Pyogenic granuloma presenting as a congenital epulis.

OBJECTIVE: To describe a clinical approach to the differential diagnosis of oral lesions in neonates. DESIGN: Case report. SETTING: Academic ambulatory care center. PARTICIPANTS: Male infant. RESULTS: A gingival mass in a male infant appeared clinically consistent with a congenital epulis. Following excision and histologic examination, the diagnosis was determined to be a pyogenic granuloma. Careful attention to alternative diagnoses led to the correct etiology. CONCLUSIONS: Primary care pediatricians encounter neonatal oral lesions infrequently. The most common oral lesions in the newborn period are Epstein pearls and Bohn nodules. This case illustrates the importance of formulating a more extensive differential diagnosis on discovery of a neonatal oral mass.

Effect of economic status on the use of house dust mite avoidance measures in asthmatic children.

To assess the effect of socioeconomic status on compliance with house dust mite avoidance measures, we interviewed the parents of 60 mite-allergic, asthmatic children about mite avoidance. Thirty were of lower socioeconomic status and 30 were of higher socioeconomic status, as determined by the type of insurance. All had previously learned mite avoidance measures at the time of diagnosis. Twenty of 30 lower socioeconomic status parents had removed stuffed toys from the child's bedroom compared with only 12 of 30 higher socioeconomic status parents (P = .07). Twelve of 30 parents in the lower socioeconomic status group had obtained plastic mattress covers compared with 22 of the 30 higher socioeconomic status parents (P = .018). Eighteen parents in the lower socioeconomic status group expressed reasons for not obtaining plastic covers. Nine cited lack of funds, four did not know where to buy them, and four did not think it would help. Of the eight parents in the higher socioeconomic status group that did not obtain covers, six cited inconvenience and two thought it would not help. We conclude that education alone will not ensure compliance with house dust mite controls. Economic factors influence utilization. Access to free or low cost mite-proof pillow and mattress covers may improve asthma care for poor children.