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Background: Dermatologists, paediatricians, and general practitioners are often consulted by worried parents for the evaluation of a cutaneous tumor. Methods: Selective literature review. Results: Only 1-2% of skin tumors excised in children turn out to be malignant when examined histologically. Warning signs of malignancy include rapid growth, firm consistency, diameter exceeding 3 cm, ulceration, a non-movable mass, and presence in the neonatal period. The more common malignant skin tumors in adults-basal cell carcinoma, cutaneous squamous cell carcinoma, and melanoma-are very rare in childhood. Congenital melanocytic nevi and sebaceous nevi bear a lower malignant potential than previously believed; nevertheless, their excision is often indicated. A Spitz nevus can mimic a melanoma both clinically and histologically. Some benign skin tumors of childhood tend to regress spontaneously within a few years but may cause complications at particular locations and when multiple. For infantile hemangiomas requiring systemic treatment because of imminent obstruction or ulceration, propranolol seems to have a far more favorable risk-benefit ratio than corticosteroids. Conclusion: Physicians need specialized knowledge in order to decide whether a skin tumor in a child should be excised, non-surgically treated, or further evaluated, or whether it can be safely left untreated because of the likelihood of spontaneous remission. [ABSTRACT FROM AUTHOR]

Background: The prevalence of psoriasis vulgaris in childhood ranges from 0.12 % in infants to 1.2 % in adolescents. Psoriasis is a polygenic disease triggered by external factors and is influenced by comorbidities such as obesity, metabolic syndrome, chronic inflammatory bowel diseases and rheumatic diseases., Clinical Features: Its clinical presentation is variable. Typical complications include erythroderma, disseminated pustulosis and arthropathy., Therapy: Amongst a wide range of topical or systemic therapeutical options, individualized treatment is based on severity, site and extent of cutaneous involvement, age, potential side-effects and comorbidities.

Background: Typhoid and paratyphoid infections (STP) are an important differential diagnosis for Salmonella enteritidis infections (NTS). The aim of this study is to carve out clinical differences between both infections., Patients/methods: We retrospectively reviewed all patients admitted to our hospital between 2007 and 2011 with a diagnosis of STP infection. History, clinical course and laboratory findings were compared with age-matched patients suffering from NTS., Results/discussion: All patients with an STP-infection showed had a positive travel history (as compared to 11.1% in the NTS group, p<0.01). Salmonella were mostly isolated from blood cultures (n=7/9) in the STP group as compared to 1/16 in the NTS group, where S. enteridis was mainly isolated from faecal cultures (p<0,01). The duration and height of fever as well as the time of hospitalization were significantly longer with STP infections than with NTS infections. Eosinopenia was observed both in STP-(100%) and NTS-infections (77.8%)., Conclusion: A positive travel history is crucial to the identification of a STP infection, as well as an eosinopenia., (© Georg Thieme Verlag KG Stuttgart · New York.)

While the impact of obesity on diabetes, cardiovascular disease and carcinoma development has been studied extensively, only little attention has been paid to its influence on the skin. Obesity alters the skin barrier, can induce skin manifestations, and worsens existing skin diseases like psoriasis. Cutaneous manifestations of obesity may be pseudoacanthosis nigricans, fibroma pendulans (skin tags, fibroepithelial polyps) and striae distensae. Obesity is also associated with hyperandrogenism in women and girls, promoting acne vulgaris, hirsutism, and androgenetic alopecia. In addition, there is a pathogenic association between obesity and psoriasis: the release of pro-inflammatory factors from fat tissue results in the worsening of psoriasis; an association between the severity of psoriasis and the body mass index has been shown. Obesity promotes skin infections like erysipelas and intertrigo.

With a prevalence of 10–12% infantile hemangiomas (IH) represent the most common skin tumor in infancy. They are characterized by a sequence of growth and, in 90%, spontaneous regression. Special manifestations of IH include hemangiomatosis, congenital hemangioma (RICH/NICH), reticular and segmental hemangiomas (PHACE, PELVIS/SACRAL syndrome). The latter represent a transition between vascular tumor and vascular malformation. Important differential diagnoses of IH include pyogenic granuloma (PG) and hemangioendothelioma (HAE) of which PG is a common, benign vascular tumor with a predilection for the facial region and a proneness to bleed whereas HAE is a slowly growing tumor exhibiting infiltrative growth; unlike IH it is associated with the Kasabach-Merritt syndrome of consumptive coagulopathy. The majority of IHs do not require therapy, however, therapy is absolutely indicated for ulcerating or obstructive IH where propranolol is considered the first-line therapy. Non-obstructive facial IH represents a relative indication for therapy. Cryotherapy is most suitable for IH with diameters below 1 cm and a depth < 4 mm.

Cutaneous infections in children and adolescents with cancer are frequently associated with a marked morbidity and mortality. Particularly neutropenic patients undergoing intensive cytostatic therapy or after allogenic stem cell transplantation are affected. In this group of patients, atypical manifestations of infectious skin disease are frequently observed which represent a diagnostic challenge. It is therefore essential for clinicians to be familiar with the clinical presentation, diagnostic methods and management of skin infections encountered in pediatric oncology.

A 12 year old boy developed scars at light-exposed areas following long-term therapy with naproxen for rheumatoid arthritis. Erythrocyte and urine porphyrin levels were not increased, and there was no evidence of increased photosensitivity. Pseudoporphyria is reported in 10-20% of those treated with naproxen for > 4 weeks. As compared to other nonsteroidal anti-inflammatory agents, the specific risk for naproxen is increased about 6fold. While the underlying abnormality has not been elucidated, formation of phototoxic metabolites in a subgroup of genetically predisposed individuals has been suggested as the most likely mechanism. Both dermatologists and rheumatologists should be aware of the risk of naproxen-induced pseudoporphyria and discontinue therapy early in order to avoid scar formation in light-exposed areas.

Worldwide tourism is an increasing industry. One result of this phenomenon is the occurrence of imported infectious diseases, as recently observed even in Germany. Leprosy ranks high among dreaded infectious diseases from tropical and subtropical countries. It remains a major health threat despite marked improvements in diagnosis and therapy. This was achieved by a better understanding of bacteriological and immunological mechanisms over the past decades, resulting in a decline of Leprosy's incidence.