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Background An inverse correlation between serum 25-hydroxyvitamin D concentration and atopic dermatitis (AD) severity has been suggested. Objective To determine if a statistically significant relationship exists between serum 25-hydroxyvitamin D concentration and AD severity. Methods A cross-sectional study was conducted of patients with AD aged 1–18 years. An objective Severity Scoring of Atopic Dermatitis (SCORAD) and a serum 25-hydroxyvitamin D concentration were measured for each subject. Statistical analysis was performed using appropriate univariate tests and multivariable models. Results Ninety-four of 97 enrolled subjects were included in the analysis. Vitamin D deficiency (25-hydroxyvitamin D <20ng/ml) was present in 37 (39%), insufficiency (25-hydroxyvitamin D 21–29 ng/mL) in 33 (35%), and sufficiency (25-hydroxyvitamin D ≥30 ng/ml) in 24 (26%). The correlation between 25-hydroxyvitamin D concentration and SCORAD was not significant (r=−0.001, p=0.99). A multivariate model showed that a lower serum 25-hydroxyvitamin D concentration was significantly associated with age ≥3-years (p<0.0001), black race (p<0.0001), and winter season (p=0.0084). Limitations Limitations of this study include the inability to control for natural sunlight exposure, vitamin D intake and AD treatment, and that only a single time point was captured. Conclusions Serum 25-hydroxyvitamin D concentration is not significantly correlated with AD severity in our pediatric population.

Two infants are described with intractable, drug-resistant seizures from birth associated with an enlarged cerebral hemisphere. The first died at sixteen months and demonstrated arrested head growth. Histology of the abnormal hemisphere showed disturbed cortical architecture, and subcortical heterotopias with multinucleate cells resembling tuberous sclerosis cells. Continuous fitting persisted in the second infant following callosal section. Hemispherectomy was undertaken in an attempt to preserve function of the "normal" hemisphere. Seizures ceased and head growth velocity accelerated. The neuropathology of the excised hemisphere is compared with the first case. From the literature this is the first report of a favourable outcome after hemispherectomy for hemimegalencephaly. The finding of an echodense enlarged hemisphere may allow presumption of this diagnosis in a neonate with unilateral seizures. After CT scan the diagnosis may be confirmed histologically providing that a precisely orientated frontal biopsy is submitted to the neuropathologist. We suggest that very early hemispherectomy may be the treatment of choice for this condition.

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