Background/Objectives
We evaluated the acceptance of synchronous (live video) telehealth for pediatric dermatology.
Methods
This was a prospective, single‐center study of patient and dermatologist surveys paired at the encounter level for telehealth encounters with Children's Hospital Colorado Pediatric Dermatology Clinic between 21 April 2020 and 22 May 2020.
Results
Dermatologists were most receptive to a telehealth encounter for isotretinoin monitoring (96.6%) and non‐isotretinoin acne (89.5%). In contrast, 71.8% and 58.8% of patients surveyed were open to telehealth for isotretinoin encounters and non‐isotretinoin acne encounters, respectively. There was no significant correlation between patient and dermatologist satisfaction regarding a telehealth encounter (r = 0.09, CI [−0.09, 0.26], p = .34) or between patient and dermatologist preference for telehealth encounter (r = 0.07, CI [−0.11, 0.25] p = .46). Dermatologists reported needing a photo to aid their physical examination in 38/363 (10.7%) of encounters and preferred in‐person examinations when an encounter would have benefitted from laboratories, procedures, dermatoscopic examination, examination by palpation, and accurate weights in infants.
Conclusions
Synchronous, live‐video telehealth is an effective method of healthcare delivery in certain situations for pediatric dermatology, but it does not replace in‐person encounters. Families and dermatologists have different perceptions about its acceptance.
Infantile myofibroma (IM) commonly presents as a benign cutaneous fibrous tumor in infancy. Although the majority of solitary IM regress without any morbidity, some cases have underlying bone or visceral involvement that can lead to both morbidity and mortality. In this report with review of the literature, we present two cases of solitary cutaneous IM with internal involvement and discuss screening cases of solitary IM with full body imaging.
Objectives
To characterize the skin and mucosal findings of NEMO syndrome.
Methods
Retrospective review of clinical characteristics from a cohort of two families with mutations in IKBKG (the NEMO‐encoding gene). A literature review identified 86 studies describing 192 patients with IKBKG mutations whose data were also included.
Setting
Single center with literature review.
Participants
Patients with mutations in IKBKG from our center and reported in the literature.
Main Outcomes and Measures
Skin and mucosal characteristics of patients with NEMO syndrome.
Results
In addition to ectodermal dysplasia and recurrent infections, male patients had findings of ichthyosis, palmoplantar keratoderma, and inflammatory skin diseases. Both male and female patients had mucocutaneous ulcers and slow‐to‐heal chronic wounds. In combination with patients from the literature, 59% (85/144) of males had ectodermal dysplasia with anhidrosis (EDA) features, and 8% and 10% (12/144; 6/63) of males and females had dental findings, respectively. 4% (6/144) of males and 32% (20/63) of females had mucocutaneous ulcers. Ichthyosis/xerosis was present in 15% of males (21/144) but only 2% (1/63) females. Similarly, 13% (18/144) of male patients presented with dermatitis while this was reported in only 2% (1/63) of females.
Conclusions
Our results both confirm and expand upon the known spectrum of mucocutaneous findings in NEMO syndrome. Further genetic studies are needed to correlate specific mutations to clinical and morphologic subtypes.
staging in accurately conveying prognosis in the context of what might be termed prominently invasive T1 melanomas and minimally invasive T2 melanomas. One beauty in the application of CTA is its utter simplicity, because the assessment can be completed in a timely fashion using conventional histopathologic sections. One flaw is that it does include an estimated component, in that the area is precisely determined through measurements of width and thickness but the proportion involved by melanoma cells is gauged by visual inspection. It seems possible if not likely that this factor could lead to poor reproducibility with broader dissemination.There are many reasons why a new paradigm fails to capture the collective imagination and supplant an existing approach. The durability of the Breslow thickness is a testament to its simplicity, teachability, general accuracy, and reproducibility. Slight improvement is probably not enough to supersede an entrenched parameter used daily in laboratories throughout the world. However, if coupled with advances in digital pathology, evaluating melanoma sections with a true measured tumor area (or what could also be termed the Breslow area) could become an invaluable element of melanoma staging.
Background/Objectives
Infantile hemangiomas (IHs) are common benign vascular tumors of infancy. IHs tend to grow in the first few months of life and then gradually involute over years, often leaving fibrofatty residua or textural changes in their place. Classically, these lesions are painless throughout their entire natural history; however, we now report on seven patients with involuted IH with intermittent but persistent sensory symptoms.
Methods
This is a multicenter case series in which members of the Birthmarks Focused Study Group of the Pediatric Dermatology Research Alliance (PeDRA) and the Hemangioma Investigator Group contributed patients with IH and dysesthesias from their clinical practices. Charts were then reviewed to document clinical details.
Results
Seven patients were included, presenting at an average age of 14.6 years (range 3‐48 years) for complaints related to discomfort in the region of involuted IH. The majority (6/7) reported pain or tenderness to the area. One patient reported pruritus. All patients reported intermittent symptoms. The length of symptoms ranged between 4 months and 5 years. Treatment was attempted in 5/7 patients. Ice, oral propranolol, topical capsaicin, and intralesional triamcinolone partially improved symptoms.
Conclusions
Persistent cutaneous dysesthesias were present in seven patients, in most cases many years after completion of involution. Further research is needed to fully elucidate the pathophysiology and optimal treatments for this IH complication.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.