European Journal of Pediatric Dermatology

Prevalence of metabolic syndrome and its parameters in pediatric psoriasis: a cross-sectional study with literature review.

A. Bansal — 2024-11-11

Background. Psoriasis is a multifactorial, chronic, inflammatory, and immune-mediated skin disease, known to be associated with various metabolic and non-metabolic comorbidities in adults due to the underlying systemic inflammatory response. It has been proposed that a similar interconnection between psoriasis and metabolic syndrome (MetS) is present in children as well. However, current literature on the prevalence of metabolic syndrome in pediatric psoriasis and data regarding its association with psoriasis severity in children are sparse in North India.
Methods. A one-year observational study was conducted to evaluate the association of MetS and its parameters among 30 children aged 10–18 years with chronic plaque psoriasis, who were compared with 30 age- and sex-matched controls. The International Diabetes Federation (IDF) 2007 criteria were used to classify patients with metabolic syndrome and disease severity was assessed based on Psoriasis Area Severity Index (PASI) score.
Results. Of 30 cases, nine (30%) cases had metabolic syndrome and of 30 controls, only three (10%) met the criteria for metabolic syndrome. However, the difference was not statistically significant (p=0.053). Various metabolic parameters such as waist circumference, weight, and diastolic blood pressure were significantly higher in psoriasis patients compared to controls. In addition, the prevalence of MetS was higher in cases with severe disease.
Conclusion. The results of the study showed an association of MetS and its parameters with pediatric psoriasis, but the results were not significant in statistical analysis, probably due to the small sample size and short duration of the study.

Correlation between clinical, immunohistological diagnosis and whole exome sequencing analysis in epidermolysis bullosa: A case series.

M. Motgi — 2024-11-11

Epidermolysis bullosa (EB) is a group of rare inherited skin diseases characterized by fragility of the skin and mucosa, resulting in vesiculo-bullae following minimal trauma. The classification of EB is based on the level of cleavage, with four main subtypes: EB simplex (EBS), junctional EB (JEB), dystrophic EB (DEB), and EB Kindler. Immunohistological and/or mutational genetic analysis is essential for an accurate diagnosis. We report a series of eleven children seen over a fourteen-month period. The study involved 11 patients, consisting of 10 males and 1 female, ranging in age from 2 days to 12 years. In each case, a medical history, a detailed clinical examination, a shave biopsy sent for antigen mapping, and a blood sample for whole exome sequencing (WES) analysis were performed. Two cases of EB simplex and two cases of dystrophic EB showed complete concordance. Three EB simplex, one junctional EB and two EB Kindler showed partial concordance. However, one case of junctional EB was discordant. All patients received wound supportive care and losartan was administered to dystrophic EB cases. For a better quality of life, patients with EB require early and accurate diagnosis integrating clinical history, antigen mapping and WES analysis.

Neurofibromatosis type 1 with combined mutation.

A.V. Mun — 2024-11-11

Neurofibromatosis is a frequent autosomal dominant inherited skin disorder caused by a pathogenic variant of the NF1 gene. An exceptional case is presented in an 8-year-old girl who also had a probably pathogenic mutation of the IGF1R gene. The differential diagnosis of the disease and the role of genetic testing in the diagnostic process were also discussed.

Porokeratotic eccrine ostial and dermal duct nevus.

Meghana Rane — 2024-11-11

Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare condition characterized by grouped, asymptomatic, linearly distributed keratotic papules and plaques on the extremities, with the characteristic histopathological appearance of porokeratosis. It is a disorder of keratinization involving the intraepidermal eccrine duct (acrosyringium) and is characterized histologically by eccrine hamartoma with cornoid lamella. Lesions usually present at birth or during childhood. We present a case of systematized PEODDN with scoliosis in an 8-year-old boy showing hyperkeratotic verrucous lesions on the palm, forearm, upper arm, legs and trunk along the lines of Blaschko, predominantly on the right side of the body since the age of 1 year with its characteristic dermoscopic and histopathological features.

Speckled lentiginous nevus with intranevic vitiligo depigmentation.

S. Patil — 2024-11-11

Vitiligo developing within congenital melanocytic nevi is a rare phenomenon. A case of a 13-year-old boy with new-onset vitiliginous lesions within a preexisting congenital segmental speckled lentiginous nevus is presented. This case highlights the importance of recognizing this unusual association and understanding its underlying pathogenesis. Based on clinical and histopathological data, possible mechanisms of this phenomenon are discussed and the relevant literature is reviewed.

Macrocephaly-cutis marmorata telangiectatica congenita with seizures. Case report and review of the literature.

S. Atitallah — 2024-11-11

Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital vascular anomaly characterized by a cutaneous reticulated vascular network. Although it is usually isolated, it can sometimes be associated with systemic anomalies, including macrocephaly, a condition termed Macrocephaly-CMTC syndrome (M-CMTC). We report the case of a one-month-old girl diagnosed with M-CMTC, associated with seizures and limb asymmetry. After treatment with antiepileptic drugs and careful follow-up, the patient’s condition improved, with regression of the skin lesions and no further seizures.

Extensive pyoderma gangrenosum in a 3-year-old boy.

P. Badabagni — 2024-11-11

Pyoderma gangrenosum (PG) is a rare inflammatory and ulcerative skin disorder often associated with inflammatory bowel disease, arthritis, and hematologic malignancies. It is characterized by painful, necrotic ulcers with violaceous borders. The disease is estimated to occur in 3 to 10 people per million per year, predominantly affecting adults between 20 and 50 years of age, with a possible higher incidence in women. The current report describes a 3-year-old boy with extensive PG lesions, an unusual presentation in pediatric age. The patient was treated with systemic corticosteroids, cyclosporine, and supportive care, including oral antibiotics and topical corticosteroid creams, which resulted in significant improvement after 2 weeks.

Pyoderma gangrenosum in children.

Y. Habibi — 2024-11-11

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that manifests as painful inflammatory skin ulcerations. It can be isolated or associated with other inflammatory diseases, especially intestinal or joint diseases. An isolated case is presented in a 12-year-old girl, who presented initial diagnostic difficulties, but responded well to systemic corticosteroid therapy.

Adverse effects of home remedies for cold influenced by social media.

Niharika — 2024-11-11

Medicinal plants have numerous positive health effects and social media promotes their use for various diseases. Garlic, a well-known herbaceous species, is often used to treat cough and cold, but it has been linked to adverse side effects, including burns. The purpose of our article is to advise patients not to apply fresh garlic to their skin or mucous membranes without knowing the subsequent consequences. In our study, an 8-month-old little girl was treated for cold and cough by using raw garlic paste on his foot, which resulted in a chemical burn.

Extensive linear porokeratosis in an 8-year-old female.

T. Theriot — 2024-11-11

An 8-year-old female presented with extensive lesions involving the left leg, arm, and face which had been present since birth with biopsy in infancy suggestive of a scar. Clinical examination revealed hyperpigmented, hyperkeratotic papules coalescing into linear plaques. Repeat biopsy confirmed the diagnosis of linear porokeratosis. This case is a valuable example of a rare condition which may present a diagnostic challenge. It underscores the importance of considering linear porokeratosis in the differential diagnosis of linear dermatoses and highlights the need for a comprehensive approach to diagnosis and management.

Partial unilateral lentiginosis in a 17-year-old girl.

S. Ramalingam — 2024-11-11

Partial unilateral lentiginosis presents as multiple lentigines confined to one side of the body; sometimes the lentigines may have a zosteriform distribution. The current paper describes the case of a 17-year-old girl with partial unilateral lentiginosis present on the right hemithorax and abdomen in the T4-T12 dermatomes and extending to the right back without crossing the midline; the differential diagnosis is discussed especially with respect to nevus spilus.

Lichen scrofulosorum in a 12-year-old girl: Role of dermoscopy and review of the literature.

H.S. Bhamidipati — 2024-11-11

Lichen scrofulosorum (LS) is a rare tuberculosis resulting from a delayed hypersensitivity reaction to Mycobacterium tuberculosis. Dermoscopy of lichen scrofulosorum is little explored in the available literature. We report the dermoscopic findings of a 12-year-old girl who presented with multiple skin-colored follicular papules on the trunk and root of the limbs with a strongly positive Mantoux test. Based on clinical, histopathological and dermoscopic features, the diagnosis of lichen scrofulosorum was confirmed and the patient started antituberculosis therapy. To the best of our knowledge, only 5 similar cases of LS with dermoscopic evaluation are available in the literature. The present case highlighted the fundamental role of dermoscopy in the diagnosis of lichen scrofulosorum, particularly its ability to differentiate it from other follicular skin disorders.

Serum sickness-like reaction to sulfamethoxazole-trimethoprim.

R. Aldeia da Silva — 2024-11-11

A 6-year-old girl with recurrent otitis media developed a serum sickness-like reaction (SSLR) following a 10-day course of sulfamethoxazole-trimethoprim (SMX-TMP). Symptoms included a pruritic rash, joint pain with edema, fever, and eye congestion, which worsened within 24 hours. Laboratory investigations ruled out infectious causes, and the diagnosis was confirmed based on the timing and clinical presentation.

Contents, issue 4, vol. 34, 2024

STAFF STAFF — 2024-11-11

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Inverse psoriasis in a 6-month-old little girl.

M. Vicente-Ferreira — 2024-11-11

Psoriasis is a chronic immune-mediated inflammatory skin disease with a recognized genetic predisposition and environmental triggers.
Inverse psoriasis is a clinical variant of psoriasis that involves the intertriginous areas, including the inguinal, perineal, genital, intergluteal, axillary, or inframammary regions. This presentation is called “inverse” because it is the reverse of the typical presentation of plaque psoriasis on the extensor surfaces. It is sometimes difficult to diagnose because of its clinical similarity to other skin disorders involving the folds, including mainly mechanical intertrigo, fungal and bacterial infections, contact dermatitis, and seborrheic dermatitis.

Hypomelanosis of Ito.

D. Pinheiro — 2024-11-11

A case of hypomelanosis of Ito diagnosed at the time of admission to a pediatric intensive care unity due to seizures is presented, emphasizing the importance of dermatological signs for the diagnosis of this neurocutaneous syndrome.

Necrolytic acral erythema and acrodermatitis enteropathica: Do they belong to the same disease spectrum?

V.V. Kulkarni — 2024-11-11

Acrodermatitis enteropathica (AE), with its classic onset at weaning, manifests with diarrhea, alopecia, and periorificial and acral lesions. This inherited skin disorder is caused by mutations in the SLC39A4 gene (solve carrier family 39 member A4) encoding the jejunal transporter of zinc ligand protein – ZIP4 –. Acquired zinc deficiency may result from malabsorption, chronic liver or kidney disease, artificial feeding, and protein-energy malnutrition.
Necrolytic acral erythema (NAE), is a distinct clinical entity associated with HCV infection, hypoalbuminemia, hypoaminoacidemia, and hyperglucagonemia, and also with zinc deficiency (both serum and epidermal). NAE usually begins in adulthood between the ages of 19 and 58 years. Typical NAE plaques with erythematous border and adherent crusts predominantly involve the dorsum of the feet and their toes. Involvement of the hands, palms, soles, buttocks, and genitals, as in the present case, is rare.

European Journal of Pediatric Dermatology, issue 4, vol. 34, 2024

STAFF STAFF — 2024-11-11

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