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Patients are commonly referred to pediatric dermatology for the evaluation of pigmented lesions. For families, pediatricians, and dermatologists alike, malignancy is the main fear. In the past few decades, there has been evolving literature to inform diagnosis and management. This article provides an update on the clinical, histopathologic, and ancillary testing for 3 categories of particularly challenging pigmented lesions: congenital melanocytic nevi, spitzoid neoplasms, and pediatric melanoma.

Pediatric dermatology is an incredibly rewarding field. Children are resilient and funny and just want to know that you are advocating for their best interests. Teaming up with children and their parents can lead to fantastic therapeutic alliances and success. The author has divided this chapter based on a handful of common pediatric dermatologic diseases and what he sees as some of the main clinical and therapeutic tips and tricks that have helped him in his practice.

Melanocytic nevi are congenital or acquired benign melanocytic neoplasms. The reason for the appearance of melanocytic nevi is not precisely known. Melanocytic nevi frequently occur in children, constituting a common reason for consultation in pediatric dermatology clinics. In our experience, many parents and caregivers present doubts and fears based more on popular beliefs than on data with valid scientific evidence. This review answers their frequently asked questions, such as the risk of malignancy, the importance of nevi location, the warning signs of malignant transformation, best prevention strategies, and optimal management, based on the most recent scientific evidence available.

Topical and systemic retinoids are often used long-term in the treatment of ichthyoses and other disorders of cornification. The Pediatric Dermatology Research Alliance (PeDRA) Use of Retinoids in Ichthyosis Work Group was formed to address the numerous clinical concerns with use of these medications in children and adolescents and to establish best practices regarding the use of retinoids. Consensus was achieved using the Delphi process with recommendations based on the best available evidence and expert opinion. An executive summary of the results is presented herein.

The first wave of the coronavirus disease 2019 (COVID‐19) pandemic had an enormous impact on health‐care services, including on care provision for children with atopic dermatitis (AD). We investigated the impact of COVID‐19 on the care for children with moderate to severe AD at our tertiary outpatient clinic and examined satisfaction with care. We reviewed outpatient records, comparing total number and types of consultations during the first COVID‐19 wave (March until July 2020) with the corresponding months of 2019 and 2018. In addition, we conducted a questionnaire‐based study investigating the impact of COVID‐19 on clinical and psychological symptoms, and satisfaction with care. A total number of 913 consultations (466 individual children) were conducted during the first COVID‐19 wave in 2020, while 698 (391 individual children) and 591 consultations (356 individual children) were conducted in 2019 and 2018. The proportion of remote consultations was higher (56.2%) compared to 14.0% in 2019 and 12.7% in 2018. Worsening of AD was reported by 9.7% of caretakers. Overall satisfaction with provided care was high (8.6; interquartile range [IQR] = 7.3–10.0). Caretakers receiving face‐to‐face consultation were significantly (p = 0.026) more satisfied (9.0; IQR = 8.0–10.0) than caretakers receiving remote consultation (7.9; IQR = 7.0–9.5). The COVID‐19 pandemic had an unprecedented impact on care provision for children with AD, particularly on the number of remote consultations. Overall satisfaction with care was high. The impact of COVID‐19 on disease severity remained limited. Remote consultations seem to be a useful tool that can be put into practice during the COVID‐19 pandemic.

Vascular anomalies comprise an array of congenital developmental disorders that can lead to significant disfigurement and physiologic disarray. The vast multitude of clinical phenotypes has inherently led to misdiagnosis and patients and families enduring long diagnostic odysseys of medical care. Although the observed variation in disease manifestations remains poorly understood, targeted next-generation sequencing has pivoted our understanding of the pathobiology of vascular anomalies and, for the first time, uncovered potential pharmacologic targets for these disorders. In this review article, we highlight current and developing targeted therapies for vascular anomalies, namely phosphoinositide 3-kinase and mitogen-activated protein kinase pathway inhibitors, and discuss the future directions of targeted therapies.

Restrictive dermopathy (RD) is a rare and lethal laminopathy caused by mutations in LMNA or ZMPSTE24. This series reports 3 patients with RD and reviews the literature of the 113 previously reported cases, including highlights of the unique constellation of clinical findings in RD, as well as histologic, radiographic, and genetic features. Early recognition of these characteristic features is vital to establish a prompt diagnosis and provide adequate family counseling for this terminal condition.

During the COVID-19 pandemic, rapid, real-world evidence is essential for the development of knowledge and subsequent public health response. In dermatology, provider-facing and patient-facing registries focused on COVID-19 have been important sources of research and new information aimed at guiding optimal patient care. The 7 dermatology registries included in this update now include more than 8000 case reports sourced from physicians and patients from countries all over the world.

Methotrexate is a drug that has been used in many areas of medicine for many years. It is used in oncology, inflammatory diseases and some dermatological diseases. It is recommended in an increasing number of dermatoses, both in the adult and children’s population. The article discusses its wide use among children in numerous dermatological diseases.

Chronic pruritus associated with systemic diseases in the pediatric population has been infrequently addressed in the literature. This review focuses on chronic pruritus presenting without cutaneous manifestations. Common systemic etiologies include diseases with hepatic, renal, and hematologic origins. This encompasses several congenital liver disorders, end-stage renal disease (ESRD), and lymphoproliferative disorders such as Hodgkin's lymphoma. In this paper, an expert panel describes the clinical characteristics, pathophysiology, and therapeutic treatment ladders for chronic pruritus associated with the aforementioned systemic etiologies. Novel therapies are also reviewed. Our aim is to shed light on this unexplored area of pediatric dermatology and instigate further research.

BACKGROUND/OBJECTIVES The Pediatric Dermatology Research Alliance (PeDRA) connects pediatric dermatologists, trainees, basic scientists, allied health professionals, and patient advocates to improve the lives of children with skin disease through research. As a training pipeline for future pediatric dermatologists and steward of research in the field, PeDRA has a responsibility to examine its history and take actionable steps to diversify its membership, grant recipients, study leads, research priorities, and leadership. METHODS In 2020, PeDRA formed an Equity, Diversity, and Inclusion Task Force to address this need. In an effort to assess PeDRA's past and plan for PeDRA's future, a review of PeDRA's membership, leadership, grant awardees, and research topics was conducted. RESULTS/CONCLUSIONS Results demonstrated gaps in PeDRA's current operational efforts to diversify the pediatric dermatology workforce and identified areas for improvement. Recommendations are proposed as a call to action for the community.

Barriers to healthcare access are healthcare inequities that have been widely studied across different medical specialties. No studies have previously evaluated the state of barriers to healthcare access research in pediatric dermatology. A systematic review was conducted to examine the types of barriers identified within pediatric dermatology literature. Relevant information was extracted and categorized into the themes of systemic, sociocultural, or individual barriers. The systemic barriers we found include finances, wait times, and geography. The sociocultural barriers included culture beliefs and communication. Patient beliefs and health knowledge were found as individual barriers. The small number and limited scope of studies we identified suggest that barriers to healthcare access in pediatric dermatology remain an understudied topic. Additional research is needed to further characterize these barriers to dermatologic care, as well as the impact of any interventions designed to overcome them.

Introduction Pruritus is a common symptom across various dermatologic conditions, with a negative impact on quality of life. Devices to quantify itch objectively primarily use scratch as a proxy. This review compares and evaluates the performance of technologies aimed at objectively measuring scratch behavior. Methods Articles identified from literature searches performed in October 2020 were reviewed and those that did not report a primary statistical performance measure (eg, sensitivity, specificity) were excluded. The articles were independently reviewed by 2 authors. Results The literature search resulted in 6231 articles, of which 24 met eligibility criteria. Studies were categorized by technology, with actigraphy being the most studied (n = 21). Wrist actigraphy's performance is poorer in pruritic patients and inherently limited in finger-dominant scratch detection. It has moderate correlations with objective measures (Eczema and Area Severity Index/Investigator's Global Assessment: rs(ρ) = 0.70-0.76), but correlations with subjective measures are poor (r2 = 0.06, rs(ρ) = 0.18-0.40 for itch measured using a visual analog scale). This may be due to varied subjective perception of itch or actigraphy's underestimation of scratch. Conclusion Actigraphy's large variability in performance and limited understanding of its specificity for scratch merits larger studies looking at validation of data analysis algorithms and device performance, particularly within target patient populations.

Background Cutaneous manifestations in hospitalized children with SARS-CoV-2 have not been studied systematically. Objective To describe the mucocutaneous involvement in pediatric patients with COVID-19 admitted to a pediatric institution in Madrid (Spain), located in a zone reporting among the highest prevalence of COVID-19 in Europe. Methods A descriptive, analytical study was conducted on a series of 50 children hospitalized with COVID-19 between March 1, 2020, and November 30, 2020. Results Twenty-one patients presented with mucocutaneous symptoms: 18 patients with macular and/or papular exanthem, 17 with conjunctival hyperemia, and 9 with red cracked lips or strawberry tongue. Eighteen patients fulfilled criteria for multisystem inflammatory syndrome in children. Patients with mucocutaneous involvement tended to be older and presented to the emergency department with poor general status and extreme tachycardia, higher C-reactive protein and D-dimer levels, and lower lymphocyte counts than patients without skin signs. Mucocutaneous manifestations pose a higher risk of admission to the pediatric intensive care unit (odds ratio, 10.24; 95% confidence interval, 2.23-46.88; P = .003). Conclusions Children hospitalized with COVID-19 frequently had mucocutaneous involvement, with most symptoms fulfilling criteria for multisystem inflammatory syndrome in children. Patients with an exanthem or conjunctival hyperemia at admission have a higher probability of pediatric intensive care admission than patients without mucocutaneous symptoms.

PURPOSE OF REVIEW: Shared decision making (SDM) is an important part of patient-centered care. However, it is neither widely practiced nor researched in pediatric dermatology. In this article, we provide practical examples of how to engage in SDM in pediatric dermatology, and identify future areas of research. RECENT FINDINGS: Children and parents/guardians desire SDM in clinical encounters. The process is applicable to discussions of medical as well as surgical care. Additionally, SDM can help prepare children for the transition from pediatric to adult/general providers. Clinicians often want more guidance on its implementation, and there is a dearth of research on SDM or decision tools specific to pediatric dermatology. SUMMARY: SDM is underused and understudied in pediatric dermatology. This article highlights how to engage in SDM and presents opportunities for research and implementation in pediatric dermatology.

Pediatric dermatologists should be aware of immunization schedules and special recommendations for patients on immunosuppressive agents due to the increased risk of vaccine-preventable infections. Prior to initiating immunosuppressive therapy, pediatric dermatologists should review a vaccine history and administer any necessary age-appropriate or catch-up vaccines. Live vaccines are typically contraindicated while on immunosuppressive therapy, while inactivated vaccines are generally safe to administer.

En dermatología pediátrica, la correcta elección de la dosis de principio activo así como del excipiente, se vuelve fundamental para conseguir los resultados terapéuticos desea-dos, por lo que se deben tener en cuenta aspectos tan variados como las características de la lesión, las del paciente, así como las del medicamento seleccionado. En la población pediátrica, se plantean dificultades añadidas tales como la limitada variedad de especialidades comerciales que se ajusten a sus particularidades. Por ello, la formulación magistral o formulación de medicamentos individualizados supone una buena alternativa terapéutica que permite emplear principios activos en los rangos terapéuticos aceptados, vehiculizados en las formas farmacéuticas idóneas, asociar varios en un mismo medicamento e incluso adaptar el vehículo al estado de la lesión, así como a las necesidades intrínsecas del paciente. Las formulaciones recogidas en este artículo, se basan en una amplia experiencia clínica y permiten a los médicos prescriptores adaptar el tratamiento de forma personalizada The administration of appropriate doses of active ingredients and excipients is crucial for achieving desired treatment outcomes in pediatric dermatology. A number of factors need to be considered, including the characteristics of the lesion, the patient, and the drug. An additional challenge in pediatric settings is the limited number of commercially available formulations suitable for use in children. Drug compounding, which is the preparation of medications tailored to the needs of individual patients, is a good alternative for pediatric populations for a number of reasons. Using a customized compound, the clinician can prescribe formulations that contain the optimal dose of the active ingredients within acceptable limits and the most suitable vehicle and formulation components. Compounding can also be used to combine several active ingredients in a single medication and even adapt the vehicle to the characteristics of the lesion and the needs of the patient. The pharmaceutical formulations described in this review are based on extensive clinical experience and can be customized to meet individual needs.

A 15-year-old boy presented to the pediatric dermatology department with long-standing patch stage CD8+ mycosis fungoides and subsequent development of recurrent pityriasis lichenoides et varioliformis acuta eruptions. There have been rare reports of patients with chronic, recalcitrant pityriasis lichenoides developing mycosis fungoides, but we believe this to be the second case of mycosis fungoides preceding a diagnosis of pityriasis lichenoides, and the first case reported in the pediatric population.

Cutaneous histopathologic diagnoses in children often differ from those in adults. Depending on practice setting, these specimens may be evaluated by dermatopathologists or pediatric pathologists. We sought to determine whether comfort level with pediatric dermatopathology is associated with prior training, pediatric dermatopathology exposure during fellowship, career duration, or specimen subtype.We surveyed dermatopathologists and pediatric pathologists practicing in the United States. Training and practice variables were evaluated by multivariable regression for association with comfort level.Of the 156 respondents, 72% were dermatopathologists (response rate 11.6%) and 28% were pediatric pathologists (response rate 9.3%). Dermatopathologists reported higher comfort overall (P .001); this was also true for inflammatory dermatoses and melanocytic neoplasms (P .001). Thirty-four percent and 75% of dermatopathologists and pediatric pathologists, respectively, reported lower comfort with pediatric skin specimens than their usual cases. Pediatric pathologists were 28% more likely to refer these cases to colleagues. Among dermatopathologists, dermatology-trained were more comfortable than pathology-trained colleagues interpreting inflammatory dermatoses (P .001).Pathologists' comfort with pediatric dermatopathology varied significantly based upon prior training, career duration, and specimen subtype. These results suggest opportunities for improving education in this domain.

Generalized Pustular Psoriasis (GPP) is a rare, severe, life-threatening form of psoriasis and accounts for up to 13.1% of all childhood psoriasis. Common first-line systemic treatment for pediatric patients with GPP include oral acitretin, cyclosporin and methotrexate which have varying efficacy and side effects but multiple interventions are often needed to induce remission and maintain long term control. Recently, the anti IL 17 A monoclonal antibody secukinumab have been shown to be effective in adult patients with GPP; however, there is lack of evidence of its usage in the pediatric population. We describe a case series of 4 pediatric patients with GPP who were treated with off-label use of secukinumab. All four patients had marked clearance and reduction in Generalized Pustular Psoriasis AreaSeverity Score (GPPASI) within first 48 h of first injection with subsequent almost complete to complete clearance of skin lesions by 1 month follow up. In conclusion, secukinumab was found to be successful in inducing remission, with rapid clearance and maintaining remission, with or without combination with other systemic agents for pediatric GPP.

Meyerson phenomenon, also known as “halo-eczema,” has been widely described over melanocytic and non-melanocytic lesions. However, its appearance over vascular anomalies is rarely observed and could lead to diagnostic errors. A case study of five patients aged between four months and two years is reported. These patients developed unique erythematous and pruritic scaly patches, being diagnosed and treated as fungal infections. Due to the lack of response to the treatment, they were referred to the pediatric dermatology practice, where the diagnosis of Meyerson phenomenon over capillary malformations was made. Topical treatment with corticosteroids led to improvement in all cases. Although Meyerson phenomenon developing over vascular anomalies is a rare condition, it is important for pediatricians and dermatologists to assess it as a part of the differential diagnosis when treating a patient with skin lesions. Recognizing this phenomenon will prevent diagnostic and therapeutic errors.

A 5-month-old boy was evaluated for an unusually large presternal bump present since birth. The ultrasound examination revealed a well-defined soft tissue mass with an oval shape. The lesion demonstrated a regular and well-demarcated outline, with an upper margin that was thinned and inserted into the upper skin plane; the content was anechoic with a small echogenic formation, mobile with changes in the patient's decubitus. The histologic diagnosis was dermoid cyst. Although dermoid cysts are commonly seen in the midline, the midsternal location, found in our patient, is rare. Dermoid cysts can have ultrasonographic features similar to those of other subcutaneous cystic masses. However, if an anechoic cyst with an internal well-circumscribed echogenic ball-like formation is seen within the presternal subcutaneous fat layer, as in our patient, dermoid cyst should be considered in the differential diagnosis of subcutaneous cystic masses.

In recent years, patient management in the area of dermatolgogical diseases has changed considerably in both adults and children. In addition to well-established topical treatment, new systemic treatment approaches have emerged. Topical treatments are still in the forefront in the management of pediatric patients with dermatological diseases. In addition, formulations are therapeutic options that enable us to increase the treatment possibilities due to the fact that we can change concentrations of ingredients, implement new findings from clinical research and/or prescribe large amounts of topical basic therapy. Extemporaneous formulations should be preferred to individual preparations.

Childhood psoriasis is recognized as a potential multisystem disorder and hence it is imperative to optimize disease management to arrest progression, minimize psychological burden and evolution of metabolic syndrome. Clinical practice recommendations are necessary to assist practitioners in appropriate decision making based on available evidence. Owing to the lack of Indian recommendations on childhood psoriasis, the SIG Pediatric Dermatology under IADVL Academy undertook an evidence-based approach based on published literature on the topic, between January 2000 and July 2020 to frame the recommendations.

In the medical literature, exanthem is the name given to a widespread rash that is usually accompanied by systemic symptoms such as fever, malaise, and headache. The combination of these factors, for example, the mobility of human populations, the onset of new diseases such as COVID and the continuous availability of new drugs, make today the interpretation of the exanthems more and more difficult. In this article, we will revise briefly the conceptual problems that, during many years, have contributed to hinder its comprehension. At the end, two tables will help physicians to orientate in this field.

Congenital melanocytic nevus (CMN) or nevi, also known as dark moles, are present at birth. While small CMN are quite common, large and giant nevi are rare and can be associated with significant psychological distress and the potential for further clinical sequelae. Neonatal clinicians can offer anticipatory guidance to families through distribution of resources and navigation to additional consultants.

The current scenario of the coronavirus disease (COVID-19) pandemic has resulted in a huge disease burden worldwide affecting people across all age groups. Although children get infected by coronavirus, they are less commonly affected. Only 2% of cases are being reported among patients aged less than 20 years of age and childhood cases constitute around 1–5% of them. Moreover, they are less likely to be seriously affected when compared to adults, with more than 90% of them being either asymptomatic or having mild to moderate disease. This could be attributed to less exposure or sensitivity to COVID-19, varying immune response mechanisms, differences in the expression/function of the Angiotensin Converting Enzyme 2 receptors or higher antibody levels to viruses owing to exposures to multiple respiratory infections, protective role of measles and BCG vaccine, and few associated comorbidities. However, children with certain underlying medical conditions like cardiac or respiratory disease, diabetes, immunodeficiency disorders, cancer or on immunosuppressants may be at a higher risk for developing severe disease.

Homeopathic Antimonium crudum may be useful in many pediatric skin conditions if prescribed on symptom similarity. It may especially be helpful in reducing the use of antibiotics and steroids in this age‐group if proven to be effective through larger scientific studies.

Introduction: Pediatric dermatology is an important branch of dermatology that deals with the diagnosis, treatment, and prevention of skin diseases occurring in infancy, childhood, and adolescence. Aims:The present study was conducted to find out the pattern and prevalence of various dermatosis among the paediatric age group. Materials and Methods: This is prospective, cross sectional study. A total 2456 patients were recruited in 1-14 year of age, who presented with dermatosis in dermatology clinic of GMERS medical college, Gandhinagar. The study was conducted from March 2016 to February 2017(12 Months), and diagnosis was made based on clinical examination and necessary investigation if required. Results: Males were outnumbered female in present study with ratio of 1.45:1. The majority of patients were in the age group of >6-14 year (44.09%). Infections and infestations were most common constituting 65.19% followed by eczema and dermatitis group of disorder constituting 12.02% (n=324). Appendageal disorder constitutes 6.42% (n=173) followed by cutaneous vascular response (4.27%), nutritional dermatosis (2.67%), pigmentary disorder (2.15%), keratinization disorder (2.0%) and papulosquamous disorder (1.89%). Least common disorder include nevi, genodermatoses, collagen vascular disorder and vesiculobullous diorde. Conclusion: This study helps us to know the prevalence of skin diseases in pediatric age group and thus we can take adequate measures for their prevention and treatment in this region. Keywords: Paediatric, Dermtoses, Infections and Infestations.

We examined the potential for virtual, pediatric group visits to reduce racial disparities in psychosocial isolation and access to care among children of color with pediatric vitiligo and alopecia areata as well as their caregivers. We have conducted 10 visits with 30 pediatric skin of color patients between 5 and 16 years old: 18 patients with alopecia areata, 12 with vitiligo, 59% female, 64% Black, and 23% Latinx, and 33 parents. After the visits, children and parents felt they had more people they knew and could reach out to about their dermatologic condition, the visits exceeded both children's and parents' expectations, and both children and parents reported that they would continue attending future group visits if offered. Group visits in the virtual format may present an opportunity for reducing racial disparities in psychosocial isolation and access to care across geographic locations in pediatric dermatology.

Languages other than English represent an ever-growing component of the tapestry of the United States. Studies have shown that language barriers can impact access to care and quality of care, particularly in specialty clinics. Given the additional challenges faced by language interpretation in pediatric settings, the field of pediatric dermatology is uniquely positioned to contribute meaningfully to improving care for families with limited English proficiency.

Amaç: Bu çalışmada amacımız; Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi (SÜEAH) Pediatrik Dermatoloji Polikliniklerine müracaat eden pediatrik yaş grubunda Atopik Dermatit (AD) hastalarında, periferik kandan ölçülebilen nötrofil lenfosit oranı (NLO), trombosit lenfosit oranı (TLO), eozinofil lenfosit oranı (ELO) ile serum total immün globobülin E (T-IgE) değerleri ve kan eozinofil sayısını tespit etmek AD ile bu parametreler arasındaki ilişkiyi araştırmaktır.Gereç ve Yöntemler: Çalışmaya dahil ettiğimiz hastalara ait veriler 01.01.2018 ile 31.10.2019 tarihleri arasında müracaat eden AD hastalarından hastane bilgi yönetimi sistemi (HBYS) üzerinden retrospektif olarak elde edildi. Kontrol grubuna alerjik hastalığı, enfeksiyonu veya kronik bir hastalığı olanlar dahil edilmedi.Bulgular: Çalışma kriterlerine uyan 30 AD hastasının 8 kız, 22 erkek olup, yaş ortalaması 9.33±5.84 olarak tespit edildi. Kontrol grubunda 30 olgunun 12’si kız, 18’i erkek olmak üzere yaş ortalaması 10.69±4.69 olarak belirlendi. AD hastalarının T-IgE değerleri 304.48±25.81 IU/mL, eozinofil düzeyleri ortalama 1.39±0.29 K/uL, NLO 2.23±1.19, TLO 123.69±41.99, ELO 0.133±0.111 olarak tespit edildi. Kontrol grubunun T-IgE değerleri 41.03±6.18 IU/mL, eozinofil düzeyleri ortalama 0.39±0.09 K/uL, NLO 1.73±0.61, 107.66±35.30, ELO 0.071±0.049 olarak tespit edildi. AD hastaları ile kontrol grubu istatistiksel olarak karşılaştırıldığında T-IgE, Eozinofil, NLO, ELO değerleri arasında (p0.05) olarak tespit edildi.Sonuç: Çalışmamızda AD hastalarında NLO, TLO, ELO ile T-IgE değerleri ile kan eozinofil düzeyleri yüksek bulunmuştur. Bu parametrelerin bu hastalığın teşhis ve takibinde önemli olduğunu ortaya koymaktadır. Bu değerlerin yüksek saptanması, daha sonraki çalışmalarda bu değerlerin referans olarak alınabilmesine katkı sağlayacaktır, Aim: Our aim in this study; In Atopic Dermatitis (AD), patients in the pediatric age group who applied to the Pediatric Dermatology Polyclinics of Sakarya University Training and Research Hospital (SUTRH), to determine neutrophil lymphocyte ratio (NLO), platelet lymphocyte ratio (TLO), eosinophil lymphocyte ratio (ELO) and serum total immune globobulin E (T-IgE) values and blood eosinophil count to investigate the relationship between AD and these parameters.Materials and Methods: The data of the patients we included in the study were obtained retrospectively from the AD patients who applied between 01.01.2018 and 31.10.2019 through the hospital information management system (HIMS). Those with allergic disease, infection or chronic disease were not included in the control group.Results: Of the 30 AD patients who met the study criteria, 8 were girls and 22 were boys, with an average age of 9.33 ± 5.84. In the control group, the average age of the patients was 12.6 girls and 18 boys, 10.69 ± 4.69. T-IgE values of AD patients were determined as 304.48±25.81 IU / mL, eosinophil levels were 1.39 ± 0.29 K / uL, NLO 2.23±1.19, TLO 123.69±41.99, ELO 0.133±0.111. T-IgE values of the control group were determined as 41.03±6.18 IU / mL, eosinophil levels on average 0.39±0.09 K / uL, NLO 1.73±0.61, 107.66±35.30, ELO 0.071±0.049. When AD patients and control groups were compared statistically, T-IgE, Eosinophil, NLO, ELO values were determined as (p 0.05).Conclusion: In our study, NLR, TLR, ELR and T-IgE values and blood eosinophil levels were found high in AD patients. It reveals that these parameters are important in the diagnosis and follow-up of this disease. High determination of these values will contribute to the reference of these values in future studies.

Introduction. — The recently identified role of a BRAF somatic mutation in the pathophysiologyof Langerhans cell histiocytosis (LCH) offers new therapeutic options. Herein we describe thecase of a 10-month-old infant with refractory high-risk LCH successfully treated with vemu-rafenib.Observation. — The patient first presented with cutaneous LCH at the age of 2 months. Thedisease remained undiagnosed until she was 6 months old, when it rapidly evolved to a multisys-temic high-risk and life-threatening disease, refractory to 2 lines of chemotherapy. BRAFV600Emutation was found at skin biopsy, and targeted therapy with vemurafenib was started whenshe was 10 months old. The treatment induced a fast and sustained response, but rapid relapseoccurred after treatment discontinuation, leading to resumption of treatment, once moreresulting in a sustained response.Conclusion. — Our case highlights the first-line role of dermatologists in establishing the diag-nosis of LCH, especially in children, in whom the eruption may be difficult to identify, leading todelayed diagnosis. Targeted therapy with vemurafenib has recently been described in children in this indication and our results support its efficacy, highlighting the need for prolonged treat-ment and raising the question of maintenance therapy, as well as the necessity for large-scaleand long-term studies., info:eu-repo/semantics/published

BACKGROUND Autoimmune bullous diseases (AIBD) are rare among children. The data describing the overall spectrum and prognosis of pediatric AIBD (pAIBD) are scarce, and there are no established treatment guidelines. OBJECTIVES The present study examined the spectrum, clinical characteristics, and long-term prognosis of pAIBD in a tertiary care pediatric dermatology unit. METHODS Retrospective records of all pAIBD cases (

BACKGROUND AND OBJECTIVES To date, there are no well-established guidelines regarding laser therapy for the treatment of cutaneous lesions in pediatric patients. We aim to ascertain the types of lasers commonly used, types of lesions treated, and factors that affect the selection of specific laser modalities in pediatric patients. STUDY DESIGN/MATERIALS AND METHODS An anonymous online survey was distributed to healthcare providers who treat children with lasers through listservs of four major national and international dermatology and laser organizations. RESULTS Outpatient office-based procedure rooms are the most common clinical setting for laser procedures (74.4%), and pulsed dye laser is the most commonly used laser (95.4%). Conditions routinely treated with lasers included port wine stains (95.4%), infantile hemangiomas (81.5%), other vascular lesions (81.5%), scars (77.7%), and hair (60.8%). 84.4% of respondents expressed concern about general anesthesia in patients

Background /objectives Although 82% of pediatricians report that their patients have difficulty accessing pediatric dermatologists, the regions with greatest need for the specialty are not well-defined. We aimed to determine the geographic distribution of pediatric dermatologists relative to the number of children and pediatric generalists. Methods We performed a cross-sectional study of all US board-certified pediatric dermatologists, generalists (defined as pediatricians and family medicine physicians), and children in 2020. Data were obtained from the Society for Pediatric Dermatology, American Board of Pediatrics, Centers for Medicare and Medicaid, and US Census Bureau. Number of children, pediatric dermatologists, and pediatric generalists were tabulated in each county and state, and the distributions of pediatric dermatologists and generalists relative to the population of children were quantified with the Gini coefficient. Results Of 317 pediatric dermatologists, 243 (76.7%) were women and 311 (98.1%) worked in a metropolitan county. A pediatric dermatologist was present in 41/50 (82%) states and 142/3228 (4.4%) counties. Not a single pediatric dermatologist was found in 54/92 (58.7%) counties with 100 000-199 999 children, 15/53 (28.3%) counties with 200 000-499 999 children, and 4/13 (30.8%) counties with ≥500 000 children. The Gini coefficient for the state-level distribution of pediatric dermatologists relative to population of children was 0.488 compared to 0.132 for that of pediatric generalists. Conclusion There is a maldistribution of pediatric dermatologists, resulting in children with unmet dermatologic needs in nine states and 96 heavily populated counties. These results can inform initiatives to recruit pediatric dermatologists and to expand telehealth access to specific high-density areas.

Background Spitzoid neoplasms in pediatric patients pose an interesting challenge for clinicians. More data on the clinical, histologic, and molecular characteristics of these lesions are necessary to distinguish features that may portend recurrence or malignant behavior to help determine future treatment guidelines in pediatric patients. Methods Institutional Review Board approval was obtained from Children's Hospital of Wisconsin to conduct a retrospective analysis of spitzoid neoplasms. Patients with biopsied or excised spitzoid neoplasms between 01/01/2000 and 08/01/2016 were included. Pertinent clinical and histologic data were collected. Atypical, unusual, or diagnostically uncertain lesions were selected for re-review. Results 266 lesions from 264 patients were included. 243 were classified as benign (91.35%), 22 as atypical (8.27%), and 1 as spitzoid melanoma (0.38%). No clinical or histologic variables were found to be statistically significant between the benign Spitz, atypical Spitz, and spitzoid melanoma cohorts. No known deaths occurred. Conclusion Our findings highlight the extreme variability of spitzoid neoplasms clinically and histologically. Importantly, this study demonstrates that the vast majority of spitzoid neoplasms in pediatric populations are benign and supports conservative management of spitzoid lesions in children.

BACKGROUND/OBJECTIVES The representation of women among practicing dermatologists has increased over the last several decades. Here, we analyze the evolving representation of women in the Society for Pediatric Dermatology (SPD) and the Pediatric Dermatology Research Alliance (PeDRA), with particular focus on the role of women as society leaders, researchers, and annual meeting speakers. METHODS A retrospective review of SPD and PeDRA professional society leaders (SPD presidents, PeDRA co-chairs, PeDRA executive committee members), grant recipients (pilot grant recipients, team/collaborative grant recipients, William Weston Research Grant recipients), and annual meeting speakers (named lecturers at the SPD Annual Meeting, plenary lecturers at the PeDRA Annual Conference) was performed. Authors of research articles in Pediatric Dermatology were reviewed at three-year intervals from 1983 through 2019. The percentage of women among all leadership, grant, authorship, and lectureship categories was analyzed over time. RESULTS Women have represented 70% of SPD presidents since 2011 and 75% of PeDRA co-chairs since 2013. The percentage of women among first and senior authors of research articles in Pediatric Dermatology increased significantly from 1983 to 2019 (Cochran Armitage test for trend, P

Children are known to disproportionately bear the health impacts of climate change, particularly children living in impoverished areas. Owing to their developing physiology and immature metabolism, distinct exposure behaviors, and reliance on adults for care and protection, children are uniquely susceptible to the adverse effects of our warming planet. Herein, we summarize the known impacts of climate change on pediatric skin health, including its effects on atopic dermatitis, vector-borne and other infectious diseases, nutritional deficiencies, and psychodermatoses.