Quality of life in children with skin disease: A Spanish sample.

INTRODUCTION: The impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. MATERIAL AND METHODS: We conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children's Dermatology Life Quality Index (CDLQI). RESULTS: In our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. DISCUSSION: Atopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment.

Estudio de la calidad de vida en Dermatología Pediátrica: un ejemplo de la población española / Quality of life in children with skin disease: A Spanish sample

Introducción: Las enfermedades cutáneas pueden afectar a la calidad de vida de forma muy variable; el impacto de algunas dermatosis puede ser similar al del asma o la fibrosis quística. Material y métodos: Realizamos un estudio observacional, descriptivo y transversal con el objetivo de describir el grado de afectación de la calidad de vida de los niños que acudieron a la consulta monográfica de Dermatología Pediátrica, mediante el Children's Dermatology Life Quality Index (CDLQI). Resultados: En este estudio la dermatosis con mayor impacto en la calidad de vida fue la dermatitis atópica, debido principalmente a síntomas como el prurito y el insomnio. El segundo grupo diagnóstico con mayor afectación fue el acné, debido principalmente a los sentimientos negativos (vergüenza, tristeza, etc.) asociados al mismo. Los pacientes con verrugas víricas y moluscos contagiosos tuvieron impacto en la calidad de vida debido principalmente al tratamiento de los mismos, que se realizó principalmente con crioterapia. La mayor parte de los pacientes con nevus o manchas café con leche no tuvieron afectación en la calidad de vida, si bien hasta un tercio de ellos tuvieron sentimientos negativos secundarios a su dermatosis. Discusión: La dermatitis atópica fue la enfermedad dermatológica común que más impactó en la calidad de vida en nuestra muestra de pacientes, aunque otros procesos también afectaron a la calidad de vida en distintos aspectos de la misma. Cabe destacar la recomendación de emplear en verrugas víricas y moluscos contagiosos tratamientos más indoloros que la crioterapia, ya que es el tratamiento lo que más impacta en la calidad de vida de los pacientes pediátricos. (AU)

Introduction: The impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. Material and methods: We conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children's Dermatology Life Quality Index (CDLQI). Results: In our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. Discussion: Atopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment. (AU)

Evaluación psicosocial en adolescentes transgénero / Psychosocial assessment in transgender adolescents

OBJETIVOS: Evaluar el estado psicosocial de los pacientes que acudan a consulta de endocrinología pediátrica por incongruencia de género y determinar el impacto en este sentido de la terapia hormonal cruzada (THC) después de un año. MATERIAL Y MÉTODOS: Se trata de un estudio analítico, prospectivo realizado en adolescentes con incongruencia de género de entre 14 y 18 años que acuden a endocrinología infantil durante 2018-2019. Tamaño muestral: 23 casos transgénero (16 masculinos y 7 femeninos) y 30 controles cis. Variables del estudio en T0 (pretratamiento) y T1 (tras un año de THC): datos sociodemográficos, Test de Utrecht, Test SDQ-Cas, APGAR familiar, Escala STAI, Test de evaluación de depresión BDI-II. RESULTADOS: Se encuentra mejoría significativa (p < 0,05) entre T0 y T1 en el grupo trans en cuanto a los síntomas emocionales, los problemas de conducta, los síntomas de hiperactividad y la conducta prosocial, así como en el grado de ansiedad y depresión. Existen diferencias significativas entre el grupo trans y los controles en T0 igualándose las puntuaciones en T1 en las escalas evaluadas. Las familias de nuestra muestra de pacientes transgénero proporcionan un entorno muy favorable según las puntuaciones obtenidas en la escala del APGAR familiar. CONCLUSIONES: Los índices de ansiedad, distrés emocional y comportamental, sintomatología depresiva, así como el sentimiento de disforia de género de nuestra muestra de pacientes transgénero fueron similares a los de población no transexual de su misma edad tras un año de THC iniciada en edades comprendidas entre los 14-18 años

OBJECTIVES: To evaluate the psychosocial status of the patients who attend a paediatric endocrinology clinic due to gender incongruity (GI), and to establish the impact on this after one-year of cross hormonal therapy (CHT). MATERIAL AND METHODS: An analytical and prospective study conducted on adolescents between 14 and 18 years old with GI, and who attended the Endocrinology clinic during 2018-2019. The sample included 23 transgender cases (16 male and 7 female cases) and 30 cisgender controls. Study variables were collected at T0 (pre-treatment) and T1 (after one year of CHT) and included sociodemographic data, Utrecht test, SDQ-Cas test, family APGAR test, STAI scale-anxiety Grade, and BDI-II depression assessment test. RESULTS: A significant improvement (P < .05) was found between T0 and T1 in the transgender group in terms of emotional symptoms, behaviour problems, hyperactivity symptoms, pro-social conduct, as well as in the degree of anxiety and depression measured by the SDQ-Cas test, the STAI and the BDI-II scale. There were significant differences in these scales between the transgender group and the controls at T0, however, the scores equalised at T1. The families in this sample of transgender patients provided a very favourable environment according to the scores obtained on the family APGAR scale. CONCLUSIONS: The rates of anxiety, emotional and behaviour distress, depressive symptomatology, as well as the feeling of gender dysphoria of these transgender patients were similar to those of non-transsexual population of the same age after one year of CHT initiated at ages between 14-18 years old

[Psychosocial assessment in transgender adolescents]. / Evaluación psicosocial en adolescentes transgénero.

OBJECTIVES: To evaluate the psychosocial status of the patients who attend a paediatric endocrinology clinic due to gender incongruity (GI), and to establish the impact on this after one-year of cross hormonal therapy (CHT). MATERIAL AND METHODS: An analytical and prospective study conducted on adolescents between 14 and 18 years old with GI, and who attended the Endocrinology clinic during 2018-2019. The sample included 23 transgender cases (16 male and 7 female cases) and 30 cisgender controls. Study variables were collected at T0 (pre-treatment) and T1 (after one year of CHT) and included sociodemographic data, Utrecht test, SDQ-Cas test, family APGAR test, STAI scale-anxiety Grade, and BDI-II depression assessment test. RESULTS: A significant improvement (P<.05) was found between T0 and T1 in the transgender group in terms of emotional symptoms, behaviour problems, hyperactivity symptoms, pro-social conduct, as well as in the degree of anxiety and depression measured by the SDQ-Cas test, the STAI and the BDI-II scale. There were significant differences in these scales between the transgender group and the controls at T0, however, the scores equalised at T1. The families in this sample of transgender patients provided a very favourable environment according to the scores obtained on the family APGAR scale. CONCLUSIONS: The rates of anxiety, emotional and behaviour distress, depressive symptomatology, as well as the feeling of gender dysphoria of these transgender patients were similar to those of non-transsexual population of the same age after one year of CHT initiated at ages between 14-18 years old.

Máculas eritematodescamativas palmoplantares / Palmoplantar erythematous squamous macula

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Transgender adolescents and acne: A cases series.

We describe the difficulties of treating acne in a series of female-to-male transgender adolescents, including concerns about potential hepatotoxicity with concomitant use of testosterone with isotretinoin or tetracyclines. Acne is a foreseeable adverse effect of testosterone treatment in transgender adolescents, so monitoring for acne is advised. The treatment of acne in transgender adolescents is important given that severe acne and transgenderism are associated with higher rates of depression and suicide.

Manifestaciones cutáneas del síndrome antifosfolípido / Cutaneous manifestations in antiphospholipid syndrome

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Infliximab treatment of psoriasis in supervised infusion centers: case management experience.

Psoriasis is a systemic chronic inflammatory disease that affects 1-3% of the world's population. Knowledge of the pathogenesis of psoriasis, particularly in the understanding of the role of T cells and tumor necrosis factor α (TNFα), and advances in immunology have led to the development of biological agents, which, due to their great effectiveness, speed of response and good tolerability, have revolutionized patient management. One of these is infliximab, a human chimeric immunoglobulin G1 monoclonal antibody composed of human antibody constant regions and murine variable regions that was developed specifically to target TNFα. The six cases presented in this series highlight the feasibility, efficacy and safety of infliximab for psoriasis when administered in a variety of patients in several infusion centers across Spain. All six patients showed improvement in their psoriasis after the initiation of infliximab and no significant tolerability issues or injection site reactions were reported, despite the presence of several comorbid conditions or patient characteristics that traditionally reduce the efficacy of psoriasis treatments. This suggests that while the management of psoriasis patients with comorbid conditions and various unfavorable prognostic characteristics requires a multidisciplinary approach to ensure the patient obtains the best therapeutic response, infliximab is an effective and well tolerated treatment in these patients.

Cold panniculitis.

Cold panniculitis has been described in children and young women following cold exposure. Histopathologically, cold panniculitis shows a mostly lobular panniculitis, which consists of an infiltrate of lymphocytes and histiocytes in the fat lobules. Usually, the dermis shows a superficial and deep perivascular infiltrate mostly composed of lymphocytes, with no vasculitis. Inflammation is most intense at the dermal-subcutaneous junction. Differential diagnosis of cold panniculitis should be established with subcutaneous fat necrosis of the newborn, sclerema neonatorum, poststeroid panniculitis, chilblains, and frostbites.

Pénfigo vulgar en la infancia / Pemphigus vulgaris in childhood

El pénfigo vulgar en la infancia es muy infrecuente, con poco más de 50 casos descritos en la literatura. Presentamos un nuevo caso de pénfigo vulgar en un niño de 11 años, comentando su evolución y respuesta al tratamiento y revisamos los casos comunicados en este grupo de edad, con especial atención al manejo terapéutico y al pronóstico de esta enfermedad en la infancia

A new case of pemphigus vulgaris in an 11 years-old boy is reported. Pemphigus vulgaris is infrequent in childhood, with over 50 cases previously reported. We comment the evolution and the response to treatment. We reviewed other cases reported in children, with special attention to the therapeutic and the prognosis of the disease in childhood