Art of prevention: The importance of measles recognition and vaccination.

Measles is a viral infection that has a characteristic pattern of prodromal symptoms followed by a rash. Previously considered an inevitable childhood condition, measles is known as the "first" classic childhood exanthem. For most children, measles was a one-time, short-term illness; however, some children developed complications that led to severe sequelae and death. The introduction of the measles vaccine dramatically decreased the number of cases, but the current trend against vaccination has caused outbreaks of the condition. We propose the implementation of the AAA approach (assume, advise, and answer) as a way for providers to directly encourage the administration of the vaccine and prevent future cases of measles.

Pre-Emptive Avoidance Strategy (P.E.A.S.) - addressing allergic contact dermatitis in pediatric populations.

Pediatric allergic contact dermatitis (ACD) has been increasingly recognized in the United States. Reported rates of positive patch tests in children referred for suspected ACD range between 27 and 95.6%. Many young children are becoming sensitized to contact allergens found in personal hygiene products. We reviewed five recent pediatric patch test studies to determine the top allergens associated with this source of ACD in children. The top ten allergens were neomycin, balsam of Peru, fragrance mix, lanolin, cocamidopropylbetaine, formaldehyde, corticosteroids, methylchlorisothiazolinone (MCI)/methylisothiazolinone (MI), propylene glycol, and benzalkonium chloride. We estimate that one third of children suffering from ACD could potentially benefit from a 'pre-emptive avoidance strategy' (P.E.A.S.) of the stated top 10 allergens.

Chronic actinic prurigo presenting in an adopted child.

In diagnosing actinic prurigo (AP), the patients' ethnic background is very helpful as this condition is associated with very specific ethnic groups. We discuss a patient with an unknown family history who presented with a rash that initially seemed like lupus, but was subsequently diagnosed as AP upon further evaluations.

The use of naltrexone in the management of severe generalized pruritus in biliary atresia: report of a case.

Generalized pruritus secondary to cholestasis is a difficult dermatologic condition to treat. We present a case of a 17-month-old child with congenital biliary atresia with generalized pruritus refractory to treatment with oral antihistamines, topical steroids, cholestyramine, and rifampin but improved remarkably with the addition of naltrexone. Naltrexone is a well-tolerated medication with little adverse effects. We believe that naltrexone may be an effective adjuvant treatment in the management of cholestatic pruritus in the pediatric population.