ABSTRACT
Atopic dermatitis (AD) is a common eczematous skin condition; as many as 10-17 percent of all children are affected, and 35-60 percent of affected patients manifest symptoms manifest during the first year of life. Treatment principles for AD in young children involve conservative measures such as avoidance of hot water and environmental irritants, combined with liberal use of emollients after bathing. Low potency topical corticosteroids (TCS) are the current standard of therapy for AD in young children, reserving mid- and high-potency TCS for severe disease. However, complications of long-term use of TCS include skin atrophy, stria formation, telangiectasia, hypopigmentation, secondary infections, steroid acne, allergic contact dermatitis, and miliaria. The pediatric population is also at increased risk for systemic absorption because of their high ratio of skin surface to body mass. Systemic absorption may result in hypothalamic-pituitary-adrenal axis suppression and ultimately growth retardation. Although most topical and systemic corticosteroids are not approved by the Food and Drug Administration for use in children less than 2 years of age, conservative treatment often fails in this age group and frequently patients are treated with TCS, antibiotics, and antihistamines.
Subject(s)
Dermatitis, Atopic/drug therapy , Immunosuppressive Agents , Tacrolimus , Administration, Cutaneous , Adrenal Cortex Hormones/adverse effects , Adrenal Cortex Hormones/therapeutic use , Anti-Bacterial Agents/therapeutic use , Dose-Response Relationship, Drug , Drug Evaluation , Drug Utilization Review , Emollients/therapeutic use , Female , Histamine H1 Antagonists/therapeutic use , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Infant , Male , Ointments , Pain/chemically induced , Pruritus/chemically induced , Retrospective Studies , Tacrolimus/administration & dosage , Tacrolimus/adverse effects , Tacrolimus/therapeutic use , Treatment OutcomeABSTRACT
Keratosis pilaris (KP) is a common hyperkeratotic condition that most commonly presents as skin-colored follicular papules surrounded by erythema. These lesions often appear grouped together on the lateral aspect of the arms, thighs, and buttocks. Although the etiology of KP is uncertain, it is thought to be the result of the formation of an orthokeratotic plug, which blocks and dilates the orifice and upper portion of the follicular infundibulum (Figure 1). Histologically, mild perivascular mononuclear cell infiltrates are usually present in the adjacent dermis. Studies have indicated a role for hormonal influences in the development of KP. The five cases presented in this study demonstrate keratosis pilaris as a condition in which the onset or severity of the dermatosis may be linked to the hormonal changes of pregnancy.
