Pediatric Dermatology最新文献

{"title":"Advancing Pediatric Teledermatology: Trends, Barriers, and Innovations in Access and Equity (2020-2024).","authors":"Julyssa A Renteria, Helana Ghali, Sharon E Albers","doi":"10.1111/pde.70044","DOIUrl":"https://doi.org/10.1111/pde.70044","url":null,"abstract":"<p><p>Pediatric teledermatology has rapidly expanded over the past four years, improving access to dermatologic care, particularly for under-resourced populations. This expansion has proven effective in reducing no-show rates, improving diagnostic accuracy, and enhancing treatment adherence. Store-and-forward and synchronous telehealth models have facilitated timely dermatologic care, particularly for conditions like acne and atopic dermatitis. However, disparities remain, with non-English speakers and publicly insured patients experiencing barriers to telemedicine access due to digital literacy gaps and limited access to technology. While teledermatology increases efficiency, limitations such as the inability to conduct tactile examinations and reliance on high-quality imaging continue to challenge its widespread adoption. Recent innovations, including artificial intelligence-driven diagnostics, teledermoscopy, and mobile-based platforms, have further optimized teledermatology's capabilities. Additionally, state policies and reimbursement structures significantly influence its accessibility and implementation. Ensuring equitable integration of teledermatology into routine care requires targeted interventions, including expanded bilingual technical support, digital literacy initiatives, and hybrid care models that balance remote consultations with in-person evaluations. Addressing these challenges will be essential for sustaining teledermatology's role in pediatric dermatology and optimizing its long-term impact on healthcare accessibility and equity. This review synthesizes evidence on the clinical performance, accessibility, and equity of pediatric teledermatology from 2020 to 2024, offering insight into implementation challenges and opportunities for future integration into routine pediatric practice.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sirolimus in the Management of Complex Infantile Hemangiomas: A State-of-the-Art Review.","authors":"Fabiana C P S Lopes, Moise L Levy, Jennifer S Ruth, Ginna Priola, Shoshana Greenberger","doi":"10.1111/pde.70071","DOIUrl":"https://doi.org/10.1111/pde.70071","url":null,"abstract":"<p><p>Infantile hemangiomas (IHs) are common, benign vascular tumors frequently managed with beta-blockers as first-line therapy. While most IHs respond to propranolol, a subset of severe, refractory, or life-threatening lesions requires alternative interventions. Sirolimus (rapamycin), a mammalian target of rapamycin (mTOR) pathway inhibitor, has emerged as a promising second-line treatment option for complicated IHs, particularly those with visceral involvement, airway compromise, functional impairment, or significant cosmetic consequences. This article reviews reported clinical experiences and mechanistic insights supporting the use of sirolimus in managing complex IHs and proposes a protocol to guide patient selection, dosing, and monitoring.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erythrokeratodermia-Cardiomyopathy Syndrome: Expanding the DSP Mutational Spectrum Beyond Proline Substitutions.","authors":"Sepideh Hamzehlou, Ryland D Mortlock, Caroline Echeandia-Francis, Jing Zhou, Chao Xing, Nnenna G Agim, Keith A Choate, Donald A Glass","doi":"10.1111/pde.70048","DOIUrl":"https://doi.org/10.1111/pde.70048","url":null,"abstract":"<p><p>Erythrokeratodermia cardiomyopathy (EKC) syndrome is a rare autosomal dominant disorder characterized by generalized erythrokeratoderma and progressive dilated cardiomyopathy, caused by pathogenic variants in the SR6 domain of desmoplakin (DSP). We report two cases of EKC with novel de novo missense DSP variants at phenylalanine position 590 (F590S and F590V), expanding the mutational spectrum beyond proline substitutions. Immunostaining demonstrated disrupted desmosomal protein localization. One patient showed significant clinical improvement with ustekinumab therapy. These findings underscore the need for early cardiac monitoring and support IL-12/23p40 inhibition as a potential therapeutic strategy in EKC.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Morel-Lavallée Lesion in a Pediatric Competitive Dancer: A Case Report and Literature Review.","authors":"Cameron Coakes, Kent Axcell, Andrea L Zaenglein, Timothy Hahn","doi":"10.1111/pde.70081","DOIUrl":"https://doi.org/10.1111/pde.70081","url":null,"abstract":"<p><p>Morel-Lavallée lesions (MLLs) are rare internal degloving injuries resulting from shearing trauma, with few reported cases in the pediatric population. We present the case of a 16-year-old female competitive dancer with persistent right knee pain, skin atrophy, and ecchymosis after trauma sustained during a national dance competition, with MRI demonstrating a loculated fluid collection consistent with an MLL. MLLs in children pose significant diagnostic challenges due to their non-specific symptoms overlapping with other musculoskeletal, autoimmune, and dermatological conditions. This case underscores the importance of early recognition and multidisciplinary management of MLLs in pediatric athletes to prevent misdiagnosis and facilitate timely treatment.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Series of Deep-Seated Pyogenic Granulomas in Pediatric Patients.","authors":"Fiore Casale, Paula North, Yvonne E Chiu, Robert Chun, Stephen R Humphrey, Leah Lalor, Matthew Plunk, Valerie Carlberg","doi":"10.1111/pde.70012","DOIUrl":"https://doi.org/10.1111/pde.70012","url":null,"abstract":"<p><p>Deep-seated pyogenic granulomas (DSPG) are a rare variant of pyogenic granulomas and are commonly mistaken for other entities. Often, DSPG present as blue papulonodules without ulceration, and their clinical and histologic appearance can mimic other common subcutaneous nodules seen in pediatric patients, including hemangiomas, venous malformations, pilomatricomas, and kaposiform hemangioendotheliomas. Herein, we describe the clinical and histologic features of six pediatric cases of DSPG, as the clinicopathologic correlation of DSPG is scarce in the literature, especially in pediatric patients.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Cutaneous Alternaria Infection Secondary to Cooling Measures in Pediatric Erythromelalgia.","authors":"Koral Cohen, Vikash Oza, Gail F Shust, Vijaya Soma, Jinpu Li","doi":"10.1111/pde.70023","DOIUrl":"https://doi.org/10.1111/pde.70023","url":null,"abstract":"<p><p>Primary erythromelalgia (PEM) is a rare neuropathic pain disorder characterized by debilitating burning pain of the extremities relieved by cold exposure. We report a pediatric patient who developed severe, full-thickness lower extremity ulcerations infected with Alternaria alternata and complicated by osteomyelitis following consistent direct skin cooling with window air conditioning. This case demonstrates serious infectious complications that can arise from cooling measures commonly employed for PEM symptom relief.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Comorbidities and Quality-of-Life Burden in Pediatric Patients With Vitiligo: A Systematic Review and Meta-Analysis.","authors":"Nawar Tarafdar, Meghna Varambally, Elena Pope, Joseph M Lam, Chaocheng Liu","doi":"10.1111/pde.70066","DOIUrl":"https://doi.org/10.1111/pde.70066","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo is an autoimmune condition that causes depigmented skin patches, often leading to challenges such as stigma, bullying, and poor self-esteem in pediatric populations. These challenges may contribute to psychiatric comorbidities and impaired quality of life (QoL). Pediatric-specific data remain limited.</p><p><strong>Objectives: </strong>To synthesize current evidence on psychiatric comorbidities and QoL outcomes in pediatric vitiligo and identify factors associated with increased psychosocial burden.</p><p><strong>Methods: </strong>PubMed, Embase, and MEDLINE were systematically searched through March 15, 2025, for primary English-language studies involving patients aged 0-18 years with vitiligo and validated psychiatric or QoL outcomes. Study quality was assessed using Oxford Centre for Evidence-Based Medicine Levels of Evidence. Meta-analyses were performed where possible, with 95% confidence intervals and I² for heterogeneity. Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation framework.</p><p><strong>Results: </strong>Fourteen studies (n = 1576) were included. Pooled means for depression (CDI: 9.93) and anxiety scores (STAI-State: 37.07; STAI-Trait: 38.27) did not exceed thresholds for probable clinical diagnosis, though heterogeneity was considerable. Pooled means for QoL burden (CDLQI: 3.00; PedsQL: 80.55) suggested mild-to-moderate QoL impairment. Multiple individual comparative studies reported greater psychiatric symptom burden and higher prevalence of depression and anxiety among vitiligo patients versus controls. Subgroup findings from selected studies also suggested worse QoL in adolescents and those with extensive or visible lesions.</p><p><strong>Conclusions: </strong>Pediatric vitiligo is associated with elevated psychiatric comorbidity prevalence, symptom burden, and mild-to-moderate QoL impairment among included studies. These findings highlight the need for clinicians to integrate psychosocial assessment into routine care. Current evidence further emphasizes incorporating routine mental health screening and multidisciplinary support into pediatric dermatology practice for children with vitiligo, although conclusions are restricted by limited and heterogeneous data.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Newborn With a Red-Brown Nasal Mass.","authors":"Neel S Raval, Bryan A Sisk, D Ashley Hill, David S Leonard, Carrie C Coughlin","doi":"10.1111/pde.70046","DOIUrl":"https://doi.org/10.1111/pde.70046","url":null,"abstract":"","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Ulcerating Infantile Hemangioma Responsive to Propranolol: A Case and Literature Review.","authors":"Nicole Schiraldi, Richard Rookwood, Mena Salman, Haley Heibel, Julia Gittler","doi":"10.1111/pde.70077","DOIUrl":"https://doi.org/10.1111/pde.70077","url":null,"abstract":"<p><p>Ulceration is the most common complication of infantile hemangiomas (IHs) and typically occurs during the early proliferative phase in the first few months of life. We present a case of a 13-month-old female with a previously stable mixed-type IH on the left abdomen that developed a painful ulceration at 12 months. The ulceration responded rapidly to oral propranolol and resolved completely without recurrence. This case highlights late ulceration in IHs, supports the potential efficacy of propranolol beyond the proliferative phase, and is accompanied by a focused review of the literature on late-ulcerating presentations.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Prepubertal-Onset Vulvar Lichen Sclerosus.","authors":"Alexandra Savage, Vera Y Miao, Gayle Fischer, Matthew Merriman, Kylie-Ann Mallitt, Rebecca B Saunderson","doi":"10.1111/pde.70056","DOIUrl":"https://doi.org/10.1111/pde.70056","url":null,"abstract":"<p><strong>Background: </strong>Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis affecting the vulvar and perianal skin. VLS has a bimodal age of onset, in pre-pubertal and post-menopausal age groups. Long-term outcomes of pre-pubertal VLS are unclear. This study aimed to establish the long-term disease activity, factors that influence disease progression, and the physical and psychological complications of pediatric VLS persisting into adulthood.</p><p><strong>Methods: </strong>A cohort study was conducted in women diagnosed with VLS pre-menarche. A retrospective chart review of 135 case records was completed. The remaining data collection occurred prospectively through (i) study questionnaires, including quality of life as assessed by the Vulvar Quality of Life Index (VQLI), and (ii) dermatologist assessments.</p><p><strong>Results: </strong>Of 135 patients screened, 68 were included. The mean age of diagnosis was 7.5 years, and the mean duration of follow-up was 12.8 years. 62% of cases achieved remission. Of patients who were adherent to treatment, 92.3% achieved remission, compared to 56.6% of patients who were non- or partially adherent. Adherence declined from menarche into early adolescence. Patients who were adherent had 60% fewer structural abnormalities. In addition, VQLI scores indicated significantly better quality of life with adherence (mean = 1.6/45) compared to partially or non-adherence (mean = 5.2/45).</p><p><strong>Conclusions: </strong>This study informs clinicians of the long-term prognosis of VLS diagnosed pre-pubertally: 62% of patients achieved remission, and the rates of remission were higher in those who adhered to treatment. Structural changes and scarring were reduced in those who adhered to treatment.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}