Pediatric dermatology
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Parvovirus B19 is responsible for a variety of cutaneous diseases, including erythema infectiosum and papular purpuric gloves-and-socks syndrome. It is also associated with other dermatologic diseases, such as systemic lupus erythematosus. To study the prevalence of parvovirus B19 infection in children with acute illness and rash, we did a prospective study of 110 children at the Chiang Mai University teaching hospital from January 2001 to November 2003. ⋯ For those with paired serum samples, there were three patients with recent parvovirus B19 infection that presented with erythema infectiosum, urticaria, and lupus erythematosus, respectively. Immunoglobulin G antibodies were tested in serum samples of 103 children; 28.2% were positive. These data indicate that parvovirus B19 is not a common cause of acute illness and rash in children.
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Pediatric dermatology · Jan 2006
Review Case ReportsInfantile Crohn disease presenting with diarrhea and pyoderma gangrenosum.
Cutaneous erosions and ulcerations in the diaper area are common in infancy and usually result from local irritation. We describe an infant with chronic diarrhea and failure to thrive who developed extensive ulcerations in the inguinal folds and perineum that were initially thought to be exclusively caused by local irritation. ⋯ Prompt diagnosis is especially important in infantile Crohn disease, since many infants require surgical resection of affected bowel, and 60% die from disease complications. This article reports a rare instance of an infant who developed pyoderma gangrenosum due to Crohn disease and reviews cutaneous signs of systemic disease in infants presenting with chronic diarrhea and rash.
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Pediatric dermatology · Nov 2005
Case ReportsPurpura after application of EMLA cream in two children.
The eutectic mixture of local anesthetic cream, a 1 : 1 mixture of prilocaine and lidocaine, 2.5% each, is frequently used in pediatric and dermatologic practice to obtain local anesthesia. Side effects include transient skin blanching, erythema, urticaria, allergic contact dermatitis, irritant contact dermatitis, hyperpigmentation, and purpura. We report two children with a purpuric reaction after application of this mixture cream. ⋯ Patch tests could not be performed in our two patients because of lack of parental consent but we suggest that the purpuric reactions were most probably of toxic origin. The pathogenesis of purpura after application of eutectic mixture of local anesthetics cream, which resolves within 2 weeks without dermatologic sequelae and without any specific therapy, is complex. The lesions are probably caused by the direct effect of the cream components on the vessels but many other factors, such as atopic dermatitis, prematurity, subjective predisposition to purpura, trauma, and thrombocytopenia may play important pathogenetic roles.
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Pediatric dermatology · Sep 2005
Case ReportsRefractory Demodex folliculitis in five children with acute lymphoblastic leukemia.
We report five children with acute lymphocytic leukemia on maintenance chemotherapy who had Demodex folliculitis. None experienced complete clearing when treated with permethrin 5% cream. ⋯ We suggest that treatment of Demodex folliculitis in children with acute lymphocytic leukemia is more difficult than is suggested in the literature. Newer sodium sulfacetamide/sulfur formulations should be considered when treating this condition, particularly in children with acute lymphocytic leukemia.
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Pediatric dermatology · Sep 2005
Case ReportsEcthyma gangrenosum-like lesions in a healthy child after infection treated with antibiotics.
Ecthyma gangrenosum is a cutaneous infection associated most commonly with pseudomonal sepsis in the immunocompromised patient. We describe a previously healthy 4-year-old boy who developed ecthyma gangrenosum-like lesions secondary to antibiotic treatment for possible streptococcal infection. The skin, ears, and extremities were involved. This presentation emphasizes the importance of awareness of the rare complication of ecthyma gangrenosum-like lesions associated with non-Pseudomonas bacterial infection treated with antibiotics, even in a previously healthy child.