Speckled acral hypopigmentation in an adolescent.

We report a case of speckled acral hypopigmentation in a 12-year-old girl. She presented with asymptomatic hypopigmented macules on the hands and feet. This rare entity is a proposed variant of reticulate acropigmentation and of unknown etiology

Pediatric Lichen Sclerosus: A Review of the Literature and Management Recommendations.

Lichen sclerosus is an uncommon, inflammatory disease of the skin and mucosa that can cause significant pruritus, pain, and scarring. There are two peaks of incidence: one in adult females, and the other in young girls. Early recognition and prompt management of the disorder is crucial in preventing long-lasting complications. This article reviews lichen sclerosus in children and provides evidence-based guidance for treatment in the pediatric population

Papular xanthomas and erosive arthritis in a 3 year old girl, is this a new MRH variant?

Xanthomatous skin lesions and arthritis in children are not a common association. We present the case of a 3 year old girl who presented with xanthomatous lesions in the periungual region of both hands, around the nares and on her forehead, associated with significant arthritis that was clinically compatible with multicentric reticulohistiocytosis. However, pathology of the xanthomatous lesions was more suggestive of papular xanthoma, a disease that is not associated with arthritis. Based on her presentation and the negative lipid workup, she was treated for presumed multicentric reticulohistiocytosis. Multiple treatment strategies were utilized, with improvement on a combination of infliximab, methotrexate, and prednisone. We review the different diagnoses that should be considered in children with xanthomas and arthritis as well as the different pharmacologic therapies used in children with multicentric reticulohistiocytosis

Evaluating Dermatology Residents Combined Oral Contraceptive Pill Prescribing Practices, Knowledge, and Comfort Level in the Management of Acne Vulgaris: A Cross-sectional Survey Study.

OBJECTIVE: Combined oral contraceptive pills (COCs) are safe and effective therapies for females with acne vulgaris. Data is lacking regarding dermatology residents\u27 COCs use. We aimed to evaluate dermatology residents\u27 knowledge, comfort level, and prescribing practices of COCs in the management of acne vulgaris. METHODS: A cross-sectional survey study was emailed to current dermatology residents in approved training programs and descriptive statistics were performed. RESULTS: Most residents reported that COCs are an effective treatment for acne (160/170, 94.1%) but, less felt adequately trained on efficacy (105/170, 61.8%) and safety (72/170, 42.4%). 30 percent (51/170) of residents\u27 attending physicians regularly prescribed COCs for acne. Half were comfortable counseling patients on adverse effects of COCs (86/170, 50.6%) while fewer were comfortable counseling on how to properly take COCs (66/170, 38.8%). 60 percent (102/170) felt comfortable prescribing COCs to healthy adolescents while 66.5 percent (113/170) were comfortable prescribing to adults. LIMITATIONS: Limitations include a small sample size, response bias, and inability to calculate an accurate response rate. CONCLUSION: This data suggests most residents recognize COCs are an effective treatment for acne vulgaris, but less feel adequately trained. Several knowledge gaps and potential educational interventions regarding COCs, including safety, efficacy, adverse effects, and contraindications, are highlighted