Current concepts in the prevention of atopic dermatitis.

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition with a profound social, economic, and psychologic impact. An effective prevention strategy would have significant socioeconomic implications worldwide. The aim of this review is to evaluate the current evidence for prevention strategies, including early intervention neonatal emollient therapy, antihistamine use, and probiotic supplementation. Although studies were fairly heterogeneous in their designs, the current cumulative data support early daily emollient therapy to reduce the incidence of AD in at-risk infants. The evidence for antihistamine use is limited, and further investigation is necessary to assess its potential role in AD prevention. Although several studies reveal a significant reduction in AD incidence with prenatal and/or postnatal probiotic supplementation, they differ in the strains, timing, dose, treatment duration, and measurement of clinical outcomes. Consequently, there are currently no firm guidelines or recommendations in place for probiotic use in pregnancy or infancy to prevent AD. Ultimately, atopic prevention remains a work in progress, and further investigations are needed to better understand the pathogenesis of AD and determine the most effective prevention strategies.

Unilateral hypertrophy of the labia minora: A case series.

Asymmetric hypertrophy of the labia minora is a variant of normal anatomy that has not been described in the pediatric dermatology literature. Although often asymptomatic, in some cases, it can cause functional, emotional, and psychological problems. We report the clinical characteristics and outcomes of four children who presented with unilateral labium minus hypertrophy. This case series aims to establish awareness of this condition among pediatric dermatologists and provide recommendations regarding management.

Clinical presentation, immunopathology, and treatment of juvenile-onset mycosis fungoides: a case series of 34 patients.

BACKGROUND: Mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma, typically presents in middle-aged to elderly individuals. OBJECTIVE: We sought to study the demographics, clinicopathologic features, treatment response, and prognosis of patients with biopsy-proven MF diagnosed before 20 years of age. METHODS: Patients were identified from a prospectively collected database for retrospective analysis. RESULTS: Of 1902 patients with MF, 34 had juvenile-onset MF: 41% were stage IA, 56% were stage IB, and 3% were stage IIB at diagnosis. The male to female ratio was 1.1:1. The median age of symptom onset was 9 years (range 3-19 years), with a delay in diagnosis between 1 month and 14 years. Patients primarily presented with hypopigmented (53%), hyperpigmented (29%), and pink-violaceous (41%) patches/plaques. Immunohistochemistry revealed 39% with CD8(+) immunophenotype, 67% of which had hypopigmented lesions. The phototherapy response rate in 21 patients was 81%. All patients who completely responded to narrowband ultraviolet B phototherapy had hypopigmented MF. LIMITATIONS: This is a single cancer center study. CONCLUSION: Juvenile-onset MF presents with early-stage disease with an overrepresentation of hypopigmented MF and CD8(+) immunophenotype. Narrowband ultraviolet B is an effective treatment option for juveniles, especially for those with the hypopigmented variant.