Varshita Chirumamilla, Rachel E Tao, Leah Lalor, Alexis J Gumm
{"title":"Is It Hepatotoxicity? Isolated AST Elevation During Isotretinoin Therapy in an Adolescent.","authors":"Varshita Chirumamilla, Rachel E Tao, Leah Lalor, Alexis J Gumm","doi":"10.1111/pde.70348","DOIUrl":"https://doi.org/10.1111/pde.70348","url":null,"abstract":"<p><p>This report describes a 14-year-old female undergoing isotretinoin therapy for severe acne who developed a persistent isolated elevation of aspartate aminotransferase (AST) with normal alanine aminotransferase (ALT), creatine kinase (CK), triglycerides, and no systemic or gastrointestinal symptoms. A focused evaluation, including medication and alcohol history review, complete blood count (CBC), and muscle and hepatic markers, showed no evidence of clinically significant hepatic, muscular, or hematologic abnormalities. Given the stable isolated pattern and reassuring workup, isotretinoin was continued without interruption, and the findings were most consistent with a benign macro-AST phenomenon. This case highlights a structured approach to isolated AST elevation during isotretinoin therapy and supports consideration of macro-AST after appropriate evaluation and exclusion of alternative causes.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840599","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}
Amy S Paller, Alan D Irvine, Eulalia Baselga, Marlies de Graaf, Elaine C Siegfried, Michael J Cork, Michele Ramien, Lawrence F Eichenfield, Bryan Adams, Rajan Gupta, Marius Ardeleanu, Annie Zhang
{"title":"Growth Assessment in Children Under 12 Years With Moderate-to-Severe Atopic Dermatitis Included in the PEDISTAD Observational Registry.","authors":"Amy S Paller, Alan D Irvine, Eulalia Baselga, Marlies de Graaf, Elaine C Siegfried, Michael J Cork, Michele Ramien, Lawrence F Eichenfield, Bryan Adams, Rajan Gupta, Marius Ardeleanu, Annie Zhang","doi":"10.1111/pde.70335","DOIUrl":"https://doi.org/10.1111/pde.70335","url":null,"abstract":"<p><strong>Background/objective: </strong>The multifactorial disease burden of moderate-to-severe atopic dermatitis (AD) may affect children's growth. We report height, weight, and body mass index (BMI) of children under 12 years old with moderate-to-severe AD in comparison to the general population.</p><p><strong>Methods: </strong>This was a cross-sectional analysis of enrollment data from PEDISTAD, a global real-world observational study of pediatric patients < 12 years old with moderate-to-severe AD.</p><p><strong>Results: </strong>Among the 1329 children with moderate-to-severe AD, 72% of male children 5 to < 12 years were below the 50th percentile for height, as were 53% of females in this age group. In contrast, the weight of children 5 to < 12 years was above the 50th percentile in 56% of males and 52% of females, resulting in above-average BMI values. In the 0 to < 5 years old age groups, height and weight were above the 50th percentile for 59% and 50% of female children, and 52% and 42% of male children, respectively.</p><p><strong>Conclusions: </strong>This real-world observational study showed in children 5 to < 12 years old with moderate-to-severe AD that the average height was lower than the US 50th percentile, with a more pronounced reduction in male children. Additionally, higher weight and, as a result, higher BMI were observed in the children included in this analysis.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03687359.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796498","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}
Adrienne Conza, Racquel A Bitar, Fiona H Lynch, Pierre-Olivier Grenier, Elena B Hawryluk, Sarah E Servattalab
{"title":"Hepatitis B Immunity in Children on Immunomodulators: Implications From a Pediatric Dermatology Cohort and Review of the Literature.","authors":"Adrienne Conza, Racquel A Bitar, Fiona H Lynch, Pierre-Olivier Grenier, Elena B Hawryluk, Sarah E Servattalab","doi":"10.1111/pde.70337","DOIUrl":"https://doi.org/10.1111/pde.70337","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aims to determine the level of hepatitis B virus (HBV) immunity in patients who had HBV serologic testing prior to starting immunomodulatory medication for dermatologic conditions at a single institution and to review evidence on waning immunity, serologic interpretation, and revaccination.</p><p><strong>Methods: </strong>We performed a retrospective chart review of pediatric and young adult patients initiated on immunomodulatory therapy for dermatologic conditions who had HBV serologic testing prior to initiation. A focused literature review was conducted on durability of HBV immunity, HBV serologies in the context of immunomodulatory medications, and revaccination recommendations.</p><p><strong>Results: </strong>In this cohort of 23 children, roughly 40% lacked HBV serologic immunity. Prior studies demonstrated that antibody-mediated protection is heterogeneous and anti-HBs titers decline over time. Existing guidelines are largely derived from adult populations. Evidence regarding revaccination strategies is mixed. Notably, absence of detectable anti-HBs antibodies does not always equate to loss of immune memory or susceptibility to infection.</p><p><strong>Conclusions: </strong>Anti-HBs titers are variable and wane over time. Experts agree that patients should receive all recommended vaccinations before starting immunomodulatory therapy and be screened for HBV beforehand, based on adult guidelines. It is uncertain how well these recommendations apply to children, who generally have lower HBV risk and prevalence. Guidance is needed on how to manage pediatric patients without serologic evidence of HBV immunity before beginning biologic treatments.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796512","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}
Racquel A Bitar, Tatiana F Abrantes, Holly Neale, Birgitta A R Schmidt, Ingrid M Ganske, Elena B Hawryluk
{"title":"Much Ado About a Mutation: Congenital Melanocytic Nevus With LINC00518 and Preferentially Expressed Antigen in Melanoma Positivity.","authors":"Racquel A Bitar, Tatiana F Abrantes, Holly Neale, Birgitta A R Schmidt, Ingrid M Ganske, Elena B Hawryluk","doi":"10.1111/pde.70341","DOIUrl":"https://doi.org/10.1111/pde.70341","url":null,"abstract":"<p><p>Small and medium sized congenital melanocytic nevi (CMN) have an overall low risk of malignant potential. This case demonstrates a pediatric patient with a small CMN positive for LINC00518 (LINC) and preferentially expressed antigen in melanoma (PRAME) on a non-invasive molecular test not yet validated in children. Although her nevus had not evolved, the availability of a molecular test and curiosity ultimately raised concern about this otherwise reassuring, stable CMN. This demonstrates the pitfalls of non-invasive testing in pediatric patients with CMN.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796501","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}
Katharina W Horn, Jessica S Hathaway, Jason E Zucker, Maria C Garzon, Brandon T Cunnane, Kimberly D Morel, Laura E Levin, Gregory J Berry, Christine T Lauren
{"title":"Staphylococcal Scalded Skin Syndrome Often Does Not Require Empiric Coverage for Methicillin Resistance.","authors":"Katharina W Horn, Jessica S Hathaway, Jason E Zucker, Maria C Garzon, Brandon T Cunnane, Kimberly D Morel, Laura E Levin, Gregory J Berry, Christine T Lauren","doi":"10.1111/pde.70279","DOIUrl":"10.1111/pde.70279","url":null,"abstract":"<p><p>Staphylococcal scalded skin syndrome (SSSS) requires empiric anti-staphylococcal antibiotic management, selected based on regional rates of resistance. We report a retrospective chart review of the 58 patients diagnosed with SSSS through dermatology consult in our pediatric emergency department between 2015 and 2024. Only one patient had methicillin-resistant bacteria isolated on superficial bacterial culture, despite antibiogram data from our pediatric emergency department demonstrating methicillin resistance in 39.5%-46.8% of overall isolates growing Staphylococcus aureus. When selecting empiric antibiotic management for SSSS, providers should consider that institutional rates of MRSA in SSSS may differ from overall MRSA rates.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679565","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}
Moira Shea, Milie M Fang, Liza Kenny, Melinda D Wu, Tracy Funk
{"title":"Oral Sirolimus Treatment for HRAS-Related Epidermal Nevus Syndrome.","authors":"Moira Shea, Milie M Fang, Liza Kenny, Melinda D Wu, Tracy Funk","doi":"10.1111/pde.70339","DOIUrl":"https://doi.org/10.1111/pde.70339","url":null,"abstract":"<p><p>This is the case of a 10-year-old female with HRAS-related epidermal nevus syndrome with extensive and severe cutaneous involvement treated with oral sirolimus. The patient had progressively enlarging verrucous periorbital plaques involving the eyelids, resulting in lagophthalmos and threatening vision. Oral sirolimus rapidly improved the cutaneous lesions and resolved the lagophthalmos. This case of a patient treated with oral sirolimus for HRAS-related epidermal nevus syndrome suggests that therapies targeting the mTOR pathway may indirectly affect the RAS/MAPK pathway.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685612","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":"DTaP-IPV Vaccination-Induced Granuloma Diagnosed With Multi-Virus/Microbial Real-Time PCR.","authors":"Hiroshi Hayashi, Yuto Otsubo, Kentaro Matsuoka, Yuho Horikoshi, Harutaka Katano, Yuki Yuza","doi":"10.1111/pde.70333","DOIUrl":"https://doi.org/10.1111/pde.70333","url":null,"abstract":"<p><p>Vaccination-induced granuloma is a common clinical diagnosis, but few reports have described the diagnostic utility of comprehensive pathological and microbiological examinations. This report details a case of DTaP-IPV vaccination-induced granuloma where the use of multi-virus/microbial real-time polymerase chain reaction (PCR) enabled a definitive molecular diagnosis. This advanced testing method confirmed the presence in the excised tissue of Bordetella pertussis and poliovirus genes from the vaccine components, a novel finding for this type of lesion. In cases requiring a definitive diagnosis, especially those where malignancy is a differential, surgical excision followed by multiplex PCR testing is a reliable option.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685607","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":"Association Between Infantile Atopic Dermatitis and Mother-to-Infant Bonding Disorder: A Cross-Sectional Study.","authors":"Sawako Kamo, Takahiro Tabuchi, Daisuke Nishi","doi":"10.1111/pde.70312","DOIUrl":"https://doi.org/10.1111/pde.70312","url":null,"abstract":"<p><strong>Background/objectives: </strong>Mother-to-infant bonding disorder (MIBD) can hugely impact the relationship between mothers and infants, maternal mental health, and child development. Although infantile atopic dermatitis (AD) is known to influence caregivers' quality of life and mental health, its effect on MIBD is not fully understood. This study examined the association between MIBD and infantile AD using data from 4236 postpartum women from a cross-sectional nationwide survey: the Japan COVID-19 and Society Internet Survey (JACSIS).</p><p><strong>Methods: </strong>We assessed MIBD using the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J), the presence of infantile AD based on maternal perception (reported AD: R-AD) and physician's diagnosis (diagnosed-AD: D-AD), and participants' demographics. To assess the association between MIBD and infantile AD, we conducted a modified Poisson regression with robust error variance that provided relative risks (RRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The prevalence of MIBD was about 24.2% (n = 1024). Whether infantile AD was R-AD (RR = 1.22, 95% CI: 1.07-1.40) or D-AD (RR = 1.41, 95% CI: 1.18-1.69), its presence was significantly associated with a higher RR for MIBD. Furthermore, we found that infantile AD was associated with a higher RR for Anger and Rejection, a subscale of the MIBS-J.</p><p><strong>Conclusions: </strong>This study showed that infantile AD is a potential risk factor for MIBD. Further studies should investigate the link between infantile AD and MIBD and determine effective support for mothers and infants with AD.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674063","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":"Chasing Ghosts in Pediatric Dermatology: Provider-Directory Inaccuracy and Medicaid Access for Children With Skin Disease.","authors":"Martha-Grace McLean","doi":"10.1111/pde.70329","DOIUrl":"https://doi.org/10.1111/pde.70329","url":null,"abstract":"","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670373","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}