Background: Latin American patients in the United States experience significant health disparities. Community health workers (promotoras de salud) reduce disparities by providing culturally appropriate education. While educational interventions have been studied in atopic dermatitis (AD), a chronic dermatologic condition affecting children, none have evaluated the use of promotoras in Spanish-speaking pediatric patients in the United States. Objective: To create and evaluate a promotora-led education program for Spanishspeaking caregivers of Latin American, pediatric patients with AD through a randomized, controlled, evaluator-blinded study. Methods: Children with moderate/severe AD (n = 48) were recruited from the pediatric dermatology clinic at Children's Health℠ in Dallas, TX and randomized to receive clinic education (n = 26) or clinic education plus promotora home visits (n = 22). The primary outcome was overall adherence to topical emollients over the 12-week study, quantified by MEMSCap™ devices; several secondary endpoints were evaluated. Results: Intention-to-treat analysis revealed a trend toward increased overall adherence to emollients over the 12-week study period in promotora (median [interquartile range, IQR]: 43% [26%-61%]) versus non-promotora (median [IQR]: 20% [11%-49%])
Community health workers (CHWs), or promotoras de salud, play important roles in health care education and advocacy in the Latin-American community and are effective due to their understanding of their communities' culture, language, and challenges. 1 Promotoras provide health education, patient navigation assistance, and deliver medical services. Promotora programs have emerged as models to address many conditions, including diabetes, cardiovascular disease, cancer screening, and mental health conditions in Latin-American communities. [2][3][4][5][6][7] Previous promotora interventions have shown improvement in health-related behavior, knowledge, patient satisfaction, and quality of life. [2][3][4][5][6][7] In the United States, communities have turned to CHWs to improve population health. In Texas, promotora certification requires completion of 160 hours of education or at least 1000 h of CHW experience.There are limited studies investigating the role of promotoras for dermatologic disease. Latin-American patients may have more
Australian, youngest yet diagnosed, and 5th only reported case of ARPC1B deficiency.A female infant born to Nepalese parents presented with bloody diarrhoea and metabolic acidosis at 2 months of age. A diagnosis of cow's milk enteritis was made and she was commenced on an elemental formula with resolution of the hematochezia and improvement in the diarrhoea. Subsequently she developed an eczematous rash which progressed to an erosive purpuric dermatitis with ulceration, and later took on a psoriasiform appearance. Skin biopsy showed a leucocytoclastic vasculitis. Her progress was complicated by cytomegalovirus infection, recurrent suppurative otitis media, twice by periorbital cellulitis, persistent oral candidiasis, urinary tract infection and failure to thrive.
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