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Introduction: Terra firma-forme dermatosis (TFFD) belongs to the group of “dirty dermatoses” and represents a not well-known and surely underestimated skin condition. Clinical cases: We present 2 cases of TFFD and present clinical and dermatoscopical findings. Results: We present specific dermatoscopical findings of TFFD. Conclusion: We propose the denomination “chromosome arms” sign for Terra firma-forme dermatosis. info:eu-repo/semantics/publishedVersion

Henoch-Schönlein purpura (HSP) represents the most common vasculitis in children. Typically, HSP manifests with palpable purpura and edema, usually following an urticarial or erythematous maculopapular eruption. Bullous HSP represents an uncommon presentation of “classic” HSP, exhibited by only 2% of affected children. We here present three cases of bullous HSP. This variant seems due to an excess of production of neutrophilic matrix metalloproteinase-9, a lytic enzyme that degrades basement membrane components, eventually leading to dermoepidermal detachment and blister formation. Notably, American College of Rheumatology (ACR), Paediatric Rheumatology European Society (PRES), European League against Rheumatism (EULAR), and Paediatric Rheumatology INternational Trials Organization (PRINTO) do not encompass blisters and/or bullae into HSP classification criteria. Outcome of bullous HSP does not differ from “classic” purpuric HSP. The former, however, demands special care measures: local pain control, topic antibiotic therapy, and protective dressings over areas of open or blistered skin. info:eu-repo/semantics/publishedVersion

nCPAP-induced nose skin injury is a common issue in NICUs all over the world. Damage may vary from simple hyperemia in the region of application of nasal cannulae up to complete destruction of the columellar region. We here report a case series of three patients displaying various grades of nasal damage, ranging from soft hyperemia to ulcerative lesions, up to complete columellar breakdown. Not only lesions with loss of substance are documented in literature; cases of post-discharge nasal vestibular stenosis and nasal synechiae obstruction are also reported. Risk factors for nCPAP-induced nasal injury include low birth weight, low gestational age, and increased time on nCPAP. Good clinical practices to prevent and treat nCPAP-induced skin damage are here briefly reviewed; strong efforts must be spent in NICU personnel education in order to enhance awareness about this topic and ensure a correct prevention. info:eu-repo/semantics/publishedVersion

A term newborn was evaluated for the presence of a lesion resembling an involuting hemangioma; dermoscopy showed some residual ectasic capillaries, consistent with the diagnosis. At 5 months, lesion appeared in further light regression, comparable to that of a classical capillary hemangioma at 2 years of life. Pediatric hemangiomas are classified into infantile and congenital hemangioma. Infantile hemangiomas typically are very pale at birth, proliferate in the first months of life and then gradually involute throughout childhood. Congenital hemangiomas are further subclassified into rapidly involuting (RICH) and non-involuting (NICH) congenital hemangioma. Recently, a new variant of RICH showing fetal involution has been described. The prominent part of the life cycle of this variant of RICH (ie, proliferation and rapid involution) seems to start prenatally, whereas regression in typical RICH usually occurs in early infancy.Our case seems to confirm the existence of such variant of RICH. info:eu-repo/semantics/publishedVersion

Evaluation of female newborn genitalia should always be carried out at pre-discharge visit in hospital nurseries in order to exclude gross malformations, potentially compatible with genetic and/or endocrine syndromes. Being aware of normal inter-individual anatomical variability of external genitalia in female newborns - as well as ethnic-related peculiarities - is important to avoid unnecessary tests, perform a correct evaluation, and reassure parents. This paper provides a small gallery of the most typical possible presentations of hymenal tags in female newborns, as encountered in our pediatric dermatology practice in the last five years. The aim of the paper is to highlight the benignity of this condition, most often autoresolutive in the first year of life, in order to prevent neonatologists and general practitioners from prescribing unnecessary tests and allow parental reassurance. info:eu-repo/semantics/publishedVersion

Pool palms is a relatively unknown entity among doctor and this may lead to its misdiagnosis. While it might look like an allergic contact dermatitis it is more related to the friction of children’s hands and feet while playing in swimming pools. A correct diagnosis can avoid expensively and potentially sensitizing diagnostic procedures such as patch testing. A new therapeutic approach is given with the idea of preventing the onset of the disease. With this report, we describe a clinical case and review the clinical data that can be useful to recognize and prevent the disease. info:eu-repo/semantics/acceptedVersion

nCPAP-induced nose skin injury is a common issue in NICUs all over the world. Damage may vary from simple hyperemia in the region of application of nasal cannulae up to complete destruction of the columellar region. We here report a case series of three patients displaying various grades of nasal damage, ranging from soft hyperemia to ulcerative lesions, up to complete columellar breakdown. Not only lesions with loss of substance are documented in literature; cases of post-discharge nasal vestibular stenosis and nasal synechiae obstruction are also reported. Risk factors for nCPAP-induced nasal injury include low birth weight, low gestational age, and increased time on nCPAP. Good clinical practices to prevent and treat nCPAP-induced skin damage are here briefly reviewed; strong efforts must be spent in NICU personnel education in order to enhance awareness about this topic and ensure a correct prevention. info:eu-repo/semantics/publishedVersion

We here present five cases of congenital melanotic lingual macules seen in our hospital. All the patients were healthy and normally thriving. A close follow-up showed that lesions were non-evolutive and allowed us to exclude malignancies. Pigmented oral lesions may show great variability in presentation, hue, number, size, and location in the oral cavity. Congenital, stable lesions generally raise less concern than acquired and/or rapidly evolving spots. As for tongue lesions, an accurate patient history and thorough head-to-toe physical examination in search for other lesions or stigmata of known syndromes is -in most cases- sufficient to exclude malignancies. Lesion excision should therefore not represent the first choice if a close clinical follow up can be established. info:eu-repo/semantics/publishedVersion

A term infant born in a resource-poor setting (Mozambique) presented with extensive disepithelization of the cranial vertex with absent underlying bony plate, disepithelization of the posterior median line, and bilateral amputation of the fifth toe. These iconic clinical features are indicative of extensive Aplasia Cutis with associated transverse limb defects, a condition known as Adams-Oliver Syndrome. Management is typically conservative; increased need for fluids, risk of electrolyte derangements and infections are possibly associated issues in the first days of life, especially in case of large lesions, and have to be carefully monitored and adequately addressed. info:eu-repo/semantics/publishedVersion

We here present a case of neonatal skin damage due to application of methylene blue (MB) on a newborn's skin. MB use should be completely eliminated in neonatal intensive care units and nurseries, because of three potentially dangerous adverse effects of this compound: (1) It may act as an irritant when applied topically on intact skin, leading to skin reddening up to deep full-thickness eschars; (2) Is possesses photosensitizing properties, and may produce skin reddening followed by blisters and peeling after UV phototherapy; (3) It is a proscribed substance in patients affected by glucose-6-phosphate dehydrogenase deficiency, a condition not easily detected in the very first days of life. info:eu-repo/semantics/acceptedVersion