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Background: Cutaneous mastocytosis (CM) is a heterogeneous disease that commonly presents with skin lesions in childhood. Objective: In this study, we aimed to evaluate the clinical and laboratory test results of our patients with CM to ascertain prognostic factors by using patients' long-term follow-up results and to determine c-KIT (receptor tyrosine kinase) mutation from peripheral blood samples, which might be responsible for the etiopathogenesis of pediatric mastocytosis. Methods: The clinical observation data of 32 children who had been diagnosed with CM were retrospectively researched. Exon 8, 9, 11, 13, and 17 c-KIT gene locations were analyzed from DNA material that was obtained from peripheral blood samples of all the patients by using polymerase chain reaction analysis and automatic DNA sequencing. Results: The tryptase level was higher in patients with familial cases and in cases of patients who had gastrointestinal mediator releasing symptoms (p = 0.017, p = 0.038, respectively). The use of clarithromycin and the use of vitamin D were determined as triggers for mediator release. Hypogammaglobulinemia was found in six patients (18.8%). Indoor tobacco exposure was seen to be higher in patients not in remission than in patients in remission (59.1% and 20%, respectively) (p = 0.040). Allergic diseases were observed in 80% of patients in complete remission and 22.7% of patients not in remission (p = 0.002). Concomitant allergic diseases were found to be good prognosis markers among pediatric patients with CM. No c-KIT mutation was discovered in any of the patients. Conclusion: In this study, tobacco exposure would seem to be a barrier for remission, and concomitant allergic diseases were seen to be a good prognosis marker. Evaluation of peripheral c-KIT mutation had no diagnostic contribution among pediatric patients with CM in contrast to adults.

Behçet Hastalığı; tekrarlayan aftöz ülserler, genital ülserler ve üveit semptomlarıyla karakterize, nadir görülen bir vaskülit türüdür. Behçet Hastalığı klasik semptomlarıyla bulgu vererek ortaya çıkabildiği gibi, çevresel faktörlere bağlı yaralar sonrası da tanı alabilmektedir. Nonkommunike hidrosel nedeniyle opere edilen 16 yaşında erkek hasta postoperatif insizyonunda akıntı ve açılma nedeniyle başvurdu, yara yeri revizyonu sonrası tekrar yara yerinde açılma ve yeni ülsere alanların gözlenmesi üzerine hastada Behçet Hastalığı düşünüldü. Kolşisin tablet, lokal antibakteriyel başlanan hastanın izleminde insizyonunda iyileşme ve genital ülserlerde düzelme görüldü. Çocuk hastalarda düşük sıklıkta görülmesi ve ortaya çıkış biçimi açısından değerlendirildiğinde oldukça nadir görülmesi nedeniyle iyileşmeyen insizyon yaraları ve ülserasyonlar bulunan olgularda Behçet Hastalığı da mutlaka akılda tutulmalıdır., Behçet’s Disease (BD) is a rare vasculitic disorder that is consists of a triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis. Although BD may present with its common symptoms, it may be appeared with the delayed healing of the wounds caused by environmental factors. 16 year-old-boy operated for noncommunicating hydrocele and short period after discharging, he presented to the emergency room with the complaint of recurrent dehiscence and serous leak of incision although it revised once. After detailed investigations the patient diagnosed as BD and treated with colchicine, so that, Behçet's disease (BD) should also be kept in mind in patients with deficient wound healing, history of surgical interventions and different ulcer lesions after surgery.

Purpose: To present the clinical features of the eyelid nodules observed in a newly determined dermatologic disorder, idiopathic facial aseptic granuloma (IFAG), and to compare them with children having acute hordeolum and chalazion. Methods: Duration of the lesion, localization, presence of coexisting facial nodules, management strategies, and response time to topical/oral antibiotics were retrospectively reviewed in 50 children with IFAG, acute hordeolum, or chalazion. Results: Fourteen children with one or more IFAG nodules on their eyelids, 28 children with one or more acute hordeolum, and 8 children with one or more chalazion were examined. Children with IFAG on their eyelids and face presented earlier than children with acute hordeolum ( P = .006). The duration of this lesion was similar among patients with IFAG on their eyelids and acute hordeolum ( P = .53). Duration of the lesion and treatment response time were shorter in children with IFAG on their eyelids and face ( P = .004) than in those with IFAG on their eyelids ( P = .013). The lesions of patients with chalazion had a longer duration compared to those with IFAG on their eyelids ( P = .005), IFAG on their eyelids and face ( P < .001), and acute hordeolum ( P = .04). Twenty patients with acute hordeolum recovered after topical antibiotics and had a similar treatment response time to those with IFAG on their eyelids and face ( P = .06) and those with IFAG on their eyelids ( P = .16). Conclusions: IFAG should be considered in the differential diagnosis of painless eyelid nodules in children. Because IFAG on the eyelids has many overlapping features with hordeola/chalazia, its differentiation may be difficult in the absence of accompanying facial granulomas. Chronic subepidermal eyelid nodules resembling skin abscess should alert clinicians for IFAG. Because IFAG responds well to oral clarithromycin, unnecessary surgical interventions should be avoided in these cases. [ J Pediatr Ophthalmol Strabismus . 2016;53(4):206–211.]

Background Recurrent aphthous stomatitis (RAS) is a common oral ulcerative condition in children. The objective was to describe the clinical features of RAS in children with accompanying clinical and laboratory findings. Methods The study included 120 patients younger than 18 years of age (mean age 9.6 ± 4.3 years) with three or more oral aphthous ulcers per year between August 2008 and February 2014. Demographic characteristics of the patients, clinical features of the ulcers, and associated clinical and laboratory findings were evaluated. Results The mean number of aphthae per year was 12.8 ± 8.5 and the mean duration of the disease was 3.6 ± 2.9 years. Minor aphthae were the most common type (87%), papulopustules were the most common accompanying cutaneous lesions (13.3%), and family history of RAS was the most common associated factor (35.8%). Genital scarring (p = 0.04) and pathergy (p = 0.01) were significantly more common in the adolescent group. Pathergy was significantly related to genital scarring (p = 0.04) and Behcet's disease (p = 0.02). There was no association between the number of aphthae per year and the duration of the disease and hematologic and immunologic abnormalities. Conclusion Our study is consistent with previous reports in terms of clinical features of aphthous ulcers, related diseases, and family history of RAS, but no associated laboratory abnormalities were noted.

Langerhans cell histiocytosis is a rare non-malignant disease with clinical heterogeneity. The disease may present with various clinical findings and may imitate many other conditions. In this report we describe a 34-month-old girl who presented with chronic otitis and otorrhea, skull fracture, rash, vulvar edema, erythema and erosion in labia majors which initially suggested child abuse but the patient was diagnosed with Langerhans cell histiocytosis.

Purpose: To evaluate the frequencies of ophthalmic abnormalities in children with congenital hypothyroidism. Methods: A total of 121 patients with a history of congenital hypothyroidism, aged 1 to 216 months, were included in the study. The initial ophthalmological examinations and demographic data of patients who were examined between April 2013 and April 2015 were retrospectively reviewed. Accompanying systemic abnormalities were also noted. Results: Ophthalmic pathology was determined in 40.4% (49 of 121) of patients with congenital hypothyroidism, of which 79.5% (39 of 49) had significant refractive errors and 32.6% (16 of 49) had strabismus. Systemic abnormalities were observed in 74.3% (90 of 121) of the children, among which 47.1% (57 of 121) were congenital heart defects and 38.0% (46 of 121) were neurologic abnormalities. A high prevalence of Down syndrome (17.3%; 21 of 121) and atopic dermatitis (8.2%; 10 of 121) was detected among patients with congenital hypothyroidism. Conclusions: In addition to many associated systemic abnormalities, ophthalmic pathologies may also occur in children with congenital hypothyroidism. Thus, routine ophthalmological examination is recommended for these children, starting from the time of initial diagnosis. [ J Pediatr Ophthalmol Strabisumus . 2016;53(1):29–34.]

To the Editor: A 21-d-old infant was admitted to our ophthalmology department due to crusting of his eyelids. He was diagnosed with conjunctivitis and given a topical antibiotic treatment. His examination revealed that Pthirus pubis parasites and their nits were adherent to the eyelashes of the right eye. The lice appeared as brown or gray moving dots, whereas their white nits were observed as immobile on the eyelashes. They were about 2 mm long with a round semitransparent body and large claws that could only be seen under a microscope. Rest of the hair-bearing skin was inspected for lice and nits, but no other parasites or eggs were detected. There were no signs of infestation in either of the parents, who underwent a meticulous examination by our dermatologist. Since the most common route of infestation by pubic lice is sexual contact, the child was also examined by our neonatology department for any signs of a sexual abuse. The examination was completely normal. Shared towels, clothing, beds, or close contact by an infected person are other possible routes. The parents speculated that the baby may have been infected at a birthday party they had attended with a crowded group of relatives. Pthirus pubis and its ova have been described on eyelids in previous reports of adults and children [1–5]. Eyelid infestation by this parasite is called ‘Phthiriasis palpebrarum’ and can cause pruritus, crusting, and a clinical picture resembling blepharoconjunctivitis. It can be underdiagnosed unless a careful examination of the eyelids is done, since the lice can deeply burrow into the eyelid margin (Figs. 1 and 2). As far as Fig. 1 Phthiriasis palpebrarum. Lice and eggs observed on the eyelashes

Orf hastalığı, Parapoxvirus ailesinden Orf virüsün etken olduğu zoonotik bir enfeksiyon hastalığıdır. Koyun ve keçilerde yaygın olarak görülmektedir. Koyun, kuzu ve keçilerin ağız etrafında ve yün bulunmayan kısımlarında papülloveziküler ve kabuklanmış lezyonlara yol açar ve lezyonun kabuğundan çevreye yayılır. Küçükbaş hayvancılıkla uğraşanlarda sıklıkla ellerde nodüller ile kendini gösterir. Kendini sınırlayan ve tedavisiz iyileşen bir hastalık olmakla birlikte; akla gelmediği zaman şarbon gibi ülkemizde endemik olan diğer zoonotik hastalıklarla karıştırılabilir. Bu nedenle orf hastalığının bilinmesi, gereksiz ileri tetkik ve tedavileri engelleyecektir. Orf hastalığı kişisel hijyen önlemleri ile önlenebilen bir hastalıktır. Bu yazıda, 13 yaşındaki bir çocukta, öykü ve fizik muayene ile tanısı konulan bir orf olgusu sunuldu., Orf disease is a zoonotic infectious disease caused by the Orf virus which is a member of the Parapoxvirus family. It is commonly seen in sheep and goats. It leads to papulovesicular and crusted sores around the mouth and the parts without wool of sheep, lambs and goats. Orf disease often manifests with hand nodules in people engaged in sheep and goat husbandry. The disease is self-limited and heals without treatment. Orf disease skin lesions can be misdiagnosed as other endemic zoonotic infections such as anthrax in our country if the disorder is not considered. Knowledge of Orf disease will therefore prevent unnecessary further evaluation and treatments. Orf disease can be prevented by personal hygiene measures. In this report, a 13-year-old boy with Orf disease who was diagnosed with the history and physical examination is presented