Dermatoscopia na Idade Pediátrica – Parte II: Dermatoses Infeciosas e Inflamatórias

Dermoscopy is a noninvasive technique that increases diagnostic accuracy of several skin lesions. Being painless, dermoscopy is particularly useful in children, sparing them from unnecessary biopsies and treatments. In part II of this article, we highlight the importance of dermoscopy for the diagnosis and follow-up of infectious and inflammatory skin disorders in pediatric patients.A dermatoscopia é uma técnica não-invasiva, que permite aumentar a acuidade diagnóstica de diversas lesões cutâneas. Sendo um procedimento indolor, a dermatoscopia é particularmente útil nas crianças, poupando-as de biópsias e terapêuticas desnecessárias. Na parte II deste artigo, destacamos a importância da dermatoscopia para diagnóstico e acompanhamento de dermatoses infeciosas e inflamatórias na idade pediátrica

Evidence of the high prevalence of neurological disorders in nonsyndromic X-linked recessive ichthyosis: a retrospective case series

[Background]: X-linked recessive ichthyosis (XLI) is a relatively common type of ichthyosis caused by a deficiency in the steroid sulfatase (STS) enzyme. It is the only type of ichthyosis that can be both syndromic and nonsyndromic. Typical clinical features include dark-brown scale of variable size favouring the extensor surfaces of the extremities.[Objectives]: To characterize clinically nonsyndromic XLI, with a particular focus on extracutaneous manifestations.[Methods]: This was a multicentre retrospective review of clinical findings from a case series of patients with a clinical and genetic diagnosis of XLI.[Results]: We identified 30 patients with XLI belonging to 25 different families carrying a deletion in the STS locus. All patients had dark scales of variable size on the extensor surfaces of the extremities. Lack of flexural involvement and pruritus were common but inconsistent findings, whereas palmoplantar hyperlinearity was absent in all but one patient. A history of orchiopexy was present in 10% and thus was more common than expected vs. the general population (3%). Neurological disorders including epilepsy (13%) and attention deficit hyperactivity disorder (ADHD; 30%) were over-represented in patients with XLI.[Conclusions]: This was a retrospective study with a limited number of patients. In the absence of confirmatory genetic testing and family history of the disease, dark-brown scale of the extensor surfaces and the absence of palmoplantar hyperlinearity appear to be the most reliable clinical findings supporting a diagnosis of XLI. Dermatologists should be aware of the high prevalence of ADHD and epilepsy in patients with nonsyndromic XLI

Two small yellowish papules in a 1 year-old boy: cutaneous leishmaniasis

Cutaneous leishma iasis (CL) is zoonosis with a spectrum of cutaneous manifestations caused by protozoan parasites of thegenus Leishmania.Manifestation varies according to the parasite virulence and the host immune response. Pentavalent antimonials (sodium stibogluconate and meglumine antimoniate) have been used as a first-line therapy for the last 70 years around the world.We report a case of a 1-year-old boy with two small yellowish papules mimicking juvenile xantogranuloma diagnosed with cutaneous leishmaniasis after a biopsy. Patient underwent treatment with 2 sessions of intralesional (IL) meglumine antimoniate (Glucantime®) with complete clearance of both lesions.Conclusion: Cutaneous leishmaniasis treatment is difficult to standardize; treatment options in children include wound careand watchful waiting,  intralesional pentavalent antimonials, topical paramomycin, or oral miltefosine

Two small yellowish papules in a 1 year-old boy: cutaneous leishmaniasis

Cutaneous leishma iasis (CL) is zoonosis with a spectrum of cutaneous manifestations caused by protozoan parasites of thegenus Leishmania.Manifestation varies according to the parasite virulence and the host immune response. Pentavalent antimonials (sodium stibogluconate and meglumine antimoniate) have been used as a first-line therapy for the last 70 years around the world.We report a case of a 1-year-old boy with two small yellowish papules mimicking juvenile xantogranuloma diagnosed with cutaneous leishmaniasis after a biopsy. Patient underwent treatment with 2 sessions of intralesional (IL) meglumine antimoniate (Glucantime®) with complete clearance of both lesions.Conclusion: Cutaneous leishmaniasis treatment is difficult to standardize; treatment options in children include wound careand watchful waiting,  intralesional pentavalent antimonials, topical paramomycin, or oral miltefosine