Pediatric Dermatology

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Masters of pediatrics

Welcome to a new department in Dermatology Times. Beginning with this month's Special Report, DT will present a monthly panel review of specific cases in pediatric dermatology, an effort coordinated by editorial adviser Lawrence Schachner, M.D. In this installment, a panel of pediatric masters discusses treatment options for the unusual case of a 12-year-old Hispanic girl who was brought in by her parents for treatment of a white spot that had developed after she was out playing in the sun.

Washington - Cutaneous lesions are common in infants with neonatal lupus erythematosus (NLE) and may have life-long sequelae. However, the most worrisome associations are its noncutaneous features and the increased risks for a mother to develop an autoimmune disorder herself, said Amy S. Paller, M.D., at the annual meeting of the American Academy of Dermatology.

Boca Raton, Fla. - Contact dermatitis from topical medications is the most common type of adverse drug reaction, and allergic contact dermatitis is the most common and most important form of contact dermatitis induced by topical drugs, according to James S. Taylor, M.D., head of the industrial dermatology section of the department of dermatology at the Cleveland Clinic Foundation in Cleveland. "Patients with medicament contact dermatitis usually have a good prognosis, but with a propensity for relapse," Dr. Taylor said.

Maui, Hawaii - For thousands of years, people have flocked to the Dead Sea searching for relief for their itchy skin. Now, Chicago-area psoriasis and atopic dermatitis sufferers are bathing in reconstituted Dead Sea water at a suburban clinic.

Tampa, Fla. -- Dermatologists can use hypnosis as an adjunctive or monotherapy for helping patients relax for in-office procedures, feel less pain, or even change habits such as skin picking. What dermatologists might not know about medical hypnosis is it usually takes only one to three minutes to induce hypnosis, using a brief hypnotic technique, according to Philip D. Shenefelt, M.D., associate professor of medicine, Division of Dermatology in the Department of Internal Medicine, University of South Florida, Tampa.

PARTICIPANTSMarcia Glynn, MD Assistant Professor, Dermatology Director, PediatricDermatology Martin Luther King/Charles R. Drew Medical Center Los Angeles,CaliforniaJudy Hunter, MD Pediatrician Principal Investigator HealthCare PartnersMedical Group Torrance, California

Q&A/ROSACEAAlbert Kligman, M.D., Ph.D., is a pioneer who continues to break new ground in dermatology. Dialogue with a Mentor is brought to you by an unrestricted educational grant from Galderma Laboratories, LP.

NL infests CABG scars

Washington, D.C. - A unique case report of necrobiosis lipoidica (NL) within coronary artery bypass graft scars presents the dermatologist with the ongoing challenge of managing an ever-present skin disorder that denies therapy, according to Shannon Heck, M.D.

Washington D.C. - Juvenile Xanthogranuloma (JXG) is a rare histiocytic proliferation of uncertain histogenesis usually found in the cephalic region and more common in males less than one year of age. So when an 11-day old female neonate presented to Wake Forest University Baptist Medical center with a firm, immobile, non-pulsatile, pink-red nodule and telangiectases localized to the right groin, JXG was not initially suspected. However, as part of the initial workup, a confirmatory biopsy revealed the diagnosis.

Rud's syndrome

Washington - Topical application of tazarotene 0.05 percent was effective in reducing cutaneous roughness and scaling in a patient with a rare form of ichthyosis known as Rud's syndrome, according to Maria Concetta Fargnoli, M.D., a dermatologist at the University of L'Aquila, Italy.

Do it yourself tx

Scottish researchers have discovered a breakthrough treatment they believe will allow thousands of skin-cancer sufferers to treat themselves at home.

National report -- In a study that could have implications for faster wound healing in the future, Australian researchers have dispelled the belief that only epidermal stem cells are capable of tissue regeneration; short term and long term. They report in the February 2004 issue of The Journal of Clinical Investigation that significant proliferative and tissue-regenerative capacity resides in the more mature progeny of keratinocyte stem cells - including early differentiating cells.

Miami, Fla. - The challenge in neonatal dermatology is that pediatricians who commonly see various skin conditions in infants often lack the training and knowledge to respond to the skin eruptions, according to the head of pediatric dermatology at the Phoenix Children's Hospital.

Washington -- A recent prospective study has shown that treatment of atopic dermatitis with tacrolimus ointment (Protopic, Fujisawa) produced clinical improvement and reduced healthcare resource use and improved patient and caregiver quality of life, said Mark Boguniewicz, M.D., professor, division of pediatric allergy-immunology, National Jewish Medical and Research Center, Denver, and University of Colorado School of Medicine.

Natural forces?

Waikoloa, Hawaii - Controlled studies show water from thermal springs in Avene, France, reduces inflammation, pruritis, and erythema, according to a general practitioner whose employer markets the water. The water is effective in treating psoriasis, inflammation caused by laser treatments, and mild to moderate atopic dermatitis, said Fran?ois Verriere, M.D., at the Hawaii Dermatology Seminar.

Waikoloa, Hawaii - Bexarotene 1 percent gel (Targretin) is a useful alternative modality, offering advantages to other therapies, for the treatment of mycosis fungoides (MF), according to Joan Guitart, M.D., at the annual Hawaii Dermatology Seminar in January.

Waikoloa, Hawaii -- Pilot study results indicate that 0.12 percent betamethasone valerate foam is more effective than vehicle alone for short-term stasis dermatitis treatment. "This topical therapy can lead to improved health-related quality of life in these patients," said Alexa Boer Kimball, M.D., assistant professor and director, dermatology clinical trials, Stanford University School of Medicine.

Washington, D.C. - Because all the ramifications of new medications - and even some of the older ones - are not yet known, practitioners should give special consideration to possible side effects. In making treatment decisions, get as much information as possible, said Roselyn E. Epps, M.D.

Miami, Fla. - Dermatologists treating pediatric skin diseases should always look for related, underlying psycho-social issues and make referrals or offer solutions when problems are identified. The challenge is that sometimes the psycho-social issues from which children and teens suffer are not so obvious, according to Karen Mallin, Psy.D., instructor in the departments of psychiatry and behavioral sciences and dermatology and cutaneous surgery at University of Miami School of Medicine, Miami.

Miami - Atopic dermatitis (AD) can be challenging to diagnose even for the seasoned dermatologist because it mimics other common skin diseases in the pediatric population. It also can be challenging to treat, with the addition of new agents on the market. There are key points to consider when making the diagnosis and tried-and-true methods of treatment to keep in mind when recommending therapies to parents and their children, according to Bernice Krafchik, M.D., dermatologist, and professor emeritus at the University of Toronto.

Washington - Facial peeling with pyruvic acid is an effective and well-tolerated treatment for patients with mild-to-moderate papulopustular acne, according to Alessia Pacifico, M.D., a dermatologist at the University of L'Aquila. Dr. Pacifico and colleagues evaluated the efficacy and tolerability of topical application of a solution of 40 to 50 percent pyruvic acid in a study enrolling 24 subjects with mild to moderate papulo-pustular acne.

Washington - The availability of a suitable animal model for atopic dermatitis could advance research in the field and aid in the development of new therapies. Scientists in Japan may have developed such a model, according to Takuya Uozumi, MS, a researcher at Lion Corp.