Background: Accurately documenting pediatric atopic dermatitis (AD) severity is important, but research tools, such as Eczema Area and Severity Index (EASI), are too time consuming for clinical settings. Product of the Physician Global Assessment and affected percentage of body surface area (PGA3BSA) is a new, rapid measure of psoriasis severity.Objective: To evaluate an Investigator Global Assessment and body surface area product (IGA3BSA) as an easy-to-use severity measure for pediatric AD.Methods: Patient-reported and objective disease severity measures were collected from 195 caretaker/ child dyads (child age range, 5-17 years) with almost clear (Validated Investigator Global Assessment for AD [vIGA] of 1) to severe (vIGA of 4) AD. Data were assessed with Spearman coefficients and plots. Severity strata were proposed by using an anchoring approach based on the EASI.Results: IGA3BSA correlates better with the EASI than IGA alone (r = 0.924 vs r = 0.757, P \ .001). Bland-Altman plot indicates high and consistent agreement between IGA3BSA and the EASI. Suggested severity strata for IGA3BSA are 0-30, mild; 30.1-130, moderate; and 130.1-400, severe (k = 0.760). Limitations:The patient cohort was predominantly from the midwestern United States.Conclusions: IGA3BSA (using the vIGA) is a simple measure that correlates well with the EASI in patients with mild to severe pediatric AD. Future work is needed to affirm reliability across IGA scales and responsiveness to change.

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Cervical lymphadenopathy is common in all age groups. Persistently enlarged cervical lymph nodes often pose a diagnostic challenge and necessitate focused clinical evaluation with targeted investigations. Pathological examination of excised node yields conclusive answer in the vast majority of cases with unsettled diagnosis. We present a case of a young man with persistent posterior cervical lymphadenopathy which on excision biopsy turned out to be Kikuchi-Fujimoto disease. With watchful follow-up, he had a self-limiting clinical course in the next few months.

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