Pediatric Dermatology最新文献

{"title":"Harlequin Ichthyosis in Resource Limited Environments: Practical Strategies to Improve Neonatal Survival.","authors":"Rodrigo Lomelí-Valdez, Luz Orozco-Covarrubias, Héctor Cantú-Maltos, Marimar Sáez-de-Ocariz","doi":"10.1111/pde.70222","DOIUrl":"10.1111/pde.70222","url":null,"abstract":"<p><p>Harlequin ichthyosis is a rare and life-threatening congenital disorder with high neonatal mortality, particularly in settings lacking specialized neonatal intensive care. We report a preterm newborn managed in a rural hospital without modern incubators, continuous monitoring, systemic retinoids at birth, or specialized personnel. Survival was achieved through pragmatic, low-cost interventions including an improvised humidified incubator, intensive topical emollient therapy, basic respiratory support, umbilical venous access for fluid and electrolyte management, and later initiation of oral isotretinoin. This case highlights that essential supportive care and adaptive use of available resources can improve outcomes in resource-limited settings.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1216-1219"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819424","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":"Congenital Milia With Alopecia and Multisystem Anomalies in Oral-Facial-Digital Syndrome Type 1.","authors":"Kawtar El Fid, Meryem Soughi, Chaimae Bouhamdi, Fatima Zohra Mernissi","doi":"10.1111/pde.70239","DOIUrl":"10.1111/pde.70239","url":null,"abstract":"<p><p>Oral-facial-digital syndrome type 1 (OFD1) is an X-linked dominant ciliopathy characterized by facial, oral, and digital anomalies, often with neurological involvement. We report an 11-month-old girl presenting with multiple congenital milia on the cheeks, forehead, and auricular helices, accompanied by sparse wiry hair, partial occipital alopecia, and trichoscopic features of pili torti and comma-shaped black dots. Additional findings included craniofacial and oral anomalies, brachydactyly, preaxial polydactyly type 1 (PPD1), and agenesis of the corpus callosum with intracerebral cysts. This case highlights the diagnostic significance of congenital milia as an early clue for recognizing OFD1.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1200-1203"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723309","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":"Childhood Atopic Dermatitis and Performance on Standardized Testing: A U.S. Birth Cohort Study.","authors":"Moshe Schneiderman, Kristina M Derrick","doi":"10.1111/pde.70266","DOIUrl":"10.1111/pde.70266","url":null,"abstract":"<p><strong>Background/objectives: </strong>Atopic dermatitis (AD) may impair children's cognition due to lost sleep and distraction from itching, and systemic inflammation. In the present study, we test whether AD is associated with lower performance on standardized testing in a racially and ethnically diverse birth cohort of urban children of mostly unwed mothers.</p><p><strong>Methods: </strong>This was a longitudinal study of 4898 children in the Future of Families and Child Wellbeing Study (FFCWS). When children were 5 and 9 years old, caregivers were asked about AD symptoms, and standardized testing evaluated children's vocabulary, reading, and math skills.</p><p><strong>Results: </strong>The study sample comprised 3641 children (1755 female). The most common racial and ethnic categories were Black, non-Hispanic (50.7%), Hispanic/Latino (26.1%), and White, non-Hispanic (20.1%). Many children were born to single mothers (77.5%). Fully adjusted longitudinal models indicated AD was associated with slightly higher vocabulary scores (β = 1.10; 95% CI, 0.12-2.08) and no difference in reading scores. At 9 years, there was no difference in math scores. Cross-year models revealed AD at 5 years was associated with slightly higher reading scores at 9 years (β = 1.47; 95% CI, 0.07-2.87). Persistent AD (Present at both 5 and 9 years) showed associations similar to AD at either year alone (no difference to slightly higher scores).</p><p><strong>Conclusions: </strong>AD seemed to be associated with comparable or slightly higher vocabulary and reading scores. Increased sedentary activities, such as reading and watching television, among children with AD may confer benefits that counterbalance or even slightly outweigh any inherent negative effects of AD on standardized testing performance.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1136-1144"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252627","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":"Epidemiological, Clinical, and Histopathological Features of Pediatric Pityriasis Lichenoides: A Retrospective Cohort With Long-Term Follow-Up.","authors":"Selcen Kundak, Yasemin Çakır","doi":"10.1111/pde.70273","DOIUrl":"10.1111/pde.70273","url":null,"abstract":"<p><strong>Objective: </strong>Pityriasis lichenoides (PL) represents a spectrum of rare inflammatory skin disorders, including pityriasis lichenoides et varioliformis acuta (PLEVA), febrile ulceronecrotic Mucha-Habermann disease (FUMHD), pityriasis lichenoides chronica (PLC), and mixed-type variants. This study aimed to describe the epidemiologic, etiologic, clinical, and histopathologic features of pediatric PL in a tertiary referral center.</p><p><strong>Methods: </strong>This retrospective study included 78 children diagnosed with PL between January 2003 and January 2017. Patients were followed for 3-7 years, with follow-up completed in 2024. Diagnosis was clinically suspected by a dermatologist and confirmed histopathologically.</p><p><strong>Results: </strong>The mean age at diagnosis was 9.2 years; 59.0% were male. A preceding infection was documented in 60.3% of patients. Disease onset was most frequent in winter (44.9%) and spring (28.2%). Lesions were generalized in 65.4% of patients. PLC was the most common subtype (66.7%), followed by PLEVA (23.1%) and mixed type (10.3%). Histopathologic findings included basal vacuolar changes (88.5%), deep inflammatory infiltrates (83.6%), and parakeratosis (82.1%). Adnexotropism, folliculotropism, and syringotropism were less frequent than previously reported. During 2-7 years of follow-up, no patient developed mycosis fungoides. The most common treatments were azithromycin with topical corticosteroids (37.2%) and erythromycin with topical corticosteroids (30.8%).</p><p><strong>Conclusion: </strong>PL predominantly affects school-age children, shows a male predominance, and often presents in winter. PLC is the most frequent subtype. The absence of progression to mycosis fungoides during long-term follow-up supports the generally favorable prognosis of childhood PL and underscores the value of large pediatric cohorts with extended follow-up.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1075-1082"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974568","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":"Quality of Life Impairment in Singaporean Adolescents With Acne Vulgaris: A Cohort Study Highlighting the Role of Self-Perception.","authors":"Karina Ruth Soenjoyo, Silas Cheng Xun Choe, Gayatiri Raveentheran, Soh Huiwei, Mark Jean Aan Koh, Lynette Wei Yi Wee","doi":"10.1111/pde.70267","DOIUrl":"10.1111/pde.70267","url":null,"abstract":"<p><strong>Background/objectives: </strong>Acne vulgaris is highly prevalent among adolescents and carries significant psychosocial burdens. This study assessed the psychosocial impact of acne and identified factors contributing to reduced quality of life among Singaporean adolescents.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between August 2023 and October 2025, recruiting patients aged 12-18 years with acne vulgaris seen at KK Women's and Children's Hospital pediatric dermatology clinics. Patient-reported outcomes were measured using the Cardiff Acne Disability Index (CADI) and the Teenager's Quality of Life Index (TQoL). Acne severity was graded by physicians using the Global Evaluation Acne (GEA) scale.</p><p><strong>Results: </strong>Among 100 participants, mean CADI and TQoL scores were 3.77 and 8.89, respectively. Self-perceived acne severity was the highest scoring CADI item but correlated poorly with physician-rated severity (r = 0.334, p = 0.001). The most affected TQoL domain was self-image. CADI and TQoL scores did not differ significantly by age, dermatological comorbidities, nodulocystic lesions, or scarring. Significantly worse scores (p < 0.05) were associated with female sex, acne duration ≥ 2 years, and truncal involvement. A strong dose-response relationship with clinician-graded severity was evident, with scores rising from mild to moderate to severe acne (CADI: 2.85, 4.63, 6.29, p < 0.001; TQoL: 6.36, 11.84, 12.71, p < 0.001).</p><p><strong>Conclusion: </strong>Adolescents with acne experience self-image concerns that are poorly aligned with physician clinical assessment. Female sex, longer duration, truncal involvement, and greater clinical severity are key determinants of QoL impairment. These findings highlight the need for timely, effective treatment alongside proactive psychosocial screening to reduce emotional and social burden in high-risk groups.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1070-1074"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932307","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":"Cutaneous Presentation of Pre-B Cell Acute Lymphoblastic Leukemia in a 3-Month-Old Boy.","authors":"Luke A Scherz, Erika J Tvedten, Kim HooKim-Vickers, Robert F Duffy","doi":"10.1111/pde.70242","DOIUrl":"10.1111/pde.70242","url":null,"abstract":"<p><p>We present a rare case of leukemia cutis as the sole presenting sign of pre-B cell acute lymphoblastic leukemia in a 3-month-old boy. The patient exhibited a solitary, erythematous scalp nodule without systemic symptoms or abnormal peripheral laboratory findings, ultimately diagnosed via biopsy and treated successfully. This case highlights the importance of early dermatologic evaluation and biopsy in persistent or atypical infant scalp lesions.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1235-1237"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869256","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":"Acute Hemorrhagic Edema of Infancy: A Safe Diagnosis or a Diagnostic Challenge? A 15 Year Retrospective Analysis.","authors":"Suzanne C Arnold, Berend Roelants, Floor M Garritsen, Anne-Moon van Tuyll van Serooskerken, Paul Vos, Mirjam van Veen","doi":"10.1111/pde.70259","DOIUrl":"10.1111/pde.70259","url":null,"abstract":"<p><strong>Background: </strong>Acute hemorrhagic edema of infancy (AHEI, or Finkelstein-Seidlmayer vasculitis) is a benign, self-limiting small vessel vasculitis that is typically diagnosed through clinical assessment alone. Its clinical overlap with diseases that have potentially more complications, such as IgA vasculitis (IgAV), poses diagnostic challenges, balancing the risk of over-treatment against the potential for missed or delayed diagnoses. This study aims to describe clinical experience with diagnosing AHEI and to identify factors associated with a diagnostic revision to IgAV.</p><p><strong>Methods: </strong>This large Dutch retrospective cohort study analyzed 89 children clinically diagnosed with AHEI between 2007 and 2024. Demographic, clinical, and laboratory data were collected from medical records. A revised diagnosis was defined as a revision of the initial AHEI diagnosis during follow-up. Descriptive analysis and logistic regression were performed to determine factors associated with diagnostic revisions.</p><p><strong>Results: </strong>Of 89 patients included, 20 (22.5%) had their initial diagnosis revised, with 9 cases reclassified as IgAV. Risk factors for the diagnostic revision to IgAV included older age (median 37 vs. 15 months, p < 0.001), presence of a painful rash (33% vs. 10%, p = 0.044), and absence of blanchable lesions (22.2% vs. 76.2%, p < 0.001). Complications occurred in seven of nine patients (78%) with IgAV.</p><p><strong>Conclusions: </strong>This study describes the AHEI patient population and highlights the importance of age, rash characteristics, and clinical features in differentiating AHEI from potentially more severe conditions such as IgAV. A proposed clinical flowchart including patient age and rash characteristics may improve diagnostic accuracy and optimize patient follow-up, balancing the need for vigilance while avoiding unnecessary treatment.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1061-1069"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875213","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":"Bridging the Diagnostic Gap in Neurofibromatosis Type 1: When to Consider NF1 cDNA Sequencing.","authors":"Brent J Doolan, Minu J Chiramel, Mitch Hendry, Andrea Shugar, Yunjia Chen, Irene Lara-Corrales, Yiming Wang","doi":"10.1111/pde.70257","DOIUrl":"10.1111/pde.70257","url":null,"abstract":"<p><p>Molecular confirmation of neurofibromatosis type 1 (NF1) is essential for accurate diagnosis, reproductive counseling, and lifelong surveillance, yet genomic DNA (gDNA)-based next-generation sequencing (NGS) panels may miss deep intronic or complex structural variants. We report five children meeting the 2021 NF1 clinical diagnostic criteria who had negative DNA-based NGS testing but were subsequently diagnosed using NF1 cDNA-based testing (NF1 cDNA testing), which identified three deep intronic variants, one 5'UTR variant, and one exonic insertion, including three novel variants. Four of the five variants produced abnormal-to-normal transcript ratios of approximately 1:1, consistent with complete loss of normal transcript from the affected allele. These variants, detected by NF1 cDNA testing, are predicted to result in the same clinical phenotype and natural history as NF1 exonic variants, underscoring the value of NF1 cDNA testing as a second-tier test when clinical suspicion remains high despite negative gDNA-based tests.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1170-1173"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932299","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":"Therapeutic Patient Education for Pediatric Atopic Dermatitis Patients: A Randomized Controlled Trial.","authors":"Mason McDowell, Alexis Navarro, Omar Siddiqui, Courtney Hanna, Hugo Hasegawa, Opemipooluwa Adedeji, Jacqueline Chang, Sherwin Fazelpour, Alejandro Barrera-Godinez, Lisa Shen, Amy B Stein, Margaret S Lee","doi":"10.1111/pde.70248","DOIUrl":"10.1111/pde.70248","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a chronic inflammatory skin condition that significantly impacts quality of life. Therapeutic patient education (TPE) improves disease outcomes, but traditional in-person programs are often inaccessible. Video- and handout-based TPE offer more feasible alternatives, though their comparative efficacy remains unclear, particularly in diverse linguistic populations.</p><p><strong>Methods: </strong>This study compared the effectiveness of video- and handout-based TPE in pediatric AD patients and their caregivers, including both English- and Spanish-speaking participants. Interventions in English or Spanish included handouts as an active control (our standard of care) or short captioned videos addressing core AD management practices. Outcomes measured at baseline and 1-10 weeks post-intervention included Patient-Oriented Eczema Measure (POEM), Child Dermatology Life Quality Index (CDLQI), and Investigator's Global Assessment (IGA), and caregiver AD confidence. Educational accessibility and viewership were assessed at follow-up.</p><p><strong>Results: </strong>Fifty-two dyads were randomized at an academic pediatric dermatology clinic; 22 (42%) completed both baseline and follow-up assessments. Across all participants, there were no statistically significant differences between handout and video groups in POEM, CDLQI, or IGA, educational accessibility, or caregiver confidence in AD management. English- and Spanish-speaking participants demonstrated comparable outcomes across all measures.</p><p><strong>Conclusion: </strong>These findings suggest that videos and handouts are both viable educational tools and support the use of well-constructed handouts as a viable, resource-conscious option, including in Spanish-speaking populations. Larger studies with improved enrollment and retention are needed to further define optimal TPE strategies.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1083-1088"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974094","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":"Diagnostic Challenges in Pediatric Dermatologic Presentations Among Pediatricians.","authors":"Kathy Boutis, Martin Pusic, Miriam Weinstein, Joel Gupta, Madeline Bell, Nikolas MacLellan, Robert Bobotsis, Rashie Brar, Cathryn Sibbald","doi":"10.1111/pde.70211","DOIUrl":"10.1111/pde.70211","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the most diagnostically challenging pediatric dermatology cases with respect to interpretation difficulty and diagnostic confusion.</p><p><strong>Methods: </strong>This was a multi-center prospective cross-sectional study. A convenience sample of pediatric trainees and attendings was eligible. Using a web-based tool, physicians diagnosed 334 pediatric dermatology image-based cases. Participants assessed whether each case was concerning, selected one of nine morphologic categories, and chose one of 35 specific diagnoses. We extracted participant responses and analyzed the data using one-parameter item response theory.</p><p><strong>Results: </strong>We enrolled 242 pediatric postgraduate trainees (n = 105) and attendings (n = 137) who completed 38,502 observations. There was no difference in the mean interpretation difficulty logit score between the diagnostic assignment of concerning (-1.6) versus nonconcerning (-1.3) cases; difference -0.3 (95% CI: -0.8, 0.2). However, there were significant differences in difficulty scores between morphological types (p < 0.001) and specific diagnoses (p < 0.001). Vesiculobullous and papulosquamous were the most difficult morphologies to classify correctly, while vascular and purpuric/petechial were the easiest. The most challenging diagnoses were herpetic infections, bullous variants of impetigo, contact dermatitis, arthropod bites, and nonspecific viral exanthems. The easiest were injury-related bruising, pernio-COVID toes, and hemangiomas. There were 20/35 (57.1%) skin conditions that demonstrated relatively frequent confusion with other skin conditions, 12/20 (60%) of which would have implications for management.</p><p><strong>Conclusions: </strong>This study provides a comprehensive data-driven assessment of diagnostic challenges in pediatric dermatology across morphologies and diagnoses. Substantial diagnostic difficulty and confusion were observed for numerous diagnoses, many with potential patient safety consequences.</p>","PeriodicalId":19819,"journal":{"name":"Pediatric Dermatology","volume":" ","pages":"1089-1097"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016761","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}