Educational intervention and atopic dermatitis: impact on quality of life and treatment.

BACKGROUND: Educational intervention (EI) could improve understanding of atopic dermatitis (AD) and adherence to treatment, decreasing severity, and improving quality of life (QoL). OBJECTIVE: This study aims to evaluate the influence of an EI on the severity of the disease and on the QoL in children with AD. METHODS: A controlled clinical trial was performed, including children up to 14 years of age with AD. Patients were allocated into control group (CG), which received usual guidelines on AD during the outpatient visit, and a study group (SG) that, in addition to the usual guidelines, participated in the EI. The severity of AD was assessed by Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI). QoL was assessed by the Children's Dermatology Life Quality Index and the Dermatitis Family Impact Questionnaire. RESULTS: Twenty-seven participants were included in the CG and 21 in the SG. There was a decrease in the median value for the QoL of children in the SG after the intervention (p = 0.04), as well as in the caregiver's (p = 0.04). In the CG, the median QoL of children and caregivers remained unaltered, for caregivers the median value for the QoL was equal throughout first and second evaluation (p = 0.32). In the SG, EASI values decreased after the intervention (p = 0.04), as well as SCORAD (p = 0.04). The CG did not show any decrease in the values of EASI (p = 0.88) scores nor of SCORAD scores (p = 0.82). CONCLUSION: The EI rendered a decrease in severity of the disease and improvement in the QoL of patients and their caregivers.

Mental disorders and atopic dermatitis in children and adolescents.

INTRODUCTION: Some authors point to a relationship between mental disorders (MD) and atopic dermatitis (AD), but few determine which MD these are, and none of them evaluate the impact of AD on their healthy siblings. AIM: To determine which MD affect children and adolescents with AD and compare it with the risk of their healthy siblings. MATERIAL AND METHODS: This is a cross-sectional, prospective study with the application of a risk assessment instrument for Mental Disorders in paediatric patients with AD and their siblings from September 2016 to June 2018. The evaluation instrument used to assess the risk of MD was the Child Behaviour Checklist (CBCL). The Wilcoxon-Mann-Whitney, Pearson's χ2 test with Yates correction and Fisher's exact test were used, considering a significance level of 5%. RESULTS: The risk of MD in participants with AD was 63.0%, and in the healthy siblings, 36.0% (p < 0.01). The risk was higher in participants with AD when compared to their siblings for the syndromes "Sleep Problems", "Thought Problems" and "Somatic Complaints". Parental concerns on socialization/bullying were also more frequent for participants with AD when compared to siblings. CONCLUSIONS: Children and adolescents with AD present a high risk of MD, and their healthy siblings also present impairment in their mental health. In both cases, this impairment is higher than the one expected in the Brazilian general paediatric population (24.6%) and global paediatric population (22.4%).

Exantema laterotorácico unilateral con evolución atípica / Unilateral laryngeal eruption with atypical evolution

Una niña lactante presentó un exantema maculo-papular pruriginoso unilateral con evolución uni y contralateral. Aparentemente, el exantema fue desencadenado por una infección viral del tracto respiratorio.Los términos con que se ha descrito esta dermatosis son:exantema latero-torácico unilateral, exantema periflexural asimétricoy más recientemente exantema superpuesto lateralizado de la infancia. Este exantema es deevolución benigna yautolimitada,se presentacomúnmente como un exantema escarlatiniforme o morbiliforme que generalmente se inicia en la axila y después se disemina al tronco y miembro superior homolateral. El tratamiento es sintomático.

A female infant presented with pruritic unilateral macular rash with bilateral evolution. Apparently, the rash was triggered by a viral respiratory tract infection. Unilateral laterothoracicexanthem, asymmetric periflexural exanthema and more recently superimposed lateralized exanthem of childhoodare terms used to define this rash. It has self-limiting evolution. Commonly presented as a scarlatiniform or morbilliformrash that usually begins in the axilla and then spreads to the trunk and homolateralupper limbs. The treatment is symptomatic.

Majocchi granuloma on a child's face.

Majocchi granuloma (MG) is a rare dermal and subcutaneous fungal infection. We report a rare case of MG on the face of a six-year-old child caused by Trichophyton mentagrophytes after long term use of topical corticosteroids and other inadequate topical medications. He was treated with griseofulvin 25 mg/kg/day for 35 days unsuccessfully and successful treatment was obtained with terbinafine.