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Background/Objectives: This subgroup analysis of the ALLEGRO phase 2b/3 trial (NCT03732807) evaluated the efficacy and safety of ritlecitinib, an oral, selective dual JAK3/TEC family kinase inhibitor, for the treatment of alopecia areata (AA) in patients aged 12–17 years. Methods: In ALLEGRO‐2b/3, patients aged ≥12 years with AA and ≥50% scalp hair loss received once‐daily ritlecitinib 50 or 30 mg (±4‐week 200‐mg loading dose) or 10 mg or placebo for 24 weeks. In a subsequent 24‐week extension period, ritlecitinib groups continued their doses, and patients initially assigned to placebo switched to 200/50 or 50 mg daily. Clinician‐ and patient‐reported hair regrowth outcomes and safety were assessed. Results: In total, 105 adolescents were randomized. At Week 24, 17%–28% of adolescents achieved a Severity of Alopecia Tool (SALT) score ≤20 (≤20% scalp without hair) in the ritlecitinib 30 mg and higher treatment groups versus 0% for placebo. At Week 48, 25%–50% of patients had a SALT score ≤20 across ritlecitinib treatment groups (30 mg and higher). Adolescents reporting that their AA "moderately" or "greatly" improved were 45%–61% in the ritlecitinib groups (30 mg and higher) (vs. 10%–22% for placebo) at Week 24 and 44%–80% at Week 48. The most common adverse events in adolescents were headache, acne, and nasopharyngitis. No deaths, major adverse cardiovascular events, malignancies, pulmonary embolisms, opportunistic infections, or herpes zoster infections were reported. Conclusion: Ritlecitinib treatment demonstrated clinician‐reported efficacy, patient‐reported improvement, and an acceptable safety profile through Week 48 in adolescents with AA with ≥50% scalp hair loss. [ABSTRACT FROM AUTHOR]

Methotrexate (MTX) is a readily accessible drug, first used in 1948 and employed for a wide variety of indications since then. However, despite widespread off‐label use, FDA labeling does not include approved indications for the use of MTX for many inflammatory skin diseases in pediatric patients, including morphea, psoriasis, atopic dermatitis, and alopecia areata, among others. Without published treatment guidelines, some clinicians may be hesitant to use MTX off‐label, or uncomfortable prescribing MTX in this population. To address this unmet need, an expert consensus committee was convened to develop evidence‐ and consensus‐based guidelines for use of MTX to treat pediatric inflammatory skin disease. Clinicians with experience and expertise in clinical research, drug development, and treating inflammatory skin disease in pediatric patients with MTX were recruited. Five committees were created based on major topic areas: (1) indications and contraindications, (2) dosing, (3) interactions with immunizations and medications, (4) adverse effects (potential for and management of), and (5) monitoring needs. Pertinent questions were generated and addressed by the relevant committee. The entire group participated in a modified Delphi process to establish agreement on recommendations for each question. The committee developed 46 evidence‐ and consensus‐based recommendations, each with >70% agreement among members, across all five topics. These are presented in tables and text, along with a discussion of supporting literature, and level of evidence. These evidence‐ and consensus‐based recommendations will support safe and effective use of MTX for the underserved population of pediatric patients who may benefit from this valuable, time‐honored medication. [ABSTRACT FROM AUTHOR]

Background/Objectives: Information is limited on the relationship between skin clearance, resolution of challenging body areas, and improvement of patient‐reported outcomes (PROs) in pediatric psoriasis. Ixekizumab, a high‐affinity monoclonal antibody that selectively targets interleukin‐17A, is approved for the treatment of moderate‐to‐severe psoriasis in patients aged 6 to <18 years. This study examines improvement in psoriasis clearance in challenging body areas in pediatric patients relative to health‐related quality of life. Methods: Data from the IXORA‐PEDS trial (NCT03073200) were analyzed, and changes from baseline were measured for overall Psoriasis Area and Severity Index (PASI), static Physicians' Global Assessment of psoriasis (sPGA), Psoriasis Scalp Severity Index (PSSI), Palmoplantar Psoriasis Area and Severity Index (PPASI), and Nail Psoriasis Severity Index. Rates of Dermatology Life Quality Index (DLQI), or Children's DLQI (CDLQI), scores of 0 or 1 were evaluated using the Cochran‐Armitage trend test. Results: Higher rates of DLQI/CDLQI (0,1) scores were significantly associated with greater PASI and PSSI responses at both Week 12 and Week 48 (p <.0001). A significant association was also observed between DLQI/CDLQI (0,1) and sPGA scores (p <.0001). Significantly higher rates of DLQI/CDLQI (0,1) scores were achieved in patients with greater levels of palmoplantar clearance as measured by PPASI at Week 12 (p =.0139), but significance was not sustained at Week 48 (p =.0896). Conclusions: Greater skin clearance and scalp resolution are associated with better PROs over a short‐term (12‐week) and long‐term (48‐week) period. This demonstrates that greater improvement of skin clearance and scalp resolution may benefit quality of life in pediatric patients with psoriasis. [ABSTRACT FROM AUTHOR]

Primary hyperhidrosis, an idiopathic disease that commonly affects the palms, soles, axillae, or craniofacial region, is characterized by perspiration in excess of what is required for physiologic cooling. This disease begins in childhood or adolescence and negatively impacts emotional, physical, and psychologic well‐being. This review explores current therapeutic options for primary hyperhidrosis in the pediatric population, including topical therapies, oral therapies, non‐surgical and procedural interventions, and adjunctive therapies. In addition, this review identifies new and emerging treatments and highlights the need for further research and therapeutic options for this impactful disease. [ABSTRACT FROM AUTHOR]

Background/Objectives: Glycopyrronium tosylate (GT) cloth, 2.4% is a topical anticholinergic approved in the United States for primary axillary hyperhidrosis in patients ≥9 years. This post hoc analysis evaluated long‐term response (efficacy and safety) in pediatric patients (≥9 to ≤16 years) to GT in the 44‐week, open‐label extension (NCT02553798) of two, phase 3, double‐blind, vehicle‐controlled, 4‐week trials (NCT02530281, NCT02530294). Methods: In the double‐blind trials, patients ≥9 years with primary axillary hyperhidrosis were randomized 2:1 to once‐daily GT:vehicle. Those who completed the study could receive open‐label GT for up to an additional 44 weeks. Safety assessments included treatment‐emergent adverse events (TEAEs) and local skin reactions (LSRs). Descriptive efficacy assessments included gravimetrically measured sweat production, Hyperhidrosis Disease Severity Scale response (≥2‐grade improvement), and Children's Dermatology Life Quality Index. Results: Of 43 pediatric patients completing either double‐blind trial, 38 (88.4%) entered the open‐label extension (age, years: 9 [n = 1], 12 [n = 2], 13 [n = 7], 14 and 15 [n = 9 each], 16 [n = 10]). The safety profile observed was similar to the double‐blind trials. Most TEAEs (>95%) were mild/moderate, related to anticholinergic activity, and infrequently led to discontinuation (n = 1/38 [2.6%]). No pediatric patients experienced a serious TEAE. Most anticholinergic TEAEs did not require a dose modification and resolved within 7 days. Approximately, one‐third of patients (n = 13/38 [34.2%]) had LSRs; most were mild/moderate in severity. Improvements in efficacy measures were maintained from the double‐blind trials. Conclusions: Long‐term, once‐daily GT for up to 48 weeks (4‐week double‐blind plus 44 week open label) provides a noninvasive, well‐tolerated treatment option for pediatric patients with primary axillary hyperhidrosis. [ABSTRACT FROM AUTHOR]

Objectives: A cleansing body wash containing diluted sodium hypochlorite (0.006% NaOCl) was evaluated for management of moderate‐to‐severe Staphylococcus aureus–colonized, atopic dermatitis in children. Methods: A 6‐week, prospective, open‐label study was conducted with 50 evaluable participants (ages 6 months to 17 years) who had moderate‐to‐severe atopic dermatitis with S aureus skin colonization documented by culture. Participants were instructed to continue using their current medications while using the study product, 0.006% NaOCl body wash, once daily to affected areas for 6 weeks. Primary outcome measures were Investigator's Global Assessment, Eczema Area and Severity Index, and Body Surface Area scores. Secondary outcome measures were the Visual Analog Scale for pruritus, Family Dermatology Life Quality Index, and Patient Satisfaction Questionnaire for Problem Areas. A subject daily diary and a six‐item subject questionnaire that provided information on preferences for bleach bath vs body wash were secondary outcome measures. Results: Daily use of the 0.006% NaOCl body wash led to improvement for all outcome measures comparing baseline to 2‐week and to 6‐week evaluations. Of the 50 skin S aureus‐positive subjects, 32/50 (64%) were still positive at 2 weeks. A 36.5% decrease in subject's daily record of topical corticosteroid application at end of study compared to baseline was found. Participant surveys indicated preferences for the body wash over bleach baths. Conclusions: Sodium hypochlorite (NaOCl) body wash improved all outcome measures for moderate‐to‐severe S aureus–colonized AD in infants, children, and adolescents. The limited reduction in S aureus further suggests that sodium hypochlorite has ameliorative effects other than antimicrobial actions. [ABSTRACT FROM AUTHOR]

Objectives: Hyperhidrosis in pediatric patients has been understudied. Post hoc analyses of two phase 3 randomized, vehicle‐controlled, 4‐week trials (ATMOS‐1 [NCT02530281] and ATMOS‐2 [NCT02530294]) were performed to assess efficacy and safety of topical anticholinergic glycopyrronium tosylate (GT) in pediatric patients. Methods: Patients had primary axillary hyperhidrosis ≥ 6 months, average Axillary Sweating Daily Diary (ASDD/ASDD‐Children [ASDD‐C]) Item 2 (sweating severity) score ≥ 4, sweat production ≥ 50 mg/5 min (each axilla), and Hyperhidrosis Disease Severity Scale (HDSS) ≥ 3. Coprimary end points were ≥ 4‐point improvement on ASDD/ASDD‐C Item 2 (a validated patient‐reported outcome) and change in gravimetrically measured sweat production at Week 4. Efficacy and safety data are shown through Week 4 for the pediatric (≥ 9 to ≤ 16 years) vs older (> 16 years) subgroups. Results: Six hundred and ninety‐seven patients were randomized in ATMOS‐1/ATMOS‐2 (GT, N = 463; vehicle, N = 234); 44 were ≥ 9 to ≤ 16 years (GT, n = 25; vehicle, n = 19). Baseline disease characteristics were generally similar across subgroups. GT‐treated pediatric vs older patients had comparable improvements in ASDD/ASDD‐C Item 2 (sweating severity) responder rate, HDSS responder rate (≥ 2‐grade improvement]), sweat production, and quality of life (mean change from Baseline in Dermatology Life Quality Index [DLQI]/children's DLQI), with greater improvement vs vehicle. Treatment‐emergent adverse events were similar between subgroups, and most were mild, transient, and infrequently led to discontinuation. Conclusions: Topical, once‐daily GT improved disease severity (ASDD/ASDD‐C, HDSS), sweat production, and quality of life (DLQI), with similar findings in children, adults, and the pooled population. GT was well tolerated, and treatment‐emergent adverse events were qualitatively similar between subgroups and consistent with other anticholinergics. [ABSTRACT FROM AUTHOR]

Abstract: Atopic dermatitis is the most common chronic skin disease, and it primarily affects children. Although atopic dermatitis (AD) has the highest effect on burden of skin disease, no high‐level studies have defined optimal therapy for severe disease. Corticosteroids have been used to treat AD since the 1950s and remain the only systemic medication with Food and Drug Administration approval for this indication in children, despite published guidelines of care that recommend against this option. Several clinical trials with level 1 evidence have supported the use of topical treatments for mild to moderate atopic dermatitis in adults and children, but these trials have had little consistency in protocol design. Consensus recommendations will help standardize clinical development and trial design for children. The Food and Drug Administration issues guidance documents for industry as a source for “the Agency's current thinking on a particular subject.” Although they are nonbinding, industry considers these documents to be the standard for clinical development and trial design. Our consensus group is the first to specifically address clinical trial design in this population. We developed a draft guidance document for industry, Developing Drugs for Treatment of Atopic Dermatitis in Children (≥3 months to <18 years of age). This draft guidance has been submitted to the Food and Drug Administration based on a provision in the Federal Register (Good Guidance Practices). [ABSTRACT FROM AUTHOR]

Abstract: Background/Objectives: Childhood‐onset psoriasis is a common skin disorder that has recently received increasing attention, particularly because of its significant medical, social, financial, and psychological burdens and its associated comorbidities. With limited data available and lack of standardized management guidelines for pediatric psoriasis, an expert panel desired to provide an updated critical overview and practical guidance for management of the affected population. Methods: A panel of pediatric dermatologists with extensive experience in pediatric psoriasis defined and prioritized a core set of topics, performed an English‐language literature review, prepared critical evaluations and presentations of topic areas, and carried out a consensus meeting and follow‐up consensus manuscript. Results: The summation of evolving perspectives in pediatric psoriasis includes epidemiology and natural history of the disease, precipitating factors and comorbidities, quality of life and burden of disease, clinical features and disease presentation, differential diagnosis, pathogenesis and treatment, including topical, photo, and systemic therapies. Conclusion: Pediatric psoriasis is an important immune‐mediated inflammatory skin disease with potential for significant impact on affected individuals and their caregivers. Current state‐of‐the‐art care is based primarily on experience and expert consensus, but pediatric data are accumulating and therapeutic options are rapidly evolving. [ABSTRACT FROM AUTHOR]

Background Phosphodiesterase-4 (PDE4) is a promising target in atopic dermatitis (AD) treatment. The pharmacokinetics (PK), safety, and efficacy of crisaborole topical ointment, 2% (formerly AN2728) (Anacor Pharmaceuticals, Palo Alto, CA), a boron-based benzoxaborole PDE4 inhibitor, were evaluated in children with mild to moderate AD. Methods This phase 1b, open-label, maximal-use study of crisaborole topical ointment, 2% applied twice daily (dose 3 mg/cm2) for 28 days enrolled patients ages 2 to 17 years with extensive AD involving 25% or more or 35% or more treatable body surface area, depending on age. Primary PK and safety assessments included systemic exposure to crisaborole and its metabolites after 7 days of treatment and the incidence of treatment-emergent adverse events (TEAEs). Secondary efficacy assessments included change from baseline in Investigator Static Global Assessment (ISGA), treatment success (ISGA score ≤1 with a two-grade or greater improvement from baseline), and improvement in five AD signs and symptoms. Results Of 34 patients enrolled, 31 completed the study. Crisaborole was rapidly absorbed, with limited systemic exposure between days 1 and 8. Twenty-three of 34 patients reported one or more TEAEs; 95% were mild or moderate and one patient discontinued because of a TEAE. Mean ISGA scores declined from 2.65 at baseline to 1.15 at day 29, 47.1% of patients achieved treatment success, and 64.7% of patients achieved ISGA scores of clear (0) or almost clear . Mean severity scores for AD signs and symptoms declined throughout the study. Conclusions This open-label study provides evidence that crisaborole topical ointment, 2% was well tolerated, with limited systemic exposure under maximal-use conditions in patients ages 2 years and older. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy and safety of onabotulinumtoxinA in adolescents with primary axillary hyperhidrosis. Methods This 52-week, multicenter, nonrandomized, open-label study was conducted in 141 adolescents ages 12 to 17 years with severe primary axillary hyperhidrosis. Patients could receive up to six treatments with onabotulinumtoxinA (50 U per axilla), with re-treatment occurring no sooner than 8 weeks after the prior treatment cycle and no later than 44 weeks after the initial treatment cycle. The primary efficacy measure was treatment response, based on self-assessed hyperhidrosis severity following the first two treatments using the 4-point Hyperhidrosis Disease Severity Scale ( HDSS). Other efficacy measures included spontaneous resting sweat production and health outcomes. Results Fifty-six (38.9%) participants underwent one treatment, 59 (41.0%) underwent two, 20 (13.9%) underwent three, 6 (4.2%) underwent four, and 3 (2.1%) underwent five. OnabotulinumtoxinA significantly improved HDSS scores and decreased sweat production compared with treatment cycle baselines. Seventy-nine patients (54.9%) responded to treatment based on HDSS criteria. From 56.6% to 72.3% of patients experienced a two-grade or more improvement at 4 and 8 weeks after each of the first two treatments. The majority (79.4%-93.2%) had a 75% or greater reduction in sweat production at week 4 (treatments 1-3). The median duration of effect for responders ranged from 134 to 152 days. Using quality of life measures, health outcomes improved markedly. Eight patients (5.6%) had mild or moderate treatment-related adverse events. No unexpected safety signals were observed in this study. Neutralizing antibodies to onabotulinumtoxinA did not develop. Conclusion OnabotulinumtoxinA injections provided beneficial effects in adolescents with primary axillary hyperhidrosis. [ABSTRACT FROM AUTHOR]

Atopic dermatitis ( AD) is a distressing dermatological disease, which is highly prevalent during infancy, can persist into later life and requires long-term management with anti-inflammatory compounds. The introduction of the topical calcineurin inhibitors ( TCIs), tacrolimus and pimecrolimus, more than 10 yr ago was a major breakthrough for the topical anti-inflammatory treatment of AD. Pimecrolimus 1% is approved for second-line use in children (≥2 yr old) and adults with mild-to-moderate AD. The age restriction was emphasized in a boxed warning added by the FDA in January 2006, which also highlights the lack of long-term safety data and the theoretical risk of skin malignancy and lymphoma. Since then, pimecrolimus has been extensively investigated in short- and long-term studies including over 4000 infants (<2 yr old). These studies showed that pimecrolimus effectively treats AD in infants, with sustained improvement with long-term intermittent use. Unlike topical corticosteroids, long-term TCI use does not carry the risks of skin atrophy, impaired epidermal barrier function or enhanced percutaneous absorption, and so is suitable for AD treatment especially in sensitive skin areas. Most importantly, the studies of pimecrolimus in infants provided no evidence for systemic immunosuppression, and a comprehensive body of evidence from clinical studies, post-marketing surveillance and epidemiological investigations does not support potential safety concerns. In conclusion, the authors consider that the labelling restrictions regarding the use of pimecrolimus in infants are no longer justified and recommend that the validity of the boxed warning for TCIs should be reconsidered. [ABSTRACT FROM AUTHOR]

Although acne vulgaris is common in preadolescents (<13 yrs), few acne treatments are currently approved for children. This study assessed the safety and efficacy of tretinoin microsphere gel (TMG) 0.04% pump in children aged 9-11 with acne vulgaris. In this multicenter, randomized, double-blind, vehicle-controlled pilot study, patients applied TMG 0.04% pump or vehicle once daily to the face for 12 weeks. Efficacy measures were changes in facial lesion counts, Investigator Global Evaluation of acne severity using two scales, and Investigator Global Assessment of Improvement from baseline to week 12. Of the 110 patients enrolled, 55 received TMG 0.04% pump, and 55 received vehicle. At week 12, there was significantly greater improvement in the least-squares mean change in noninflammatory lesions with TMG 0.04% than with vehicle (−19.9 vs −9.7, p = 0.04) and a significant difference in Investigator Global Assessment of improvement at week 12 between the children treated with TMG 0.04% pump and those treated with vehicle (p = 0.02), but there were no discernible differences in static acne severity scales. Change from baseline in signs and symptoms of cutaneous irritation were similar between the active and vehicle arms at week 12. This study demonstrated statistically significant differences in the reduction of noninflammatory lesions between TMG 0.04% pump and vehicle in patients aged 9-11 with acne vulgaris. Additional studies are warranted to further characterize the safety and efficacy of TMG 0.04% pump for the treatment of acne in the preadolescent population. [ABSTRACT FROM AUTHOR]

Impetigo is a common cutaneous infection that is especially prevalent in children. The prevalence of colonization and infection with resistant strains is continually increasing, forcing clinicians to reevaluate treatment strategies. Newer topical agents are effective in treating infections with resistant strains and may help minimize resistance and adverse effects from systemic agents. Use of topical disinfectants to decrease colonization is an important adjunctive measure. Physicians should be aware of local resistance patterns in impetigo to help guide therapy. [ABSTRACT FROM AUTHOR]

Hyperhidrosis is a disorder of excessive sweating beyond what is physiologically necessary for thermoregulation. Primary hyperhidrosis is localized; it can affect the axillae, palms, soles, face, and other areas and is idiopathic. The prevalence of hyperhidrosis in the United States is estimated to be 2.8% of the population, with about one-half (1.4%) of these individuals having the axillary form. Hyperhidrosis occurs in both children and adults, with the average age of onset of primary hyperhidrosis being 14–25 years. This disorder can be detrimental to a patient’s social, professional, psychological, and physical well-being. Early detection and management can significantly improve a patient’s quality of life, yet hyperhidrosis remains widely under diagnosed and under treated, particularly among pediatric patients. The purpose of this article is to review the treatment of pediatric hyperhidrosis, and to increase awareness and inspire further research on this important and often overlooked medical problem. [ABSTRACT FROM AUTHOR]

Corticosteroids are currently the first line of treatment for patients with atopic dermatitis. In the pediatric population however, the potential impact of adrenal suppression is always an important safety concern. Twenty boys and girls, 5–12 years of age, with normal adrenal function and a history of atopic dermatitis were maximally treated three times daily with a lipid-rich, moisturizing formulation of hydrocortisone butyrate 0.1% for up to 4 weeks. At the conclusion of the 4-week treatment period, cosyntropin injection stimulation testing showed no evidence of adrenal suppression. In addition, the therapy was noted to be highly efficacious, with a clinical success rate of 80% (Physician Global Score of (0) clear or (1) almost clear). No local side effects associated with prolonged use of topical corticosteroids were reported. In summary, this study supports the contention that this lipid-rich, moisturizing formulation of hydrocortisone butyrate 0.1% was a well-tolerated and beneficial treatment for atopic dermatitis, demonstrating no adrenal suppression in the pediatric population aged 5–12 years. The relevance of these findings for children below 5 years of age, because of difference in body mass/surface area ratios, remains to be determined. [ABSTRACT FROM AUTHOR]

Neonatal primary cutaneous aspergillosis usually presents as an erythematous plaque with pustules that evolve into an eschar. Immunocompromised patients and premature neonates are at risk of developing this disease. Early diagnosis and treatment are critical in preventing progression to a systemic illness. We report a preterm neonate with primary cutaneous aspergillosis and discuss the etiologies, presentations, and treatments for this illness. [ABSTRACT FROM AUTHOR]

Malignant rhabdoid tumor is a rare and highly aggressive malignancy of unknown etiology. We report a primary cutaneous rhabdoid tumor on the upper back of a newborn. It was initially diagnosed as a hemangioma clinically, and that diagnosis was supported by radiologic studies, Including magnetic resonance imaging. However, detailed investigation with light microscopy, immunohistochemistry, and electron microscopy enabled us to make a diagnosis of rhabdoid tumor. This is the seventh reported case of rhabdoid tumor with primary cutaneous involvement. [ABSTRACT FROM AUTHOR]

Two Sore of Mexican ancestry had focal epithelial hyperplasia (FEH). The Salons on the oral mucosa of the older child were initially misinterpreted as representing sexual abuse. Microscopic evaluation of a hematoxylin and eosin-stained section from a lower lip papule demonstrated the histologic features of FEH. Although human papillomavirus (HPV) type 13 and HPV32 have been most consistently present in FEH lesions, types 6, 11, 13, and 32 were not detected in the paraffin embedded tissue specimen of our patient using an in situ hybridization technique. The lesions persisted or recurred during management using destructive modalities; subsequently, they completely resolved spontaneously. [ABSTRACT FROM AUTHOR]

The article presents information on proceedings of the concurrent sessions. Researcher William Weston from Denver, Colorado, emphasized that erythema multiforme (EM) minor and erythema multiform major are different disorders. Although drugs most frequently have been associated with EM major, herpes simplex virus is the most common cause of EM minor. Researcher Neil Shear from Toronto, Canada, noted a genetic predisposition to severe drug reactions, including EM major, such as by slow acetylation of certain drugs. The alteration in drug metabolism may explain why 69% of patients react to phenytoin, phenobarbital and carbamazepine.

Aberrant embryologic development at the neural crest may clinically result in on of several patterns of malformation. Four examples of the neurocristopathy syndrome are described that collectively feature a very broad range of expression in then Infants. Because of the many expressions, the syndrome may not be recognized. We believe that greater familiarity with the disorder will aid In the discovery of unsuspected anomalies and provide clues about pradisposing etiologies. [ABSTRACT FROM AUTHOR]

Presents a transcript of the proceedings of the 14th Annual Meeting of the Society for the Pediatric Dermatology held on June 22-24, 1989 in Quebec City, Quebec.

We evaluated two patients with hereditary bullous polkiloderma. Both tiad acral bullae, generalized poikiloderma with prominent atrophy, and acral keratoses. One patient, with sporadic disease, had, in addition, urethrai and subglottic stenoses, webbing of digits, and poor dentition. Hie other patient, whose disease was dominantly inherited, had koilonychia. The results of cutaneous histopathology, electron microscopy, and immunofluorescence mapping studies are presented, it is possibie that Kindler syndrome and Weary's hereditary acrokeratotic poikiloderma are variants of the same disease. [ABSTRACT FROM AUTHOR]

Tinea capitis is still with us. The hair has been beaten into submission by irradiation in past years: the organisms have been beaten into submission with griseofulvin and other agents; yet the disease lives on. We thought ii appropriate to have a symposium on the subject of the epidemiology of tinea capitis, its changing nature, its complications, the carrier state, differential diagnosis, culture techniques, and the current status of the management of its various causes. As one of our authors stated it is a `vexatious" disease. [ABSTRACT FROM AUTHOR]

Children with tinea capitis caused by Trichophyton tonsurans often have a lifetime of association with the organism and in spite of intermittent therapy, as adults pass the infection to successive generations. While most current treatment regimens are directed at treating the individual patient our study supports the need to evaluate and possibly treat all family members and their home environment. [ABSTRACT FROM AUTHOR]

Trichostasis spinulosa is a common disorder of follicular hyperkeratosis that is often confused clinically with similar disorders, such as keratosis pilaris and eruptive vellus hair cysts. Six patients from the UTMB dermatology clinic who had trichostasis spinulosa are presented. Two of the six also had keratosis pilaris and one had eruptive vellus hair cysts. The present study was undertaken to compare and contrast the clinical presentation and histopathologic appearance of these three disorders. The results of the study and review of the literature revealed differences in distribution of lesions and microscopic appearance of follicular and histopathologic material. [ABSTRACT FROM AUTHOR]

Osteochondromas are among the most common cartilaginous neoplasms, but are rarely seen on the fingers and toes. We report a 10-year-old girl who had a dystrophic fingernail since infancy that was identified as a subungual osteochondroma radiologically and histopathologically. The clinical, radiographic, and histopathologic features, as well as the pertinent differential diagnoses and treatment options are discussed. [ABSTRACT FROM AUTHOR]

Tinea faciei has been observed periodically in children, however, it is a relatively rare occurrence in infancy. We examined three infants with tinea faciei caused by Tichophyton tonsurans. Two of the patients were potassium hydroxide (KOH) negative for fungal hyphae but culture positive, while the third was both KOH and culture positive. Trichophyton tonsurans/ was isolated from the scalp of family members in two of the three infants. [ABSTRACT FROM AUTHOR]

An abstract of the article "Maximal Use Systemic Exposure (MUSE) Study Evaluating AN2728 Ointment, 2%, a Novel Boron-based Small Molecule, for the Treatment of Pediatric and Adolescent Subjects with Mild-to-Moderate Atopic Dermatitis," by Leon Kircik and colleagues is presented.

Ecthyma gangrenosum is the cutaneous manifestation of pseudomonas infection in patients with sepsis. A previously healthy 7-month-old girl who developed ecthyma gangrenosum without apparent inciting factors became neutropenic secondary to autoimmune neutropenia 2 months after initial presentation. She was treated with appropriate surgical and medical intervention and was discharged in stable condition only to die suddenly 2 days after discharge. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about diagnosis of X-linked ichthyosis.