Pediatric Dermatology最新文献

{"title":"Changes in Skin Barrier Function in Neonates: Daily Variation and Impact of Bathing.","authors":"Fumi Tanaka, Chiemi Hayashi, Mayumi Iida, Kimika Shinya, Masaki Futamura","doi":"10.1111/pde.15772","DOIUrl":"https://doi.org/10.1111/pde.15772","url":null,"abstract":"<p><strong>Background: </strong>The skin barrier function is an important predictor of neonatal barrier defects. This study aimed to investigate the daily changes in skin barrier function and the impact of bathing on skin barrier function in neonates.</p><p><strong>Methods: </strong>We assessed the transepidermal water loss (TEWL) and stratum corneum hydration (SCH) on the forehead, cheek, volar forearm, and chest from days 2 to 7 and at 1 month after birth. Additionally, we measured the values after bathing and compared them with the pre-bathing values.</p><p><strong>Results: </strong>Sixty-six neonates were involved in the assessment, and each value at the four sites showed significant correlations. TEWL remained stable between days 2 and 7, but SCH significantly increased at most sites. Both significantly increased by 1.5-2 times in 1 month. After bathing, TEWL increased by more than 20% but decreased again after 3 h.</p><p><strong>Conclusions: </strong>TEWL did not change significantly with age during the first week of life. To minimize the effects of bathing, TEWL should be measured at least 3 h after bathing.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472019","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 in Pediatric Trichotillomania: A Multicenter Cohort Study.","authors":"Margaux Games, Zane Sejdiu, Erum N Ilyas","doi":"10.1111/pde.15791","DOIUrl":"https://doi.org/10.1111/pde.15791","url":null,"abstract":"<p><strong>Background: </strong>Trichotillomania (TTM) significantly increases the risk of psychiatric comorbidities. Sparse research in pediatric populations necessitates larger studies to assess these risks. This study investigates the risk of developing psychiatric comorbidities in pediatric TTM patients.</p><p><strong>Methods: </strong>This case-control study assessed pediatric patients (< 18 years old) with TTM diagnosed between May 18, 2013, and January 1, 2024, using US-based data from the TriNetX global research network. TTM patients (ICD-10 diagnostic category F63.3) aged 18 years or younger at diagnosis and control patients (ICD-10 code Z00.129) matched for age, sex, race, and ethnicity were assessed. Propensity score matching yielded 16,590 patients in each cohort. The analysis assessed subsequent diagnoses of ADHD, conduct disorders, tic disorders, obsessive-compulsive disorder, anxiety disorders, dissociative, stress-related, and somatoform disorders, mood disorders, and suicide attempts compared to controls.</p><p><strong>Results: </strong>TTM patients under 18 years exhibited significantly greater risks of subsequent diagnoses for ADHD (OR: 2.002; CI 1.841-2.178; p < 0.001), conduct disorders (OR: 3.668; 3.2-3.668; p < 0.0001), tic disorders (OR: 2.247; 1.826-2.765; p < 0.0001), obsessive-compulsive disorder (OR: 11.047; 8.822-13.832; p < 0.0001), anxiety disorders (OR: 3.583; 3.387-3.7; p < 0.0001), dissociative, stress-related, and somatoform disorders (OR: 6.179; 3.935-9.701; p < 0.0001), mood disorders (OR: 2.476; 2.288-2.68; p < 0.0001), and suicide attempts (OR: 1.81; 1.121-2.924; p = 0.0139) compared to controls. TTM patients had the greatest risk of psychiatric diagnosis 1 year postindex event.</p><p><strong>Conclusions: </strong>Pediatric TTM patients have higher psychiatric comorbidity risks, necessitating timely intervention and comprehensive management. Dermatologists can facilitate access to behavioral and pharmacological care, enhancing patient outcomes.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472025","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":"Agminated Eruptive Melanocytic Nevi and Nail Changes Following Toxic Epidermal Necrolysis in a Pediatric Patient: A Case Report and Systematic Review of the Literature.","authors":"Scott C Jaros, Dean S Morrell, Elizabeth L Nieman","doi":"10.1111/pde.15777","DOIUrl":"https://doi.org/10.1111/pde.15777","url":null,"abstract":"<p><p>Eruptive melanocytic nevi (EMN) have been reported in the setting of immunosuppression, chemotherapy, and bullous skin disease, including less commonly, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). This case report presents a 4-year-old girl who developed agminated EMN and nail changes after TEN. A systematic review of the literature supports clinically appropriate follow-up of EMN, as there is no reports of malignancy in EMN following SJS/TEN, nor reports of pediatric melanoma arising within EMN of any etiology. Further study of the possible correlation of nail changes with the development of EMN and better characterization of the dermoscopic features of EMN could improve monitoring and care of these patients.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472018","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":"Safety of Prior Propranolol Therapy for Infantile Hemangioma.","authors":"Iraj Hasan, Zachary Zinn","doi":"10.1111/pde.15753","DOIUrl":"https://doi.org/10.1111/pde.15753","url":null,"abstract":"<p><p>Propranolol has been the primary treatment for infantile hemangioma (IH) since 2008. Prior studies have investigated the effects in late childhood of propranolol therapy given in infancy for IH, including neurocognitive dysfunction, sleep disorders, and hypoglycemia. However, few studies have determined the risk of these adverse effects later in life. Using the TrinetX database, we studied the risk of growth impairment, sleep disorders, learning disabilities, and diabetes mellitus in children aged 10-17 years who had received propranolol for IH in infancy. The maximum age of 17 years was chosen for the study, as propranolol was established as a treatment for IH in 2008. The results showed no statistically significant risk of growth impairment, sleep disorders, learning disabilities, or diabetes mellitus in IH patients treated with propranolol. These findings support existing evidence that propranolol therapy given in infancy for IH is not associated with long-term adverse effects up to age 17 years in the studied patient population.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392288","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":"Pre-procedural Topical Antisepsis in the Neonate: A Systematic Review Evaluating Risk Factors for Skin Injury.","authors":"Carly Mulinda, Sana Suhail, Bronwyn Sutherland, Christine T Lauren, Raegan D Hunt","doi":"10.1111/pde.15773","DOIUrl":"https://doi.org/10.1111/pde.15773","url":null,"abstract":"<p><strong>Background: </strong>Pre-procedural antisepsis is a critical component of hospital-acquired infection prevention in the neonatal intensive care unit (NICU). However, broadly utilized topical antiseptic agents pose an elevated risk of disruption to neonatal skin integrity, and evidence-based guidelines are lacking. This systematic review of the literature sought to assess and characterize the predisposing risk factors for and types of neonatal skin injury from topical antiseptic agents.</p><p><strong>Methods: </strong>A systematic search of Medline Ovid, Embase, Web of Science, CINAHL, and Cochrane Library was conducted, including academic literature providing data on neonatal skin injuries related to topical antisepsis in the NICU.</p><p><strong>Results: </strong>A total of 19 articles (99 patients) met the inclusion criteria. Of the available data, most reported skin injuries were described in extremely preterm (98.1%) and very low birth weight (98.4%) infants. The majority of reported adverse cutaneous events were attributed to chlorhexidine preparations (74.8%), followed by octenidine (18.2%), povidone-iodine (6.1%), and isopropyl alcohol (2.0%). Erythema (40.1%), skin breakdown (23.4%), and chemical burns (17.5%) were the skin reactions reported most frequently, followed by skin irritation (8.3%), and skin necrosis (2.8%).</p><p><strong>Conclusions: </strong>Our findings indicate that both extremely preterm and very low birth weight infants are particularly susceptible to skin toxicities from pre-procedural antiseptic preparations. These data underscore the need for future research to support the development of guidelines which minimize iatrogenic cutaneous injuries in the neonatal population, specifically for the care of infants under 2 months of age, for whom current recommendations are lacking due to a paucity of data.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375717","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":"Treatment Adherence in Pediatric Atopic Dermatitis: A Systematic Review.","authors":"Caitlyn B Dagenet, Lauren Gawey, Sahar Davoudi, Elaine Ma, Charlotte Jeong, Swetha Atluri, Jay M Kincannon, Jennifer L Hsiao, Steven R Feldman, Vivian Y Shi","doi":"10.1111/pde.15771","DOIUrl":"https://doi.org/10.1111/pde.15771","url":null,"abstract":"<p><strong>Introduction: </strong>Adherence to pediatric atopic dermatitis (AD) treatment regimens can be complex and a major challenge to optimizing treatment outcome. We aimed to review factors associated with nonadherence in pediatric AD and propose interventions to improve adherence.</p><p><strong>Methods: </strong>PubMed and EMBASE databases were systematically searched for articles from 2000 to February 2023 related to AD and adherence, with an additional update in December 2023. Non-human studies, reviews, commentaries, and meta-analyses were excluded. Articles were sorted into pediatric versus adult study population based on volume. Herein, we examine the results of papers discussing adherence factors related to pediatric patients.</p><p><strong>Results: </strong>A total of 62 studies met inclusion criteria. Thirty-six studies surveyed patients and caregivers (N = 10,268) to identify barriers to treatment adherence. None of the included studies were specific to systemic medications. Barriers included poor caregiver quality of life, inadequate AD-related education, topical corticosteroid (TCS) phobia, unclear therapy-related instructions, and dissatisfaction with physician interaction. Five studies solely measured adherence using medication electronic monitoring systems, Morisky medication adherence scale, or self-reported adherence to measure adherence to topical medications. Twenty-one studies described interventions involving nurse-led or web-based education programs, text message or email reminders, and TCS education. Adherence was improved with caregiver education programs, daily text-message reminders, eczema action plans, TCS potency \"traffic light\" color system, and frequent follow-up visits.</p><p><strong>Conclusion: </strong>Adherence to pediatric AD treatment poses a multifactorial challenge for caregivers and patients. This study provides an index of strategies to optimize adherence, as it is essential for prevention of long-term sequela associated with AD in children. As the AD treatment landscape rapidly expands, further studies are vital to assess pediatric adherence to new topical, oral, and injectable medications.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42023488557.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372476","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 Case Series of Refractory Pediatric Atopic Dermatitis Effectively Treated With Dupilumab in Combination With Abrocitinib.","authors":"Wei Chern Gavin Fong, Htet Hla Win Kaung, Rhea Lopes, Alpa Kanji, Jane Ravenscroft, Ting Seng Tang, Carsten Flohr","doi":"10.1111/pde.15761","DOIUrl":"https://doi.org/10.1111/pde.15761","url":null,"abstract":"<p><p>Children with severe atopic dermatitis (AD), refractory to conventional systemic treatment as well as single-agent biologic and Janus kinase inhibitor (JAKi) such as abrocitinib, currently face a lack of treatment options. In response to this clinical conundrum, we present three cases of severe and refractory pediatric AD successfully managed with combined dupilumab and abrocitinib. These children had exhausted all conventional treatments and had undergone treatment with both dupilumab and abrocitinib individually, as well as dupilumab in conjunction with methotrexate. It was only when the combination of dupilumab and abrocitinib was introduced that they finally achieved noticeable and sustained improvements in disease control.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372475","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":"Elucidating disparities in sunscreen coverage among state Medicaid preferred drug lists.","authors":"Celine M Schreidah, Joshua A Kent, Oluwaseyi Adeuyan, Emily R Gordon, Caroline Chen, Brigit A Lapolla, Lauren M Fahmy, Dawn Queen, Megan H Trager, Faramarz H Samie, Larisa J Geskin, Christine T Lauren","doi":"10.1111/pde.15720","DOIUrl":"https://doi.org/10.1111/pde.15720","url":null,"abstract":"<p><p>Regular application of over-the-counter (OTC) sunscreen is considered the foundation of skin cancer prevention, yet OTC sunscreen is not eligible for reimbursement in almost all state Medicaid benefit plans. On review of 111 Medicaid preferred drug lists (PDLs) across 50 states and the District of Columbia (DC), only five plans were identified that incorporate coverage of sunscreen. Thus, many recipients of Medicaid, the majority of whom are individuals and families of lower socioeconomic status, may encounter financial difficulty and thus forego utilizing sun protective measures due to financial constraints. Here, we compare current Medicaid coverage of OTC sunscreen and discuss calculated and theoretical annual costs of this skin cancer prevention method.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351623","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":"Dermatologic Conditions in Down Syndrome: A Multi-Site Retrospective Review of International Classification of Diseases Codes.","authors":"Tasya Rakasiwi, Chenin Ryan, Amy Stein, Alan Vu, Morgan Dykman, Ipsit Shah, Catherine Reilly, Gabrielle Brokamp, Mia A Mologousis, Bailey Komishke, Vincent Hou, Sheilagh Maguiness, A Yasmine Kirkorian, Harper Price, Elena B Hawryluk, Esteban Fernandez Faith, Irene Lara-Corrales, Emily Gurnee, Kristen E Holland, Jillian F Rork","doi":"10.1111/pde.15757","DOIUrl":"https://doi.org/10.1111/pde.15757","url":null,"abstract":"<p><strong>Background and objective: </strong>As the population and life expectancy of people with Down syndrome increases, identifying common skin conditions throughout the lifespan will help inform clinical care and research. We sought to evaluate dermatologic conditions diagnosed in pediatric and adult patients with Down syndrome.</p><p><strong>Methods: </strong>This multicenter retrospective study analyzed demographic and outpatient visit International Classification of Diseases codes of patients with Down syndrome evaluated at outpatient dermatology clinics in the United States or Canada between 2011 and 2021.</p><p><strong>Results: </strong>A total of 1529 patients with Down syndrome were identified from eight academic medical centers: 50.8% were children (0-12 years), 25.2% were adolescents (13-17 years), and 24% were adults (18 years and older). Eczematous dermatitis was the most common diagnosis overall (26%), followed by folliculitis (19.3%) and seborrheic dermatitis (15.6%). Other notable diagnoses included dermatophyte infections (13%), alopecia areata (11.6%), and psoriasis (6.7%). About 4.3% of visits included a code for high-risk medication use. Eczematous dermatitis, alopecia areata, and folliculitis were the most common diagnoses observed in children; folliculitis, hidradenitis suppurativa, and eczematous dermatitis in adolescents; and seborrheic dermatitis, eczematous dermatitis, and folliculitis in adults.</p><p><strong>Conclusions: </strong>Dermatologic conditions in patients with Down syndrome vary by age, but are most often eczematous, adnexal, and cutaneous autoimmune disorders. This multicenter retrospective review identifies skin diseases that should be prioritized for clinical care guideline development and research in the Down syndrome community.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351622","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":"Two for One: Tuberculid and Leukocytoclastic Vasculitis in an Adolescent.","authors":"Jordan K Bui, Mairead Baker, Kaiane Habeshian","doi":"10.1111/pde.15747","DOIUrl":"https://doi.org/10.1111/pde.15747","url":null,"abstract":"<p><p>A 13-year-old girl with fevers, abdominal pain, and vomiting for 4 days presented with a full body pruritic rash that began in the axilla and spread rapidly to the rest of the body. She was recently diagnosed with tuberculosis and had been on rifampin, isoniazid, pyrazinamide and ethambutol (RIPE) therapy for 1 month to treat this infection, raising concern for a severe drug reaction. On exam, there were pink to hemorrhagic crusted papules diffusely on the body; two skin biopsies from the right ankle and right arm showed leukocytoclastic vasculitis and tuberculid pathologies, respectively. Tuberculids are a cutaneous form of tuberculosis that represent a hypersensitivity reaction to Mycobacterium tuberculosis or its antigens. These rashes can mimic other common diseases, and this case highlights the importance of obtaining histopathology early in the disease course for accurate and prompt diagnosis.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351624","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}