Generalized morphea with concurrent vitiligo in a four-year-old boy

Morphea, a localized type of scleroderma, is a rare fibrosing disorder of the skin that presents with a variety of clinical manifestations such as linear morphea, plaque morphea, generalized morphea and other miscellaneous groups. It has an incidence rate of 0.4-2.7 cases per 100,000 people. Generalized morphea is defined as four or more plaques larger than 3cm, and/or involving of two or more anatomical sites. Among pediatric population, 5% of the cases present as generalized morphea. Concomitant vitiligo is found in in 7% of morphea cases. We report a case of generalized morphea in a four-year-old boy who presented with a one-year history of multiple, well-defined, indurated, annular, skin-colored to hyperpigmented plaques with central atrophy on the mid to lower back and left cheek. There was also concurrent two-year history of multiple ill-defined vitiliginous patches on the upper back, upper arms, and elbow.

Bubbly orange baby: A rare case of diffuse cutaneous mastocytosis, bullous type

Mastocytosis is an uncommon, sporadic, heterogenous illness resulting from hyperplasia of mast cells. Diffuse cutaneous mastocytosis is the rarest subtype of mastocytosis affecting children, with bullous mastocytosis being its least common variety. Systemic manifestations like nausea, vomiting, bone pain, diarrhea, and central nervous system abnormalities are less common in children than adults. We report a four-month old male who presented with a two-month history of generalized yellowish to tan macules, papules and plaques with peau d'orange texture, with some blisters and erosions on the back, abdomen and scalp. Darier's sign was positive. Baseline laboratory workup were negative for systemic involvement. CD117 and Giemsa staining were positive for mast cells. Based on the clinical findings and histopathologic results, a diagnosis of bullous mastocytosis was made. Treatment included ketotifen drops, mupirocin cream and cetirizine drops, which resulted in flattening of most lesions and resolution of blisters and erosions.

A randomized, double-blind, placebo-controlled study on the safety and efficacy of 0.025% capsaicin (Capsicum annuum var. longum) cream against 1% hydrocortisone cream as an anti-inflammatory and anti-pruritic preparation for mosquito bites

BACKGROUND: Mosquito bite is a common dermatological complaint with various treatments but with no gold standard treatment regimen. OBJECTIVE: To compare the safety and efficacy of 0.025% capsaicin cream against 1% hydrocortisone cream and placebo as anti-inflammatory and anti-pruritic preparation for mosquito bites. METHODS: Seventy-five volunteers were enrolled in the placebo-controlled trial and randomized into three treatment groups. They were exposed to laboratory-reared mosquitoes to incur bites and to apply the designated cream. Anti-inflammatory and anti-pruritic effects were determined by mean lesion size, physician's global assessment, pruritus intensity score and 100mm visual analog scale. RESULTS: The mean lesion size and physician's global assessment, pruritus intensity score and visual analog scale showed no significant difference between 0.025% capsaicin and 1% hydrocortisone and they were both found to be superior to placebo (p-valueCONCLUSION: 0.025% capsaicin is comparable to 1% hydrocortisone as an anti-inflammatory and anti-pruritic preparation for mosquito bites.