CHILD syndrome in a mother and her daughter: a case report

Congenital Hemidysplasia with Ichthyosiform nevus and Limb Defects [CHILD] syndrome is a very rare syndrome. It is inherited as X-linked dominant trait. The cutaneous lesions and extracutaneous defects are peculiar; as they involve one half of the body. We present here two Jordanian cases of CHILD syndrome, a new born girl and her mother. Up to our knowledge these cases are the first reported cases of CHILD syndrome in Jordan. The rarity of this syndrome prompted us to report these two cases

Punch minigrafting for stable vitiligo: our experience at the Jordanian royal medical services

To evaluate punch mini grafting as one of the existing surgical methods used to treat stable vitiligo in patients with vitiligo involving small areas of skin. This study was conducted at two of the Jordanian Royal Medical Services Hospitals over a two year period from June 2009 to June 2011. Twenty nine patients with stable vitiligo of three to 10 year duration [mean 6 years], and a duration of disease stability from one to six years [mean 3 years], were treated by implanting small sized autologus full thickness skin grafts into the vitiligenous areas. The grafts were harvested from normally pigmented skin. Patients were followed up monthly for twelve months. In each follow up they were evaluated for the amount of repigmentation of the treated area and for the presence of any complications. The overall response of the treated lesions was clinically assessed by two different dermatologists at six months postoperatively and based on the degree of pigmentation it was defined as: poor [repigmentation <30%], fair [31-50%], good [51-75%] and excellent [>75%]. A simple statistical analysis of frequencies, means and percentages was used to describe the study variables. A total of 89.6% of patients showed good to excellent repigmentation by six months. Complications were encountered in 10 patients [34.5%] and included cobblestoning in two patients [6.9%], graft displacement in six patients [20.7%] and minor infections in two patients [6.9%]. No graft depigmentation or relapse of vitiligo in the treated areas was noted. No koebnerization or scarring was noted in the donor areas. Minigrafts seem to be a good treatment option for patients with stable vitiligo. Patient selection and attention to details in the technique can improve the outcome

Herpes zoster in children

The aim of this study was to describe the epidemiology, clinical manifestations, therapy and outcome of herpes zoster in children. The medical records of 21 patients with herpes zoster who were referred to the dermatology clinic between February 2003 and July 2005 were reviewed. The total numbers of patients were 12 males [57.1%] and nine females [42.9%]. Their age ranged between 5 and 14 years. The diagnosis was made depending on history and the clinical manifestation. Aciclovir therapy was given systemically within three days of the onset of the exanthem. Amongst the 21 subjects, eight patients had underlying hematological malignancy in the form of acute lymphoblastic leukemia and these represent the immunocompromised group. The other 13 patients were otherwise healthy [immunocompetent group]. Two children in the immunocompetent group were born to mothers who had varicella during pregnancy [intrauterine] at two and seven months of gestation. The other 11 patients had varicella under the age of four years and herpes zoster 4-8 years later. Among the immunocompromised children only two patients had varicella under the age of four years, they all had varicella before the appearance of malignancy, and all patients in this group had herpes zoster between the age of 9 -14 years. Zoster is a rare disease in childhood. Varicella in early childhood is a risk factor of herpes zoster in immunocompromised and immunocompetent children. Most cases of childhood zoster occur in otherwise healthy children. The appearance of herpes zoster in a young child does not always imply an underlying immunodeficiency or malignancy. The prognosis is generally excellent

Glucagonoma presenting as necrolytic migratory erythema in a long-standing type II diabetic patient

We report a case of glucagonoma in a 60-year old diabetic lady who was seen by a dermatologist for a superficial erythematous skin eruption with flaccid bullae over both legs of recent onset. These findings warranted further investigations that revealed a pancreatic mass lesion involving the distal body and tail with three metastatic deposits within the right lobe of the liver. Distal pancreatectomy and splenectomy were performed and histological examination of the excised specimen confirmed the diagnosis of pancreatic glucagonoma with liver metastasis. Blood sugar levels became more controlled postoperatively. The skin lesion disappeared completely six months after surgery. The lady enjoys fairly good health, and is maintained on Somatostatin analogues for control of metastasis that are stable after 18 months of follow up