ABSTRACT
Recurrent aphthous stomatitis (RAS) is a chronic disorder of unknown etiology characterized by recurring ulcers involving the oral mucosa in patients with no other manifestations. It is a common cause of oral ulcers in children. In its major form, RAS can be a severe and disabling disorder due to pain and scarring, and poses a therapeutic challenge. Therapies for major RAS include prednisone, thalidomide, colchicine, and dapsone. However, many patients do not achieve adequate control of the disease with them (J Clin Diagn Res, 10, 2016 and ZE08). We report a case of severe RAS in a teenager with a dramatic response to adalimumab.
Subject(s)
Adalimumab/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Stomatitis, Aphthous/drug therapy , Adolescent , Humans , Male , RecurrenceABSTRACT
Viral exanthems are frequent in children and are mostly self-limited. Early recognition and differentiation from other childhood illnesses are important to direct further investigations and treatment initiation. The clinical presentation of viral exanthems in children includes a polymorphic spectrum of skin eruptions ranging from classic viral exanthems to "atypical" presentations that can mimic nonviral diseases; thus, viral exanthems of childhood can be readily diagnosed on clinical grounds, but not rarely do they represent a diagnostic challenge. In this review, we focus on viral diseases in children that may be difficult to diagnose due to their clinical similarities with nonviral diseases, and we offer clues for the differential diagnosis and proper diagnostic testing in such cases.
Subject(s)
Exanthema/diagnosis , Exanthema/virology , Skin/virology , Acrodermatitis , Angiomatosis , Chikungunya Fever , Child , Child, Preschool , Clinical Laboratory Techniques , Dengue , Diagnosis, Differential , Exanthema/pathology , Female , Hand, Foot and Mouth Disease , Herpesvirus 4, Human , Humans , Immunocompromised Host , Infant , Male , Serologic Tests , Skin/pathology , Zika VirusABSTRACT
Mastocytosis is a heterogeneous group of disorders with a variable clinical course, ranging from indolent disease with normal life expectancy to highly aggressive disease. In the skin, mast cells may show a spindle-shape appearance or appear as round cells with wide, polygonal cytoplasm. In this study, we present a case series of 4 patients with cutaneous childhood-onset mastocytosis in whom skin mast cells showed striking nuclear pleomorphism with bilobed and multilobed nuclei. Such finding does not seem to represent a malignant phenotype of the disease in the skin, although the true biological significance and the potential prognostic impact remain to be determined.
Subject(s)
Cell Nucleus/pathology , Mast Cells/pathology , Mastocytosis, Cutaneous/pathology , Adolescent , Child , Child, Preschool , Female , Humans , Male , Young AdultABSTRACT
We report two unrelated infants in whom chronic urticaria was the first clinical manifestation of cryopyrin-associated periodic syndrome, which should be suspected in infants with early-onset chronic urticaria, especially if there is a neutrophil-rich infiltrate in the skin biopsy. Early diagnosis of cryopyrin-associated periodic syndrome may lead to early and successful treatment with anti-interleukin-1 medications.
