Pityriasis Rubra Pilaris in a 3-Year-Old Male.

A 3-year-old male presented with progressive pruritic red-orange plaques across most of his body with erythema, desquamation, and fissuring of the hands and feet. He was diagnosed with classic juvenile (type III) pityriasis rubra pilaris (PRP) and treated with oral isotretinoin for 6 months. His skin findings resolved quickly during the treatment period, with residual postinflammatory hypopigmentation resolving within a year. PRP is rare in pediatric patients and standard recommended treatment algorithms for this population are not currently available. Diagnostic and treatment guidelines for PRP are based almost exclusively on case reports or case series, most of which focus on adult patients. The presentation, evaluation, and management of PRP are discussed.

Laparoscopic excision of urachal cyst in pediatric age: report of three cases and review of the literature.

OBJECTIVE: To determine the role of laparoscopic surgery in the treatment of pediatric urachal disorders. METHODS: Case reports and a literature review of laparoscopic excision of urachal remnants. RESULTS: In a five-year period, three children were diagnosed with urachal anomalies presenting as abdominal or urinary symptoms, and were treated by laparoscopic surgery. The average age was 8.3 years (range, 4-13),and there were two girls and one boy. Mean operative time was 90 minutes (range, 60-120), and there were nopostoperative complications. The three patients were all discharged by postoperative day four. CONCLUSION: Laparoscopy is an effective and safe minimally invasive technique in the management of pediatricurachal anomalies. It is effective even in cases of infected urachal cysts.

Functional gastrointestinal disorders in children: an Italian prospective survey.

OBJECTIVES: To assess the prevalence and natural history of functional gastrointestinal disorders (FGIDs) in children using the Rome Criteria. METHODS: Thirteen primary care pediatricians were randomly selected from the Campania region of the Italian National Health Service. Each pediatrician completed a detailed FGID questionnaire on consecutive patients seen during a 3-month period. A total of 9660 patients aged birth to 12 years were enrolled prospectively during this 3-month period. Follow-up was performed at 1-, 3-, and 12-month intervals. RESULTS: A total of 194 children initially met strict criteria for at least 1 FGID. A total of 72 (37.1%) children had infant regurgitation, 26 (13.4%) had functional dyspepsia, 27 (13.9%) had irritable bowel syndrome, and 66 (34.1%) had functional constipation or other defecation disorders. All children who had a diagnosis of FGIDs were reevaluated at 1, 3, and 12 months to study the natural history of the illnesses. Additional evaluation revealed 5 children who had developed an organic diagnosis. Therefore, 5 (2.5%) of 194 children who had a diagnosis of FGIDs by the Rome criteria had a change in diagnosis to an organic disease during the study period, none of whom experienced permanent sequelae. CONCLUSIONS: Of 194 children who received a prospective diagnosis of FGIDs using the Rome criteria, 97.5% continued to satisfy the diagnostic criteria or were improved at follow-up. The low prevalence of functional dyspepsia and irritable bowel syndrome in our population is most likely explained by the lack of adolescents in our sample.