Cold urticaria as a complication of cryotherapy in the treatment of viral warts.

Cryotherapy with liquid nitrogen has been established as the first-line treatment for pediatric patients with viral warts. Cold-induced urticaria (CU) is a rare skin reaction triggered by cold stimuli. We present the case of a pediatric patient with viral warts who developed CU after receiving cryotherapy.

Morphea mimicking facial capillary malformations: Two new cases and review of the literature.

Morphea and facial capillary malformations (port-wine stains) are distinct conditions that can affect the pediatric population. Early localized morphea mimicking a capillary malformation is an uncommon clinical presentation. We present two new cases of girls, aged 2 and 3 years, who presented with erythematous patches, initially diagnosed as capillary malformations, which were later diagnosed as morphea. We also performed a literature review, yielding 12 additional cases that underscore that the unusual presentation of morphea may delay correct diagnosis. Although early management of morphea reduces long-term sequelae, it is important to delay laser treatment for selected acquired vascular malformations, until the diagnosis of morphea is excluded.

Investigación de una sospecha de brote de lipoatrofia semicircular en niños / Investigation of a suspected outbreak of lipoatrophia semicircularis in children

Antecedentes y objetivo: Los informes recientes sobre brotes de lipoatrofia semicircular (LS) en diversos países han generado debate acerca del papel potencial de las características ambientales de los puestos de trabajo en los nuevos edificios. El objetivo de este estudio fue investigar la sospecha de un brote de LS entre los niños de una guardería pública de Barcelona, lo cual generó una tremenda alarma. Métodos: Realizamos una valoración epidemiológica, incluyendo análisis descriptivo y de prevalencia, y una investigación ambiental seguida de una valoración psiquiátrica de acuerdo con los criterios de Small. Comparamos la prevalencia de LS y su intervalo de confianza del 95% entre los niños y entre el personal de la guardería en estudio, y con otros centros. Resultados: Entre los 86 niños que acudieron a la guardería detectamos 11 casos confirmados y 2 casos posibles de LS (15,1%), y entre los 41 niños que acudieron a otros centros identificamos 8 casos confirmados y 4 casos posibles (29,3%) (p=0,10). Entre el personal de la guardería, detectamos 8 casos de LS (66,7%), y entre las 19 mujeres que trabajaban en otros sitios identificamos 14 con la misma condición que el personal (73,7%) (p=0,98). Se clasificaron finalmente todas las lesiones como hendiduras con diferentes localizaciones. La evaluación ambiental no identificó ningún factor de riesgo con relación significativa con la aparición del brote. Dicho brote compartió 13 de los criterios de Small en relación con el trastorno somatoforme epidémico («histeria colectiva»). Conclusión: La presencia de hendiduras puede considerarse como una variante de la normalidad en las extremidades inferiores de los niños. El desarrollo característico del proceso nos conduce a la conclusión de que este brote fue un trastorno somatoforme epidémico (AU)

Background and objective: Recent reports of outbreaks of lipoatrophia semicircularis (LS) in various countries have generated discussion regarding the potential role of the environmental characteristics of office workplaces in new buildings. The objective of this study was to investigate a suspected outbreak of LS among children in a public school in Barcelona, which generated tremendous alarm. Methods: We performed an epidemiological assessment including descriptive and prevalence analyses, and an environmental investigation followed by a psychiatric assessment according to Small's criteria. We compared the prevalence of LS and its 95% confidence interval between children and staff attending the day-care centre under study and other centres. Results: Among 86 children attending a day-care centre we detected 11 confirmed and 2 possible cases of LS (15.1%) while among 41 children attending other day-care centres we identified 8 cases and 4 possible cases (29.3%) (P=.10). Among 12 day-care staff, we detected 8 cases of LS (66.7%) while among 19 women working different jobs we identified 14 with the same condition as the staff (73.7%) (P=.98). All lesions were finally classified as indentations with different locations. The environmental evaluation didn’t identify any exposure factors with a significant role in the onset of the outbreak. The outbreak shared 13 of Small's 16 criteria regarding epidemic somatoform disorder (‘mass hysteria’). Conclusion: The presence of indentations can be considered a normal variant in the lower extremities of children. The characteristic development of the process leads us to the conclusion that this outbreak was an epidemic somatoform disorder (AU)

Investigation of a suspected outbreak of lipoatrophia semicircularis in children. / Investigación de una sospecha de brote de lipoatrofia semicircular en niños.

BACKGROUND AND OBJECTIVE: Recent reports of outbreaks of lipoatrophia semicircularis (LS) in various countries have generated discussion regarding the potential role of the environmental characteristics of office workplaces in new buildings. The objective of this study was to investigate a suspected outbreak of LS among children in a public school in Barcelona, which generated tremendous alarm. METHODS: We performed an epidemiological assessment including descriptive and prevalence analyses, and an environmental investigation followed by a psychiatric assessment according to Small's criteria. We compared the prevalence of LS and its 95% confidence interval between children and staff attending the day-care centre under study and other centres. RESULTS: Among 86 children attending a day-care centre we detected 11 confirmed and 2 possible cases of LS (15.1%) while among 41 children attending other day-care centres we identified 8 cases and 4 possible cases (29.3%) (P=.10). Among 12 day-care staff, we detected 8 cases of LS (66.7%) while among 19 women working different jobs we identified 14 with the same condition as the staff (73.7%) (P=.98). All lesions were finally classified as indentations with different locations. The environmental evaluation didn't identify any exposure factors with a significant role in the onset of the outbreak. The outbreak shared 13 of Small's 16 criteria regarding epidemic somatoform disorder ("mass hysteria"). CONCLUSION: The presence of indentations can be considered a normal variant in the lower extremities of children. The characteristic development of the process leads us to the conclusion that this outbreak was an epidemic somatoform disorder.

Linear Morphea Mimicking Lichen Striatus in Its Early Presentation.

Linear morphea and lichen striatus are distinct conditions that have been linked in only one previous case report. We describe two patients with facial lichen striatus preceding linear morphea at the same site. A possible pathogenic relationship is discussed.

An unusually severe case of dermatosis neglecta: a diagnostic challenge.

Dermatosis neglecta is a condition secondary to lack of cleanliness, characterized by the formation of hyperkeratotic plaques located in a particular region of the body, usually due to a disability, and it is considered a diagnostic challenge because it can mimic other entities. We present the case of an 18-year-old woman with a 2-month history of progressive brown verrucous plaque in her face. Our first impression was seborrheic dermatitis and she was treated with facial cleanser soap and topic hydrocortisone 1%. One month later, she arrived with new lesions. Because of this our diagnosis changed to Darier's disease versus seborrheic pemphigus versus foliaceus pemphigus. Histopathology and immunofluorescence studies were compatible with seborrheic dermatitis. The patient complained of depression and social withdrawal and denied facial cleansing. Facial cleansing was performed during consultation presenting resolution of the lesions, which confirmed the diagnosis of dermatosis neglecta. Dermatosis neglecta is a disease that can be frequently misdiagnosed, since it has many differential diagnoses, such as hyperkeratotic syndromes. It should be recognized early and aggressive diagnostic and therapeutic methods should be avoided.