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Diapering practices vary among different countries from the use of cloth diapers to the modern disposable diaper. In the last few decades, diaper technology has advanced significantly thus decreasing the prevalence of diaper dermatitis. Recent innovative techniques used in the manufacturing of diapers include incorporation of superabsorbent polymer gel that can absorb 30 times its weight in liquid. Recently, smart diapers have been developed which not only prevents diaper dermatitis but significantly has reduced the burden on parents. This article reviews how changes in disposable diaper technology have improved diapering practices.

Topical corticosteroid has been used in treatment of various skin disorders from several decades. There are lots of misconceptions among caregivers and parents regarding the use and its adverse effects which have led to steroid phobia. Topical corticosteroid can be used safely in children at the appropriate dose and duration but if misused can lead to local and systemic side effects. Hence it should be carefully prescribed with proper indications and after a thorough counseling to parents regarding application and importance of adherence.

Childhood onset systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. Subacute cutaneous lupus erythematosus (SCLE) is a rare subtype of juvenile onset SLE. Renal involvement is seen in 50–70% of cases of SLE in children and could be the initial presenting clinical feature in many cases. Here we present a child with lupus nephritis who later developed skin lesions suggestive of SCLE.

Sjogren-Larsson syndrome (SLS) is a rare autosomal recessive disorder characterized by triad of congenital ichthyosis, spastic paresis, and mental retardation. It is an inborn error of lipid metabolism caused by deficiency of the enzyme fatty aldehyde dehydrogenase. We report our observations of six children with SLS.

Congenital cutaneous candidiasis (CCC) is an uncommon disease affecting newborns which manifests within first 6 days of life following an ascending infection from birth canal or as transplacental infection. Diagnosis is challenging due to its varied clinical manifestation ranging from mild asymptomatic illness to fatal disseminated disease. We describe a full-term newborn child with CCC with dissemination born to mother with vaginal candidiasis, positive for Candida ciferri by fungal culture. This highlights the importance of maternal history of vaginal discharge during pregnancy to diagnose and prevent neonatal disseminated infection which further aids for adequate early treatment to prevent subsequent mortality.

Blue rubber bleb nevus syndrome (BRBNS) is a rare vascular disorder with multiple haemangiomas in the skin, gastrointestinal tract and other visceral organs often associated with fatal bleeding and anaemia. We report a 13-year-old female child with multiple haemangiomas on skin and gastrointestinal tract with refractory anaemia. Awareness of this entity is necessary to prevent complications.

Marie-Unna type of hereditary hypotrichosis is a rare autosomal dominant disorder that has a distinctive type of hair loss pattern that varies with child's age. It is characterized by sparse or absent hair at birth with regrowth of coarse, wiry twisted hair from childhood, followed by progressive loss on approaching puberty. We report a 12-year-old male child with characteristic clinical features suggestive of hereditary hypotrichosis of Marie-Unna type.

Bathing suit ichthyosis (BSI) is a rare, autosomal recessive form of congenital ichthyosis. The phenotypic expression of this unique form of ichthyosis is limited to the involvement of bathing suit area owing to the temperature-sensitive mutation of transglutaminase 1 gene. Lack of Indian literature of this rare condition made us to report three cases of BSI in healthy female children who presented with ichthyotic scales on the trunk since birth with sparing of extremities.

Linear verrucous hemangioma (VH) is a rare congenital disorder of vascular malformation characterized by the presence of verrucous and vascular plaques or nodules arranged in a linear array. Clinically, the closest differential includes angiokeratoma which can be differentiated based on histopathology. We herein report a case of linear VH in a pediatric age group.

To study the frequency and clinical pattern of vesiculobullous disorders in children. A retrospective chart review of all children diagnosed with vesiculobullous disorders over a period of 36 mo from January 2011 through December 2013 was performed. All children 18 y and below were included in the study. A total of 213 children presenting with vesiculobullous lesions were examined during the study period. Vesiculobullous disorders constituted 3.6 % of the total 5889 dermatoses seen during this period. The most common vesiculobullous disorder in children was infections (129, 60.6 %), followed by genodermatoses (35, 16.4 %), inflammatory disorders (33, 15.5 %), drug reaction (7, 3.3 %) and trauma (5, 2.3 %). Autoimmune and metabolic disorders constituted 1.4 % (three children) and 0.5 % (one child) respectively. This study highlights the varied spectrum of vesiculobullous disorders seen in the pediatric population. Cutaneous infections and inherited disorders were the most common disorders observed in the present study.

Neurocutaneous melanosis is congenital melanocytic nevus with neurological manifestations. We report a 4-year-old female child presenting with hyperpigmented and nodular skin lesion associated with developmental delay and convulsions. The child had multiple brownish-black nevi on the face and chest and giant melanocytic nevi on thoraco-abdomen, back, and gluteal region. Computed tomography scan of the brain showed calcification in the pons, right cerebellar hemisphere, and left medial temporal lobe. Skin biopsy done from nodular hyperpigmented site was suggestive of melanocytic nevi. Electroencephalogram showed multifocal epileptiform discharges.

Chromoblastomycosis is a chronic granulomatous infection of the skin and subcutaneous tissue caused by specific group of dematiaceous fungi. The infection results from traumatic injury and is seen more commonly on feet and lower legs. It is rarely seen in children and metastatic spread to other systems is exceptionally rare. We report a 12-year-old immunocompetent male child diagnosed with chromoblastomycosis on the lower leg, who in a span of few months developed osteomyelitis and left hemiparesis. Fungal culture showed growth of Exophiala spinifera. Child showed good improvement with voriconazole and itraconazole after 1 year of treatment. Skin lesions healed with minimal scarring and his power improved.

Food allergy in atopic dermatitis (AD) is debatable from decades. Role of diet in the cause and treatment of AD is controversial and is not well-defined. Allergists and pediatricians are convinced about the food allergy in AD whereas many dermatologists are contrary for this. However, there are studies in the Indian and western literature supporting the evidence that elimination diet may improve the severe type of AD. There is increasing awareness and lot of misconception among caregivers about food allergy and hence careful understanding about this concept is necessary to counsel parents. Recent evidence-based literature suggests avoidance of proven food allergens in AD could be beneficial in moderate to severe type of AD.

Erythrokeratodermia variabilis (EKV) are a rare heterogeneous group of inherited cornification disorders. They are characterized by two distinct morphological types of skin lesions: Fixed hyperkeratotic plaques and sharply marginated, pruritic, and migratory erythematous lesions. We report three cases of EKV along with a review of literature.

Pigmentary mosaicism is a spectrum of disorders characterized by dyspigmentation along the lines of blaschko and other patterns such as phylloid, checkerboard and patchy pigmentation without midline separation. This group of disorders may be associated with or without systemic abnormalities. Pigmentary mosaicism includes hypomelanoses of Ito, linear and whorled nevoid hypermelanosis, phylloid hypo- and hypermelanosis and pigmentary mosaicism of both hypopigmented and hyperpigmented type. We describe a case of pigmentary mosaicism with constellation of multiple extracutaneous abnormalities.

Netherton syndrome is a rare symptom complex characterized by an ichthyotic skin disorder, greatly elevated IgE levels with atopic manifestations, and characteristic hair shaft abnormalities. We report a 2-year-old male child, who presented with erythroderma, increased serum IgE levels, and trichorrhexis nodosa which can be easily misdiagnosed as psoriatic erythroderma.

Background A 50-year-old male was diagnosed to have a right eye sclerouveitis and left eye granulomatous anterior uveitis due to Hansen's disease. We are reporting the anterior segment optical coherence tomography (ASOCT) findings of iris granuloma in this case. Findings Skin biopsy revealed plenty of acid fast bacilli with a bacteriological index of 5 suggestive of multibacillary polar lepromatous leprosy. ASOCT revealed well-demarcated smooth-surfaced nodular lesion with internal hyporeflectivity corresponding to the areas of granuloma which decreased in size following treatment with antileprosy drugs and systemic and topical steroids. Conclusion ASOCT is a non-invasive technique to assess the extent of involvement of anterior segment in Hansen's disease and is a useful tool in follow-up. This is also the first report on ASOCT findings of iris granuloma in Hansen's disease.