The impact of vitamin D supplementation on serum cathelicidin levels and the clinical course of atopic dermatitis in children.

BACKGROUND: Cathelicidin has been correlated with the pathophysiology of atopic dermatitis (AD). An indirect correlation of vitamin D with the course of the disease has already been reported as it directly affects the levels of cathelicidin. The purpose of the present article is to investigate the impact of vitamin D supplementation on the course of AD. METHODS: We conducted a prospective observational study. The severity of AD was assessed with the clinical tool SCORAD (SCORing Atopic Dermatitis) which is developed by the European Task Force on AD. RESULTS: Fifty children with AD were enrolled and stratified in two groups based on the severity of SCORAD. Children with severe AD (SCORAD Index >40) received higher doses of vitamin D in order to sufficiently reduce the disease (comparable SCORAD Index for children with mild atopic dermatitis). While the baseline SCORAD differed statistically significant level between the two groups of children with AD (P<0.001) this difference disappeared at 20 (P=0.649) days and remained statistically insignificant both at 45 days (P=0.610), and at the end of the administration of treatment (P=0.474). This effect was based on a significant downregulation of the severity of symptoms in the group of children that received 2400 IU of vitamin D. CONCLUSIONS: The findings of our study suggest that vitamin D may be accurately used in current clinical practice for the management of AD. However, the recommended dose should be titrated taking in mind the severity of the disease.

Infant penile tuberculosis following circumcision.

Primary penile tuberculosis associated with bilateral inguinal lymphadenopathy is described in a previously healthy 10-month old infant, who had been circumcised in Pakistan 4 months earlier. Mycobacterium tuberculosis was detected by acid fast stain, PCR and culture in specimens obtained from the penile ulcer and the excised inguinal lymph nodes.

Severe disseminated tuberculosis in a 4-month-old infant initially presenting with multiform cutaneous lesions.

A 4-month-old female infant presented with 1 month history of horizontal nystagmus and discrete multiform skin lesions. The patient was initially diagnosed with congenital nystagmus and staphylococcal skin infection not responding to antimicrobial agents. The development of severe systemic symptoms led to extensive investigations and the diagnosis of disseminated tuberculosis. Mycobacterium tuberculosis (MTB) was isolated from the skin and cerebrospinal fluid. The patient was treated with isoniazid, rifampicin, pyrizinamide, streptomycin and dexamethasone. Skin lesions resolved completely but severe neurological deficits persisted.

Ichthyosis follicularis with alopecia and photophobia in a girl with cataract: histological and electron microscopy findings.

A rare congenital ectodermal disorder characterized by ichthyosis follicularis, alopecia and photophobia has been designated the acronym IFAP. An X-linked recessive mode of inheritance was initially proposed but a few recent reports in girls suggested genetic heterogeneity of this syndrome. We herein describe a 3-year-old girl with clinical and histological features typical of IFAP. In addition to the already known features of the syndrome the patient also developed bilateral cataract. Electron microscopy examination of the skin showed partial disruption of the intercellular bridges, spongiotic changes and decrease in the number and size of desmosomes supporting the notion that IFAP may be a cell-to-cell adhesion disorder.

Effects of methylprednisolone pulses on renal function of guinea pigs.

Methylprednisolone produced a dose dependant significant increase in glomerular filtration rate, a significant decrease in sodium excretion, and a significant increase in urinary alkaline phosphatase activity in guinea pigs. The renal histology in groups with 4, 5 and 6 doses revealed mild degenerative changes in the tubular epithelial cells. The results suggest the beneficial effects of methylprednisolone pulse therapy on renal function mainly by increasing glomerular filtration rate with only minimal side effects.