ABSTRACT
To describe clinical manifestations, differential diagnosis, and treatment outcome of Erythema Toxicum Neonatorum in healthy newborns at King Hussein Medical Center and Queen Rania Children's Hospital. The medical records review was conducted for patients with clinical diagnosis of Erythema Toxicum Neonatorum who were treated at King Hussein Medical Center and Queen Rania Children's Hospital dermatology clinics between February 2008 and September 2012. Extracted data include duration of pregnancy, type of delivery, age, sex, cutaneous rash characteristics, associated clinical conditions, laboratory investigations, skin biopsy, and treatment. Simple statistical analyses [mean, frequency, and percentage] were used to describe the study variables. The study included 152 patients, 88 males and 64 females with a male to female ratio of 1.4:1. The age at onset of the rash ranged from one to 11 days [mean age was 4 days]. All subjects were products of hospital-based deliveries. The erythematous and papular type was the commonest [73.7%]. History of drug intake during pregnancy was found in about two thirds of cases [66%]. Four subjects [2.64%] had lymphadenopathy and five [3.22%] had moderate fever. Tzanck smear was done in 17 subjects with severe skin rash. Skin biopsy was done in four patients. About half cases received oral antihistamine treatment and the rashes disappeared over 24 to 36 hours. Follow up was done for four weeks. Erythema Toxicum Neonatorum is a self-limiting disease and without long term sequalae. More efforts are needed to raise awareness of this condition amongst health care professionals to avoid unnecessary investigations and treatment as it is sometimes misdiagnosed as bacterial infection
ABSTRACT
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
ABSTRACT
This observational study aims to review our experience in using cryotherapy for the management of genital warts during pregnancy over a five-year period. Fifty-three pregnant women with established genital warts were managed during the period from January 2000 to April 2005. There were 23 patients in the first trimester, 22 in the second, and 8 in the third trimester. Base line laboratory investigations were performed to establish any abnormalities and any other concurrent sexually transmitted diseases before starting treatment in each patient. Sexual abstinence or the use of protective barriers was advised to all patients. Cryotherapy was performed for the treatment of all genital warts. The treatment was on an out-patient basis, and the women were followed up every two weeks throughout pregnancy, and every month afterwards until nine months post delivery. Infants were also examined at birth and at nine months of age. There was dramatic response to local cryotherapy during pregnancy against genital warts, with 84.9% clearance of lesions prior to delivery. There were no cases of premature labour or premature rupture of membranes directly related to treatment, and there were no cases of neonatal genital or laryngeal involvement. Although no recurrences of lesions were observed before delivery, there was an overall recurrence rate of 45.3% at nine months post delivery. Cryotherapy is an effective and safe method for the treatment of genital warts throughout pregnancy