{"title":"From Collodion Membrane to Alopecia: An Insight Into IFAP/BRESHECK Syndrome.","authors":"Hami Kork, Ömer Cacina, Tuğba Kevser Uzunçakmak, Dilek Uludağ Alkaya, Nilay Güneş, Aynur Islamova, Burhan Engin, Beyhan Tüysüz","doi":"10.1111/pde.70352","DOIUrl":"https://doi.org/10.1111/pde.70352","url":null,"abstract":"<p><p>Ichthyosis follicularis, atrichia, and photophobia (IFAP) syndrome is a rare genodermatosis characterized by follicular ichthyosis, alopecia, and photophobia; classical X-linked disease is caused by MBTPS2 variants, whereas autosomal dominant forms are associated with SREBF1 variants. The severe IFAP/BRESHECK phenotype may include brain anomalies, intellectual disability, ectodermal dysplasia, skeletal defects, Hirschsprung disease, ear and eye anomalies, cleft palate, cryptorchidism, and kidney abnormalities. We present a 7-year-old male patient with a collodion membrane at birth, severe ichthyosis, alopecia, neurodevelopmental impairment, Hirschsprung disease, limbal stem cell deficiency, and the hemizygous pathogenic MBTPS2 variant NM_015884.4:c.1286G>A (p.Arg429His). This case highlights an uncommon combination of severe manifestations within the MBTPS2-related IFAP/BRESHECK spectrum and emphasizes the importance of multidisciplinary long-term follow-up.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128013","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":"Loose Anagen Hair Syndrome: A Scoping Review.","authors":"Romy Shenderey, Hailey Land, Eric McMullen, Daniela Giansante, Grace Xiong, Katya Peri, Raquel Ocvirk, Justin Trasolini, Laurence Mainville, Shireen Dumont, Narachai Julanon, Cathryn Sibbald, Jeffrey Donovan","doi":"10.1111/pde.70342","DOIUrl":"https://doi.org/10.1111/pde.70342","url":null,"abstract":"<p><p>Loose anagen hair syndrome (LAHS) is a rare, non-scarring alopecia that may occur sporadically or follow autosomal dominant inheritance. The objective of this study was to review the etiology, clinical presentation, diagnostic features (including trichoscopy, trichogram, and microscopy), natural history, and treatment outcomes of LAHS. A scoping review was conducted using MEDLINE, Embase, Web of Science, Scopus, and CENTRAL databases. Seventy-six studies, encompassing 425 patients with LAHS (mean age: 6.2 years), were included. Most patients were female (78.6%) with Type A LAHS (88.5%). The most common trichoscopic findings were follicular units containing single hairs (92.9%) and rectangular black granular structures (57.5%). Genetic associations included mutations in keratin genes (e.g., KRT32, KRT71, and related keratin family genes) and syndromic overlap, most prominently Noonan-like syndrome with loose anagen hair. 16.8% received treatment, primarily with topical minoxidil (88.2%). Complete resolution occurred in 14.7% of treated patients and two untreated patients. Evidence was limited predominantly to case reports and case series, with inconsistent follow-up data. LAHS should be considered in children presenting with diffuse shedding and easily extractable hair. Topical or oral minoxidil may be beneficial, but further studies are needed to clarify the natural history and comparative effectiveness of treatment.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127983","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}
Ou Jia Emilie Wang, Alennie Lopez, Renee Gabrielle Fajardo, Richard I Crawford, Joseph M Lam
{"title":"Atrophic Papulosis: A Systematic Review of Pediatric Cases.","authors":"Ou Jia Emilie Wang, Alennie Lopez, Renee Gabrielle Fajardo, Richard I Crawford, Joseph M Lam","doi":"10.1111/pde.70334","DOIUrl":"https://doi.org/10.1111/pde.70334","url":null,"abstract":"<p><strong>Background: </strong>Atrophic papulosis is a rare occlusive vasculopathy that can present with isolated cutaneous disease or with systemic involvement. Pediatric cases are uncommon, and existing reports are heterogeneous, limiting understanding of disease patterns, timing of organ involvement, and outcomes.</p><p><strong>Methods: </strong>A systematic literature search identified pediatric patients (< 18 years at symptom onset) diagnosed with atrophic papulosis. Case-level data were extracted where available. Patients were classified as benign atrophic papulosis (BAP) or malignant atrophic papulosis (MAP). Descriptive analyses were performed to summarize organ involvement, timing relative to cutaneous onset, multisystem disease patterns, treatments, and outcomes.</p><p><strong>Results: </strong>Thirty-six reports describing 54 pediatric patients were identified. At the most recent follow-up, 8 patients (14.8%) were classified as BAP and 46 (85.2%) as MAP. Among MAP patients, central nervous system (CNS) involvement was most common (71.7%), followed by gastrointestinal involvement (67.4%). Multisystem extracutaneous disease occurred frequently (78.3%). Systemic involvement typically developed within the first year after the onset of cutaneous disease, although the interval varied substantially among patients. Treatment outcomes ranged from clinical stability to progressive multisystem disease and death.</p><p><strong>Conclusions: </strong>In pediatric patients, atrophic papulosis is often classified as malignant, with frequent CNS and gastrointestinal involvement. These findings underscore the need for early recognition and longitudinal follow-up.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112999","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":"Gold, Glitter-Like Appearance of a Neonatal Scalp Wound.","authors":"Kristen Stephenson, Ashley Khouri, Luke Johnson","doi":"10.1111/pde.70381","DOIUrl":"https://doi.org/10.1111/pde.70381","url":null,"abstract":"<p><p>This report describes the case of a 2-month-old female, born prematurely at 25 weeks as part of a twin gestation, who developed an adhesive-related traumatic ulcer on the scalp during NICU admission for postnatally acquired cytomegalovirus infection. Following routine wound care with topical gentian violet, the wound developed an unexpected gold, glitter-like hue overlying the ulcer bed, initially raising concern that an additional topical product had been applied or that an interaction between applied agents had occurred. After further investigation, the striking appearance was attributed to a combination of thin-film optical interference, environment-dependent spectral shifts, and partial conversion of crystal violet to its reduced leuco (colorless) form. Recognition of this benign physicochemical phenomenon is clinically important, as awareness that this finding represents an optical property of gentian violet itself may prevent unnecessary diagnostic escalation, including repeat biopsies or empiric antimicrobial therapy.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113077","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}
Jacob Chacko, Teja Buddhavarapu, Joy Wan, Patrick McMahon
{"title":"Impact of a Simplified, Visual Educational Intervention on Caregiver Understanding of Pediatric Atopic Dermatitis: A Clinic-Based Randomized Study.","authors":"Jacob Chacko, Teja Buddhavarapu, Joy Wan, Patrick McMahon","doi":"10.1111/pde.70322","DOIUrl":"https://doi.org/10.1111/pde.70322","url":null,"abstract":"<p><p>Atopic dermatitis (AD), a widespread and chronic disease, has educational resources that exceed readability guidelines and lack visual reinforcement, disproportionately impacting families with low health literacy. We conducted a pilot study to determine whether a simplified, visually enhanced handout would improve understanding of AD care compared with a conventional, text-dominant handout and a no-handout control with 47 caregivers assigned to one of the three groups. Participants provided with a visual handout had the highest average score improvement, significantly greater than both control participants and those provided a conventional handout. These findings illustrate the benefit of using simplified, visual educational materials in improving pediatric AD caregiver understanding and reducing disparities in dermatological care.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113325","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":"Expanding Access to Care: Implementation of a Pediatric and Young Adult Laser Hair Removal Program for Hidradenitis Suppurativa.","authors":"Sarah Lee, Sarah Servattalab, Yasin Damji","doi":"10.1111/pde.70373","DOIUrl":"https://doi.org/10.1111/pde.70373","url":null,"abstract":"<p><p>Laser hair removal (LHR) is an effective adjunctive therapy for hidradenitis suppurativa (HS), but access is often limited by inconsistent insurance coverage. A retrospective review was conducted of 21 pediatric and young adult patients enrolled in an LHR program for HS at a tertiary children's hospital. Among patients receiving two or more sessions (n = 20), 86% demonstrated visible hair thinning or reduced hair regrowth on examination, and 81% self-reported decreased flare severity or frequency, with no adverse events observed. All treatments were ultimately covered by insurance through a standardized prior authorization process, supporting the feasibility of expanding access to LHR for pediatric and young adult patients with HS.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113024","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":"Morphological Variations and Anatomical Distribution of Atypical Eschars in Pediatric Scrub Typhus: A Prospective Observational Study.","authors":"Dinesh Kumar Narayanasamy, Thirunavukkarasu Arun Babu, Anandaraj Rajagopal, Prakash Mathiyalagen","doi":"10.1111/pde.70375","DOIUrl":"https://doi.org/10.1111/pde.70375","url":null,"abstract":"<p><strong>Background: </strong>Necrotic flexural eschar is a pathognomonic cutaneous marker of scrub typhus (ST). Relying solely on the classic necrotic flexural eschar can result in missed diagnoses when lesions present atypically. This study evaluated the clinical profile and predictors of atypical eschars (ATEs) in children with ST.</p><p><strong>Methods: </strong>In this 5-year prospective observational study from South India, children (< 12 years) with serologically confirmed ST (IgM ELISA) were systematically examined for eschars using a standardized whole-body assessment. Eschars were classified as typical eschars (TEs: necrotic ulcer with or without scab) or ATE (non-necrotic papule with umbilication). Children were grouped based on their eschar phenotype. Clinical features, anatomical distribution, laboratory parameters, and outcomes were compared.</p><p><strong>Results: </strong>Of the 692 confirmed ST cases, 349 (50.4%) children with inoculation site eschars were included. Among them, 261 (74.8%) had TE and 88 (25.2%) had ATE. A total of 398 eschars were identified, as some children had multiple lesions. ATEs were significantly more common in exposed, non-flexural sites, whereas TEs predominantly involved flexural regions, such as the axilla and groin. Independent predictors of ATE included multiple eschars (aOR 2.77; 95% CI 1.16-6.75) and leukocytosis (aOR 2.22; 95% CI 1.21-4.06). Flexural location and regional lymphadenopathy were inversely associated with ATE. Disease severity and clinical outcomes were comparable between the groups.</p><p><strong>Conclusion: </strong>One-fourth of pediatric ST cases with eschars have atypical lesions, which are often multiple, located at exposed sites, and lack regional lymphadenopathy. Diagnostic evaluation must extend beyond flexural folds, as ATEs are clinically and diagnostically equivalent to typical lesions.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113334","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":"Letter to the Editor Re: The Association Between Isotretinoin Use and Suicidality in Adolescents: A Narrative Review.","authors":"James Gaston, David Orchard","doi":"10.1111/pde.70371","DOIUrl":"https://doi.org/10.1111/pde.70371","url":null,"abstract":"","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081818","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}
Carli Needle Lawrence, Derek E Maas, Archie J Spindler, Isabella Zappi, Margaret Cote, Anna L Brinks, Caitlin A Kearney, Carli Tucci, Annalie M Brody, Ambika Nohria, Seth J Orlow, Vikash S Oza, Jerry Shapiro, Kristen I Lo Sicco
{"title":"Depictions of Alopecia in Children's Animated Films: A Cross-Studio Analysis.","authors":"Carli Needle Lawrence, Derek E Maas, Archie J Spindler, Isabella Zappi, Margaret Cote, Anna L Brinks, Caitlin A Kearney, Carli Tucci, Annalie M Brody, Ambika Nohria, Seth J Orlow, Vikash S Oza, Jerry Shapiro, Kristen I Lo Sicco","doi":"10.1111/pde.70365","DOIUrl":"https://doi.org/10.1111/pde.70365","url":null,"abstract":"<p><p>Children with alopecia experience significant psychosocial challenges, and portrayals in animated films may shape how young audiences perceive hair loss and identity. Alopecia representation across 139 children's animated films from Disney, Pixar, DreamWorks, and Studio Ghibli was analyzed, identifying 177 total characters that were verified by a hair specialist dermatologist and evaluated by independent raters, with statistical comparisons performed using χ<sup>2</sup> and Fisher's exact tests. Characters with alopecia were predominantly male, human, and peripheral, with androgenetic alopecia most common; overall, they were more frequently depicted as intelligent, leaders, and heroes, although female characters were more often portrayed as villainous or frightening, and children as clumsy. Despite some positive associations, these findings highlight persistent sex- and age-based disparities, suggesting a cultural bias that frames male-pattern hair loss favorably while reinforcing stigmatizing portrayals in women and children, underscoring the need for more balanced and inclusive representation.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081769","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}