRACT FROM AUTHOR]

Erythema multiforme is exceptional in newborns, and none of the few available reports has revealed a clear etiologic agent, not even herpes simplex virus. Immunocompetent patients rarely present with cutaneous cytomegalovirus involvement, and few cases of cytomegalovirus-associated erythema multiforme have been described, none of them in newborns. We report the first case of erythema multiforme in a newborn associated with cytomegalovirus infection. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 13-year-old boy who was admitted to the hospital with cheilitis which worsened after using lip balms. It talks about the boy having a history of atopic dermatitis along with his parents being diagnosed with seasonal allergy. It tells about a patch tests revealing that the patient was allergic to pure castor oil present in lip balms. It speaks about the boy being diagnosed with oedema of lips and erythema after the examination.

The article presents a case study of a two year-old boy who presented with recent history of flat-topped papules which were presented on his face. Histopathology of a biopsy specimen obtained from papule revealed an infiltrate in papillary dermis which contained pleomorphic histiocytes and eosinophilic cytoplasm.

We describe the case of a 33-week preterm infant who developed nonimmune hydrops fetalis secondary to a kaposiform hemangioendothelioma ( KHE). The tumor was successfully treated with vincristine, prednisone, ticlopidine, and aspirin. KHE can be an unusual cause of hydrops fetalis; in such cases, diagnosis can be challenging since generalized edema can obscure KHE. [ABSTRACT FROM AUTHOR]

Papular elastorrhexis ( PE) is an uncommon elastic tissue disorder clinically characterized by the onset of asymptomatic flesh-colored to whitish papules over the trunk and upper limbs in children. Its etiology remains unknown, although isolated familial cases have suggested that acquired and inherited forms of the disease may exist. We present the case of a 13-year-old boy with human immunodeficiency virus who presented with such lesions after immunological recovery from very low CD4+ counts after introducing highly active antiretroviral therapy. Because neutrophils and macrophages are implicated in elastin metabolism and degradation pathways, immune dysregulation might be another etiologic factor to be considered in this rare disease. [ABSTRACT FROM AUTHOR]

Sinus histiocytosis with massive lymphadenopathy, or Rosai-Dorfman disease ( RDD), is commonly characterized by painless cervical lymphadenopathy. Exclusively cutaneous Rosai-Dorfman disease is rare. In the absence of massive lymphadenopathy, the nonspecific skin lesions may complicate the diagnosis. To our knowledge, the case reported herein is the youngest case of extranodal cutaneous RDD. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 13-year-old girl who was diagnosed with desmoplastic spitz nevus (DSN). Topics discussed include the dermal deposition of pigment, transformation of DNS into desmoplastic melanoma (DMM), and immunohistochemistry showing positive staining. Also mentioned are the negative pigment network (NPN), level of dermal collagen, and proliferation of large epithelioid melanocytes.

Episcleral hemangiomas are usually associated with neonatal hemangiomatosis. Recently, propranolol has been described for the treatment of this entity. We present for the first time a patient with an episcleral hemangioma without neonatal hemangiomatosis successfully treated with topical timolol., (© 2014 Wiley Periodicals, Inc.)