Outcomes of surgical treatment for hemangiomas

Abstract

Objective

To quantify complications and rates of adverse events associated with surgical excision of hemangiomas in children using a national surgical database.

Data source

Pediatric American College of Surgeons (ACS) National Surgical Quality Improvement Program^® (ACS NSQIP^®‐pediatric), years 2012‐2016.

Methods

Subjects included children under 18 years with a postoperative diagnosis of International Classification of Diseases (ICD), 9th revision code: 228.00 and 228.01, or ICD 10 codes D18.00 and D18.01—hemangioma, any site and hemangioma, of skin and subcutaneous tissue.

Results

A total of 1180 patients were included. The median age was 3.2 years (interquartile range [IQR] 1.2 to 6.4 years old). No occurrences of deep incisional surgical site infection, nerve injury, mortality, sepsis, septic shock, or blood stream infections were noted. In multivariate analysis, age ≤ 3 years and advanced American Society of Anesthesiologists class were significant predictors of adverse events (P = 0.035 and 0.001, respectively).

Conclusions

For children with infantile hemangioma who fail to respond or have an incomplete response to medical therapy, surgical resection may be a relatively safe treatment alternative. Children older than 3 years of age with hemangiomas had less surgical adverse events than younger children. Overall, however, the surgical complications rates were low and deemed relatively minor.

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CEDNIK syndrome in an Indian patient with a novel mutation of the SNAP29 gene

Abstract

CEDNIK (CErebral Dysgenesis, Neuropathy, Ichthyosis, and Keratoderma) syndrome is a neuroichthyotic syndrome characterized by a constellation of clinical features including severe developmental retardation, microcephaly, and facial dysmorphism. Here, we report the first case of CEDNIK syndrome from India presenting with characteristic clinical features and harboring a novel mutation of SNAP29 gene.

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Pediatric melanoma: Characterizing 256 cases from the Colorado Central Cancer Registry

Abstract

Background

Melanoma is a rare diagnosis in the pediatric population. Differences in incidence, presentation, and survival distinguish pediatric melanoma from adult melanoma. In order to improve our understanding of pediatric melanoma, our case series investigates differences in incidence, age of onset, and anatomic site between male and female pediatric melanoma patients in Colorado between 1988 and 2015.

Methods

All data were gathered from the Colorado Central Cancer Registry. A request for de‐identified data on pediatric melanoma patients between 1988 and 2015 was made by the University of Colorado Department of Dermatology. Chi‐square tests were used to compare the differences reported in melanoma between sex, age‐groups, and site of lesion.

Results

A total of 256 cases of melanoma were reported in Colorado in patients < 20 years of age between 1988 and 2015. Overall incidence of pediatric melanoma in Colorado increased from 1988 to 1999 but declined from 2001 to 2011. There was a significant predominance of female cases in the 10‐14 age‐group (P = 0.0477) and 15‐19 age‐group (P = 0.0472). Both groups had increased incidence of melanoma with increasing age. The mean age of onset for both sexes was 16 years old. Boys were more likely to have melanoma of the scalp and neck (P = 0.0523) and less likely to have melanoma of the leg (P = 0.0049).

Conclusion

Among the pediatric population, girls 10‐14 and 15‐19 years old are at a significantly increased risk of melanoma compared to boys in these age‐groups. Our study found sex‐specific differences in anatomic site consistent with prior literature. Further investigations should aim to identify causes for these sex‐specific differences in order to better guide public health initiatives.

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Linear porokeratosis associated with Bardet‐Biedl syndrome: A case report

Abstract

This case report presents a 17‐year‐old boy with Bardet‐Biedl syndrome (BBS) and a long‐standing hyperpigmented eruption on the left trunk and upper extremity, clinically and histologically consistent with linear porokeratosis (LP). BBS patients frequently require solid organ transplant, and subsequent immunosuppression places them at especially high risk for malignant transformation of premalignant skin lesions such as LP. Although BBS affects multiple organ systems, there are only a handful of case reports detailing associated cutaneous involvement, and, to our knowledge, this is the first reported case of linear porokeratosis occurring in patient with BBS.

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Nevus depigmentosus: review of a mark of distinction

Abstract

Nevus depigmentosus (ND), also known as nevus achromicus or achromic nevus, is an uncommon congenital hypomelanosis of the skin that is often characterized as being nonprogressive and having serrated borders. It needs to be distinguished from other hypopigmented skin conditions such as nevus anemicus, hypomelanosis of Ito, Fitzpatrick patches (ash leaf spots) of tuberous sclerosis, vitiligo, indeterminate leprosy, and pigment demarcation lines. Treatment may be desired for aesthetic and possible psychosocial considerations. We review and update knowledge about ND and its simulants.

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Unusual case of rosacea fulminans after topical metronidazole application

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Low dose acitretin versus methotrexate in the treatment of palmoplantar psoriasis: a case series

Abstract

Palmoplantar psoriasis (PP) is a localized form of psoriasis presenting with thick and scaly plaques commonly with painful and bleeding fissures involving the palms and soles (1‐3). The treatment of PP is generally challenging because of resistance to treatments (4). Methotrexate and acitretin have been compared in the treatment of PP, with a superiority of methotrexate at week 12 (5).

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