Open clinical study of the efficacy and safety of terbinafine cream 1% in children with tinea corporis and tinea cruris.

BACKGROUND: Topical application of antifungal agents is considered the treatment of choice for dermatomycoses. Most of the available drugs are fungistatic, requiring long term treatment to prevent relapses. Terbinafine is a synthetic antifungal agent that, because of its fungicidal action, provides high cure rates and low relapse rates after short periods of treatment. METHODS: Ninety-seven children ages 2 to 15 years with a suspected diagnosis of tinea corporis and/or tinea cruris were enrolled in this open trial. After mycologic assessment to confirm diagnosis (culture and direct microscopy) terbinafine 1% cream was applied once daily during 1 week. Clinical and mycologic assessments were made at the baseline visit and on Days 7, 14 and 21. Efficacy assessment was based on 88 children (9 patients excluded by protocol violation). RESULTS: Therapy was considered effective in 92.0% (81 of 88) of patients (complete clinical and mycologic cure or mycologic cure with minimum signs and symptoms or clinical improvement, > or = 50%). Tolerability was assessed in 97 patients on an intention-to-treat basis. Adverse reactions were itching 3% (3 of 97), itching associated with erythema exacerbation 1% (1 of 97) and contact dermatitis 1% (1 of 97). CONCLUSION: Terbinafine 1% cream appears to be an effective and well-tolerated treatment for tinea corporis and tinea cruris in children.

Sexually transmitted diseases in children.

Sexually transmitted diseases (STDs) in children may be transmitted by sexual abuse, by accidental contact, or perinatally. Although only 2% to 10% of abused children become infected, childhood syphilis, gonorrhea, condylomata acuminata, and Chlamydia trachomatis must always be considered. We reviewed data from our hospital regarding the frequency, prevalence, routes of transmission, and clinical features of these infections. Ninety-five percent of acquired syphilis in children is transmitted by sexual abuse. The perpetrator is usually someone the child knows or trusts. Of our 21 patients under 14 years of age with acquired syphilis, most were 4 to 8 years old. Girls were infected twice as often as boys. Sexual contact was confirmed in 71.4%. A chancre sore was infrequent in children; condylomata lata was the most frequent cutaneous lesion (80.9%). In the last 10 years, 102 cases of congenital syphilis were diagnosed in our hospital. The main clinical findings were bone involvement (78.7%), hepatosplenomegaly (68.8%), cutaneous lesions (50.8%), and jaundice (15.1%). Gonorrhea was detected in only nine children. Vulvovaginitis was the most common clinical manifestation. Sexual transmission was documented in three patients. Accidental contact with their infected mother occurred in two sisters. Three newborns acquired the disease during delivery. The STDs in children are a worrisome problem. Evaluation for sexual abuse should be done in all cases. Prevention and treatment of adults are the main steps to prevent these infections in children.

[Childhood acropustulosis. A study of 10 cases]. / Acropustulose infantil. Estudo de dez casos.

Ten cases of infantile acropustulosis were studied clinically, in laboratory and histopathologically. There was no racial predominance. In most of the cases the lesions started in the first 6 months of life and were located mainly on the feet severe itching. Was a constant symptom. Laboratory studies were negative for fungus, bacteria and acarus. Atopy was found in 20% of the cases and 30% of the families. Blood eosinophiles was found in 70% of the lesions.

Elastolisis post-inflamatoria y cutis laxa (sindrome de Marshall). / Post-inflamatory elastolysis and cutis laxa (Marshall's syndrome)

Se presentan 2 casos de elastolisis post-inflamatoria con cutis laxa en ninos, siendo uno de ellos de raza blanca y sexo masculino, lo cual es considerado excepcional en la literatura. La manifestacion clinica inicial fue con lesiones que simulaban picaduras de insecto, con posterior diseminacion en erupcion tipo eritema polimorfo; al involucionar dejaron la piel floja, con aspecto de cutis laxa. Se subraya la presencia de dolor en las lesiones durante la fase aguda y la formacion de quistes de inclusion epidermica, en las areas priviamente comprometidoas. Los estudios histopatologicos revelan alteraciones en evolucion fue favorable en uno, con cura clinica y sin recidiva por un periodo de observacion de 3 anos. En el otro caso fue desfavorable, con cardiomiopatia grave y muerte a los 2 anos. Se trata, probablemente, del segundo caso de elastolisis post-inflamatoria con compromiso de un organo interno

[Kwashiorkor. Dermatological and clinical aspects (Analysis of 100 cases)]. / Kwashiorkor. Aspectos clínicos e dermatológicos (Análise de 100 casos)

The Authors study 100 children with "kwashiorkor", treated at Municipal Hospital Jesus (Rio de Janeiro). The children came from prolitic families of low economical resources. Their age is between 4 months and 8 years, 53% of them beiney halfbreed, 32% white people and 15% negroes. Diagnosis was based on alimentary deficiency in high caloric value proteins (100%), oedema (100%), muco-cutaneous alterations (78%), capillary changes (65%), apathy (75%), muco-cutaneous pallox (67%), and complementary examinations (total and fraction proteins, sodium, potassium hemoglobin). They emphasize the role of intercurrent infections (verminosis, pneumopathies, virosis, otitis, etc.). Treatment was carried out through correction of desnutrition, hydro-electrolytical troubles and infectious diseases.