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2.
Pediatr Dermatol ; 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38725265

RESUMO

Social media is increasingly used by patients for the management of skin conditions like acne, despite the potential risk for low-quality information. This study surveyed 45 participants between the ages of 12 and 17 years to investigate factors that could be associated with social media use among adolescents with acne. The likelihood of social media use was not significantly increased by clinical severity of acne, more severe physical barriers (greater than or equal to 20 miles to the dermatology clinic), more severe temporal barriers (waiting 12 or more weeks for a first dermatology appointment), or worsened quality of life (assessed via the Skindex-Teen score). This study increases understanding of adolescents' social media behaviors, particularly as a way to seek information for skin conditions like acne.

3.
Pediatr Dermatol ; 41(3): 560-562, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38459646

RESUMO

Issues of health equity are rightfully in the national spotlight. Here we present a narrative piece on the sacred importance of hair and its ties to cultural identity among many Native communities in the United States. We introduce unique values ascribed to hair in some Native cultures, and include examples of how hair has played an important role in both abuse and generational trauma for many individuals and families. By sharing experiences, we hope to illuminate perspectives often underrepresented, and to enable more culturally humble, responsive, and informed dermatologic care.


Assuntos
Cabelo , Humanos , Estados Unidos , Dermatologistas/psicologia , Dermatologia , Indígenas Norte-Americanos
6.
Pediatr Dermatol ; 38(6): 1488-1499, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34651341

RESUMO

Reflectance confocal microscopy is an innovative imaging modality, which noninvasively provides an optical image to aid in the diagnosis of skin lesions. While performing a skin biopsy for histopathologic analysis is the gold standard to definitively diagnose skin disease, this may prove to be more difficult in the pediatric population. This will occasionally necessitate sedation or general anesthesia as an approach, which carries a number of different risks. Reflectance confocal microscopy is an exciting new avenue in the support of diagnosing skin pathology, with the goal of improving pediatric patient tolerance and experience when examining epidermal and superficial dermal skin lesions. This review discusses the utility of reflectance confocal microscopy for pediatric dermatology patients pertaining to melanocytic and non-melanocytic skin neoplasms and inflammatory and infectious skin diseases in children.


Assuntos
Dermatologia , Criança , Humanos , Microscopia Confocal
7.
JAAD Case Rep ; 11: 33-35, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33898681
9.
Semin Arthritis Rheum ; 50(4): 645-656, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32504991

RESUMO

BACKGROUND: Localized scleroderma (LS) is a rare chronic immune-mediated skin condition of unknown etiology characterized by an inflammatory response in the skin and subcutaneous tissues resulting in collagen deposition and subsequent fibrosis. There is no cure for LS. No therapies have been licensed specifically for the treatment of LS and the clinical management of the disease remains largely empirical. Abatacept, a recombinant fusion protein interfering with the T-cell costimulatory pathway, has been reported to be effective in adult cases of LS. We report the successful use of abatacept in a juvenile localized scleroderma (jLS) cohort and conduct a systematic literature review to evaluate the evidence supporting the use of abatacept in the treatment of LS. METHODS: We compiled retrospectively the clinical data on 8 cases of jLS that were treated with abatacept in our academic center. A systematic review protocol was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) guidelines and has been registered with the international prospective register of systematic reviews (PROSPERO). Standardized searches of MEDLINE/PubMed and EMBASE were undertaken to identify studies reporting the use of abatacept in the treatment of LS. Heterogeneity in study design, interventions and reported outcomes necessitated a qualitative data synthesis. RESULTS: The use of abatacept was effective and safe in our cohort of jLS patients. Our standardized searches identified 30 articles, of which 3 deemed eligible for full data extraction. All 3 studies were small (total of 18 patients; mean 6 subjects per study), single center, open-label, uncontrolled and non-randomized. The Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) identified high risk-of bias for confounding variables and blinding of assessors in each of the 3 studies evaluated and in our pediatric case series. CONCLUSIONS: The evidence-base to support the use of abatacept in the treatment of LS is currently limited and clinical practice guidelines should take a measured approach to such recommended therapy. Nonetheless, as the empirical evidence on the clinical effectiveness of abatacept in the treatment of LS accumulates, a double-blind placebo-controlled randomized clinical trial is necessary to formally evaluate the observations documented by case-based reports.


Assuntos
Abatacepte/administração & dosagem , Esclerodermia Localizada/tratamento farmacológico , Abatacepte/efeitos adversos , Adolescente , Criança , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Masculino , Resultado do Tratamento
10.
Pediatr Dermatol ; 36(6): 835-842, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31576603

RESUMO

BACKGROUND/OBJECTIVES: Congenital hemangiomas (CH) are a group of benign vascular tumors that are present at birth and exhibit variable involution during infancy. Congenital hemangiomas that do not involute are typically solitary patch or plaque-type tumors that grow proportionally with somatic growth. We report a case series of 9 patients with persistent CH, which exhibited uncommon features including segmental involvement, recurrent or severe pain, or growth via volumetric increase in size or apparent increased extent of anatomic involvement over time. METHODS: Via retrospective chart review, we included patients with persistent CH and atypical presentations. Available data regarding clinical characteristics, natural history, histopathology, imaging, and genetic tests were collected. RESULTS: Data on 9 patients were collected, including 7 noninvoluting CH and 2 partially involuting CH. Three of the 9 cases had segmental distribution, 6 had apparent growth or clinical evolution, and 4 were symptomatic with pain. One also had marked localized intravascular coagulopathy. CONCLUSIONS: Ongoing or recurrent pain and large extent of anatomic involvement can be features of CH, albeit uncommon ones, and can pose both diagnostic and management challenges. Tissue genomic studies can offer a novel tool for CH diagnosis.


Assuntos
Hemangioma/congênito , Neoplasias Cutâneas/congênito , Neoplasias Vasculares/congênito , Adolescente , Adulto , Criança , Pré-Escolar , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Hemangioma/diagnóstico , Hemangioma/terapia , Humanos , Lactente , Masculino , Medição da Dor , Fenótipo , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/terapia
11.
Pediatr Dermatol ; 32(5): e217-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26138991

RESUMO

Currently there exist few reported cases where lasers are used successfully to treat glomuvenous malformations in adolescents. In the two cases described here, we provide evidence that the long-pulsed neodymium-doped yttrium aluminum garnet laser is an effective and safe alternative treatment for these lesions. Our case series is unique because it focuses on adolescents, the population that most often seeks treatment for this dermatologic condition.


Assuntos
Tumor Glômico/cirurgia , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Paraganglioma Extrassuprarrenal/cirurgia , Adolescente , Criança , Estética , Feminino , Seguimentos , Tumor Glômico/diagnóstico , Humanos , Paraganglioma Extrassuprarrenal/diagnóstico , Doenças Raras , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Pediatr Dermatol ; 32(5): 714-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25639516

RESUMO

Behçet disease is a complex, multisystem disease characterized by recurrent oral and genital ulcerations. It rarely occurs in infants or children. Neonatal Behçet disease has been reported in infants whose ulcers resolve at or before 9 weeks of age. Few cases of neonatal Behçet disease persisting into childhood have previously been reported. We report the case of a 1-month-old infant who presented with severe recurrent genital ulcerations and at 6 months developed recurrent oral ulcerations. Her orogenital ulcerations continue to recur. Human leukocyte antigen testing revealed HLA-B51 and B44 positivity. This is a case of pediatric Behçet disease in the neonatal period. Behçet disease should be considered in the differential diagnosis of recurrent genital and oral ulcerations in infants and children.


Assuntos
Síndrome de Behçet/diagnóstico , Doenças dos Genitais Femininos/diagnóstico , Úlceras Orais/diagnóstico , Úlcera/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recidiva
14.
Pediatr Clin North Am ; 61(2): 443-55, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24636655

RESUMO

Superficial fungal infections can involve the hair, skin, and nails. Most affected children are healthy, although immunosuppression is a risk factor for more severe presentation. Causative organisms typically are members of the Trichophyton, Microsporum, and Epidermophyton genera (dermatophytes), can be acquired from other infected humans, animals, or soil, and illicit a host inflammatory response. Nondermatophyte infections include pityriasis versicolor. In this article, the most common clinical presentations, diagnostic recommendations, and treatment algorithms for dermatophyte and nondermatophyte mycoses in children and adolescents are described.


Assuntos
Antifúngicos/uso terapêutico , Dermatomicoses/diagnóstico , Pele/microbiologia , Adolescente , Criança , Dermatomicoses/tratamento farmacológico , Dermatomicoses/microbiologia , Diagnóstico Diferencial , Humanos
16.
Pediatr Dermatol ; 31(1): 111-3, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24266857

RESUMO

Mastocytosis is a relatively common disorder characterized by mast cell collections in the skin and other organ systems. Affected children are more likely than adults to have limited cutaneous disease. We report two patients with localized vulvar mastocytosis in the absence of other cutaneous findings and review previous reports of vulvar involvement in cutaneous mastocytosis.


Assuntos
Mastocitose Cutânea/patologia , Vulva/patologia , Vulvite/patologia , Biópsia , Criança , Pré-Escolar , Feminino , Humanos
18.
Pediatr Dermatol ; 31(3): 368-72, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23106790

RESUMO

A 2-year-old African American, Hispanic boy presented with well-defined, violaceous, annular dermal plaques without scale over the upper extremities, face, lower extremities, and buttocks. The clinical presentation and laboratory studies were consistent with a diagnosis of subacute cutaneous lupus erythematous (SCLE). SCLE presenting in childhood is exceedingly rare, with only eight cases previously reported. It is important to clinically differentiate SCLE from other eruptions more common to children, such as atopic dermatitis, urticarial drug eruptions, and psoriasis vulgaris, because progression to systemic lupus erythematous (SLE) may occur. SLE needs to be closely followed. We present the first case (to our knowledge) of SCLE in a child of African American or Hispanic descent and provide a table of other documented pediatric presentations of SCLE for comparison.


Assuntos
Lúpus Eritematoso Cutâneo/diagnóstico , Lúpus Eritematoso Cutâneo/patologia , Pele/patologia , Biópsia , Pré-Escolar , Diagnóstico Diferencial , Humanos , Masculino , Índice de Gravidade de Doença
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