Pediatricians' Awareness of Pediatric Psoriasis in the Makkah Region, Saudi Arabia.

Background Psoriasis is an autoimmune disease characterized by the typical appearance of red, thickened, scaly patches on the skin (plaques). These plaques can vary in size and distribution from person to person. In some individuals, it may affect small areas of skin, while in others, large areas covering their body may be involved. Patients with psoriasis might be identified by pediatricians before being seen by dermatologists, highlighting the need for pediatricians to be aware and knowledgeable about pediatric psoriasis. Objective To evaluate the knowledge and management of pediatric psoriasis among pediatricians and pediatric residents in the Makkah region, Saudi Arabia. Methods This was a cross-sectional study using a questionnaire targeted at pediatricians. It inquired about sociodemographic details, knowledge of psoriasis risk factors, diagnosis, management, comorbidity screening, and indications for consulting a dermatologist. The knowledge score cut-off was set at 60%, with scores below this threshold considered indicative of poor knowledge and scores above it reflecting good knowledge. Results A total of 139 participants completed the questionnaire; 103 (74.1%) were from Jeddah, 101 (72.7%) were pediatric residents, 118 (84.9%) were general pediatricians, and 18 (15.1%) were in subspecialties. About a third, 49 (35.3%), reported having seen a child with psoriasis. Most participants, 84 (60.4%), had a good knowledge level regarding psoriasis. The vast majority, 119 (85.6%), stated that topical therapies are the first-line treatment; 105 (75.5%) reported being confident in diagnosing psoriasis, and having previously seen a patient with psoriasis was associated with certainty in diagnosis (p-value=0.048); 82 (59%) referred patients to dermatologists. Physician position (p-value=0.049) and being in a general specialty (p-value=0.048) were associated with higher knowledge. Conclusion Overall, participants had good knowledge of pediatric psoriasis and its management. However, there is still a need for improvement.

Retraction: Unicentric Castleman Disease With Systemic Symptoms: A Rare Case From Family Practice.

[This retracts the article DOI: 10.7759/cureus.21132.].

Unicentric Castleman Disease With Systemic Symptoms: A Rare Case From Family Practice.

Palpable lymphadenopathy is very common in children. The vast majority of cases are due to benign conditions and self-limiting diseases. Careful clinical evaluation, with thorough history taking and make a comprehensive physical examination, is essential to avoid unnecessary invasive procedures and not to misdiagnose possible serious underlying conditions. We report the case of a 9-year-old child with a lump in the right axilla that was first noticed with a swelling two months ago. The lump was not painful but its size has been gradually increasing. The symptom was associated with night sweats. However, there was no history of cough, fever, or weight loss. The child had no history of animal contact or insect bites. No recent travel or history of contact with any sick person was reported. His vaccination schedule was up-to-date. Upon examination, the patient had a smooth non-tender swelling in the right axilla. It measured around 4 x 4 cm. The overlying skin was normal with no erythema or ulceration. The swelling was mobile and was not adherent to the overlying skin. Laboratory investigation showed mild anemia, thrombocytosis, and elevated C-reactive protein level. An ultrasound examination demonstrated a well-circumscribed enlarged lymph node, measuring 3.4 cm in short axis, with an increased blood flow on color doppler. Biopsy findings showed proliferation of the follicular lymphoid tissues that were centered around penetrative vessels giving the appearance of "onion skin" in keeping with Castleman disease. Complete surgical resection of the lymph node was performed and resulted in the resolution of the systemic symptoms. Castleman disease is a rare lymphoproliferative disorder with shared histopathological features. Unicentric Castleman disease usually presents with isolated asymptomatic lymphadenopathy. However, the present case demonstrated that patients with unicentric Castleman disease may exhibit systemic constitutional symptoms similar to that of the multicentric subtype.