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This case report describes significant longitudinal ridging and nail plate crumbling on several of a patient’s fingernails.

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.

Case Presentation A 68-year-old man developed an erythematous, papular, pruritic rash on his right thigh 1 month prior to presentation. It subsequently spread to his other extremities and trunk. He also endorsed fevers of > 38.3°C, night sweats, fatigue, shortness of breath, and a dry cough. He was prescribed triamcinolone 0.1% cream for his rash and azithromycin for presumed community-acquired pneumonia, with no improvement in symptoms. He had a history of relapsing polychondritis for which he was prescribed infliximab and low-dose prednisone. He had never smoked tobacco, did not use alcohol or illicit substances, and had no significant travel history.

The October 2018 report from the United Nations Intergovernmental Panel on Climate Change predicts significant threats to human health secondary to anthropogenic global warming; children have been and will continue to be disproportionately affected by these weather-related changes. Multiple physician groups have acknowledged climate change as a public health issue, calling upon providers to educate their communities about this looming health crisis while also reducing their individual carbon footprints. A significant body of literature has also documented the adverse dermatologic consequences of a warmer planet, highlighting the importance of pediatric dermatologists in addressing climate change. Here, we summarize the rationale for the pediatric dermatologist as public health advocate, providing specific actionable items through which our specialty can positively address the climate change crisis and in turn protect the health of our patients now and in the future.