Aim Kikuchi‐Fujimoto disease (KFD) is an important cause of lymphadenitis in children. The primary aim of this study was to investigate the clinical characteristics of children with KFD and to assess the recurrence of this disease. Methods This is a retrospective study of patients younger than 18 years old, who were diagnosed with KFD from January 2000 to September 2017 at KK Women's and Children's Hospital. Records of children with a histological diagnosis of KFD from a lymph node biopsy were obtained from the Department of Pathology. Case notes and electronic medical records of the patients were reviewed. Data collected included patient characteristics, symptoms, clinical and laboratory findings, treatment and follow‐up. Results A total of 98 patients were identified. There were 52 boys and 46 girls with a median age of 11.2 years old. Recurrence occurred in 12 (12.2%) patients. One patient developed systemic lupus erythematosus 10 years after diagnosis of KFD. Recurrent cases were more likely to be managed as an inpatient and have fever at presentation of their first episode of KFD. Conclusion In our study, KFD in children had a higher prevalence among boys, and had a recurrence rate of 12.2%, with 1% of patients developing systemic lupus erythematosus. We recommend that patients be followed up for recurrence and advised to monitor for symptoms of recurrence.

The case of a 6-year-old boy with congenital blindness and features suggestive of autism spectrum disorder (ASD) is reported. He presented to a developmental paediatrician with global developmental delay, worsening self-injurious behaviours and difficulties in social interaction, transitions and interactive play. He demonstrated poor response to his name, rigidity, repetitive behaviours and had a sensory profile suggestive of ASD. This paper discusses the challenges in diagnosing and managing ASD in visually impaired children.

AimsTo describe clinical characteristics of childhood Kikuchi Disease (KD) so as to increase awareness among clinicians; this would hopefully lead to early recognition and appropriate management. We also sought to determine risk factors for recurrent KD.MethodsThis was a retrospective review of children <16 years-of-age with histologically proven KD from 2005 to 2012. We retrieved clinical records and collected data on clinical characteristics, laboratory findings, treatment and outcomes. Chi-Square analysis was performed to determine risk factors for recurrent KD.ResultsFifty-two patients were identified; 56% (29/52) were male, with a median age of 11.1 years (92.3% were older than 7 years-of-age). Thirty-one children (59.6%) presented with fever, with a median duration of 10 days. At presentation, 24 children (46.1%) had complaints of fever and neck swelling, 21 had neck swelling alone, while 7 presented only with fever. Median duration of neck swelling at presentation was 28 days. Despite this, all cases had prominent cervical lymphadenopathy detected on physical examination.Two children (3.8%) had a history of Kawasaki disease, 2 had lymphoma/ leukaemia previously requiring chemotherapy, and 2 had a family history of Systemic Lupus Erythematosus (SLE). Five (9.6%) had a recent history of cervical lymphadenitis. Out of 32 children tested for antinuclear antibody (ANA) titres, 5 were positive; only 1 had a titre >1/800.None of the patients responded to antibiotic therapy, and all required complete excision biopsy, with a median time to diagnosis of 9.5 days. Sixteen patients (30.8%) did not respond to complete excision and required adjunctive steroid therapy. Median duration of steroid therapy was 16 days.Median duration of follow-up was 1 year. Six children (11%) had recurrent KD. The only risk factor identified for recurrent KD was fever at initial presentation (p = 0.032). One patient, who was diagnosed with KD at 5 years of age, subsequently developed SLE at age 15 (he was ANA negative throughout presentation and subsequent follow-up).ConclusionKikuchi Disease should be considered in children with subacute cervical lymphadenopathy with or without prolonged fever. These children are at risk of developing subsequent SLE and long-term follow-up is required.

Results Nighty-seven subjects completed this study, and 33 (34%) had active physician-diagnosed eczema at 12 months. Twenty-six out of 81 (32%) subjects showed positive in SPT. Eighteen was classified as atopic eczema patients, while 12 were classified as non-atopic eczema patients. During the study period in total 297 skin swab samples were collected. Alpha diversity represented by Shannon (p=0.001) and Simpson (p=0.004) indices significantly increased from 1 month to 6 months age, and beta diversity (p=0.001) differed across time as well. Relative abundance of Staphylococcus (p<0.001 and 0.04 respectively) and Corynebacterium (p<0.001 and <0.001 respectively) progressively decreased across time (adjusted pvalue: 1 month to 6 months vs 6 months to 12 months). Alpha diversity of skin microbiome at 12 months was significantly lower in atopic eczema patients than that in non-atopic eczema patients (Shannon p=0.002, Simpson p=0.001). Alpha diversity at 1 month and 6 months did not show significant differences among groups. Differences regarding beta diversity and taxa abundance were not found between atopic and nonatopic eczema patients across time. Conclusions Skin microbiome profiles differ slightly between infantile eczema with and without atopy. Alpha diversity of skin microbiota at left antecubital fossa is lower in atopic eczema patients compared with that of non-atopic eczema patients only during flare-ups at 12 months. This study cannot detect such difference at earlier time points.