Background. Annular dermatoses are a group of diseases with major clinical manifestation of rashes of relevant form. This manifestation pattern causes difficulties in diagnosis. The case of rarely diagnosed annular dermatosis is presented: serum siknesslike reaction (SSLR) triggered by the Epstein – Barr virus (EBV). Clinical case description. Patient D., 8 years old girl, noted abdominal pain 3 weeks before hospitalization, and later numerous polymorphic rashes (erythematous macules, urticarial elements), swelling and pain in joints. Self-treatment with non-steroidal anti-inflammatory and systemic antihistamines did not lead to any improvement. The patient was hospitalized in the pediatric department at the place of residence, where the diagnosis “Henoch-Schonlein purpura, mixed type” was established according to the results of physical, laboratory (double increase of ALT and AST, ESR up to 166 mm/h, IgM to EBV), and ultrasound (mesenteric lymph nodes hyperplasia) studies. Systemic glucocorticosteroids have led to improvement, however, few days after the end of the treatment there was relapse of rash and arthralgia. Thus, the girl was administrated to clinical diagnostic center. Patient’s general condition was satisfactory at the time of examination. There were numerous erythematous annular urticarial and macular elements (3–12 cm) on the skin of face, body and limbs. Some foci, as well as some resolved rashes had blue spots with indistinct boundaries that disappeared after compression. Mucous membranes, nails and hair were intact. Subjective symptoms — slight burning around rashes, at palpation — low-intensity pain in the left radiocarpal joint. Blood tests: C-reactive protein concentration increased up to 12 mg/L, ESR up to 26 mm/h, IgG to EBV up to 47.7. Conclusion. During differential diagnosis we should consider the possibility of SSLR development in all pediatric patients with annular rashes associated with arthralgia and/or arthritis, fever, history of drug use (most often beta-lactam antibiotics), recent vaccination or manifestations of viral infection, especially in case of cyanotic spots after rashes resolution and non-specific laboratory parameters.
This article describes various COVID-19 dermatological manifestations that can develop in children. Their incidence and clinical features are described. Pseudo-freezing rashes were considered as the most typical in children population after coronavirus infection. Description of skin manifestations in multisystem inflammatory syndrome in children is also presented, issues of laboratory diagnosis are covered as well.
Background. Psoriasis is a polygenic multifactorial immune-mediated disease. Its course can be aggravated by associated obesity. Recently, there is negative trend that is characterized by the increase in the number of moderate to severe psoriasis cases among children, and majority of them have obesity. Identification of factors that that are relevant in these two conditions will allow us to improve and optimize the genetically engineered biological therapy for this category of patients.Objective. The aim of the study is to evaluate epicardial adipose tissue thickness, serum leptin levels, eating behavior via the data from Children’s Eating Behaviour Questionnaire (CEBQ) for patients with psoriasis and obesity, and compare the results with control group – patients with psoriasis and no associated obesity.Results. We have studied 12 patients with established diagnosis of psoriasis, 5 of them had diagnosis of obesity. Epicardial fat thickening was revealed in 20% of cases in the study group (patients with psoriasis and obesity), and no epicardial fat thickening was revealed in the control group. The increase in serum leptin was revealed in 100% of cases in obese patients with psoriasis, and only in 14% of cases in the control group. The mean leptin level in obese patients was 16.65 ng/ml, in the group with normal body weight – 7.08 ng/ml. Obese patients have shown higher values in “food approach” scales group in comparison to normal weight patients.Conclusion. Patients with obesity and psoriasis has shown elevated leptin levels, higher incidence of epicardial fat thickening, and tendency to develop abnormal eating behavior.
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