Pyoderma gangrenosum (PG) is a sterile neutrophilic disorder that rarely affects children. Clinical, epidemiological, and therapeutic data on pediatric PG is poor as there are many newly reported associated diseases and drugs. This paper aims to review all recent available data on pediatric PG. A systematic review of the literature was conducted using Embase, Medline, and Cochrane databases. A total of 132 articles were included in the review. The most commonly reported underlying diseases in pediatric PG are inflammatory bowel diseases followed by hematologic disorders, vasculitis, immune deficiencies and Pyogenic Arthritis, Pyoderma gangrenosum and Acne (PAPA) syndrome. More than half of the cases occur with no underlying disease. The most frequently reported clinical presentation is multiple disseminated ulcers. Treatment should be tailored according to the underlying etiology. It includes systemic steroids, corticosteroid sparing agents such as dapsone and cyclosporine, and TNF-alpha inhibitors such as adalimumab and infliximab. Response to treatment is high with cure rates reaching 90%. A high index of suspicion and a thorough workup are mandatory in the management of pediatric PG.

Highlights The main advantage of minimally invasive techniques for the treatment of retrocaval ureter is less blood loss during surgery. Other advantages are shorter hospital stay, less postoperative pain and superior esthetic results. Pure laparoscopic treatment (as in our two cases) seems feasible and technically reliable with excellent functional outcome. Intracorporeal anastomosis of the ureter remains the main limiting factor.

Splinter hemorrhages (SHs) of the nails represent a frequent although not specific clinical finding that has been associated with conditions of varying severity. However, to date, there is no single report of their characteristics and etiologies. The aim of this study is to guide clinical practice by reviewing all of the data concerning SH of the nails that have become available since the first description of this condition was published in 1923, with particular reference to all clinical features, associated medical conditions, pathogenesis, and necessary workup. PubMed and EMBASE were searched using the keywords "splinter" AND "hemorrhage*"; the only articles excluded were those studying SHs of the retina. Splinter hemorrhage is a frequent nail disorder that may be idiopathic, drug-induced, or a sign of a dermatological disease, such as psoriasis and lichen planus, or a wide range of systemic disorders, the most important of which are infections and vasculitis. Clinicians and dermatologists should be aware of all the clinical features of both SH and associated medical conditions.

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