Linear juvenile dermatomyositis: A segmental manifestation.

A 7-year-old girl presented with proximal muscle weakness and skin lesions. Physical examination revealed violaceous papules on the right forearm in a blaschkoid distribution. Her symptoms and test results were consistent with juvenile dermatomyositis. An unusual superimposed segmental manifestation of this disease is discussed.

Congenital tufted angioma: A multicenter retrospective study of 30 cases.

BACKGROUND: Recent reports indicate that tufted angioma is a rare vascular neoplasm that manifests more frequently at birth than previously thought. Few studies specifically address congenital presentation. OBJECTIVES: We analyzed the clinicopathological characteristics, clinical course, and treatment of congenital tufted angioma (cTA) and evaluated variables that were indicative of problematic lesions. METHODS: We performed an observational retrospective study of 30 patients with cTA in 9 Spanish hospitals over a 14-year period. Histopathology and immunohistochemistry studies were performed. RESULTS: Congenital tufted angioma mainly affected the limbs (56.67%), followed by the face and/or neck (23.33%). Almost three-quarters of facial cTA were located over the mandibular area. Immunohistochemically, proliferating cells expressed markers of endothelial cells, with some clusters of cells, especially at the periphery of the aggregates, showing positivity for podoplanin. As no associated complications were observed in 66.67% of cases, no treatment was started. LIMITATIONS: Data were collected retrospectively. CONCLUSIONS: Our findings emphasize the clinical features and course of cTA. The possibility of cTA should be considered when a poorly defined congenital infiltrative vascular tumor with(out) overlying hirsutism appears over the mandibular area. Location on the face and/or neck requires a more comprehensive workup, since potentially severe complications often appear early.

Dermatología en pieles oscuras / Dermatology in dark skins

La dermatología constituye un motivo de consulta frecuente en Pediatría y aún más en los servicios de Pediatría de Atención Primaria. En los últimos años, el aumento de niños inmigrantes de países en vías de desarrollo y niños procedentes de adopciones internacionales ha cambiado la patología habitual en nuestro medio. El pediatra y el dermatólogo deben aprender a explorar la piel de estos niños que tienen un color de piel diferente al nuestro y saber diferenciar la normalidad de la patología. Aunque los niños inmigrantes pueden tener otras enfermedades porque están predispuestos genéticamente, la mayoría serán enfermedades infecciosas. Es un reto saber diagnosticar y tratar las enfermedades procedentes de sus países de origen que antes solo veíamos en los libros

Dermatology is a frequent reason for consultation in pediatrics and even more in pediatric primary care services. In recent years, the increase in immigrant children from developing countries and children from international adoption has changed the usual pathology in our environment. The pediatrician and the dermatologist must learn to explore the skin of these children who have a different skin color from ours and know how to differentiate the normality of the pathology. Although immigrant children may have other diseases because they are genetically predisposed, most will be infectious diseases. It is a challenge to know how to diagnose and treat diseases from their countries of origin that we used to see only in books

Cutaneous Mucinosis of Infancy: A Rare Congenital Case with Coexisting Progressive, Eruptive, and Spontaneously Involuting Lesions.

Cutaneous mucinosis in infancy is rare. We report an infant with multiple congenital papules distributed over the trunk, neck, and extremities. These papules were mainly dispersed, but they also coalesced into plaques. Histopathologic findings showed features of cutaneous mucinosis of infancy (CMI). Over 2 years of follow-up, we observed that the preexisting lesions on the lower back and left trunk progressively increased in size, and a few new scattered papules continued to appear, mainly on the trunk; several lesions spontaneously resolved with no further complications. CMI is considered to be a persistent cutaneous disorder, even though spontaneously regressing cases have rarely been reported. This case demonstrates the broad clinical spectrum of CMI, with progressive, eruptive, and spontaneously involuting lesions all present in the same patient. This condition should be considered in the differential diagnosis of congenital or infantile-onset papules and plaques, especially those yellowish in color.

Mosaicismo diploide/triploide: un fenotipo variable, pero característico / Diploid/triploid mosaicism: a variable but characteristic phenotype

Introducción. El mosaicismo diploide/triploide es una alteración cromosómica poco frecuente. La produce un fallo en la división poscigótica durante el desarrollo embrionario. Da lugar a la coexistencia de dos líneas celulares con diferente constitución cromosómica (46,XX y 69,XXX) en un mismo individuo. Su fenotipo clínico es característico. Las alteraciones pigmentarias con un patrón de distribución que sigue las líneas de Blaschko son el principal signo guía, así como las alteraciones de otros tejidos derivados del ectodermo. Casos clínicos. Describimos las características clínicas de tres pacientes afectos de mosaicismo diploide/triploide y realizamos una comparación de su fenotipo clínico con el de los casos publicados previamente en la bibliografía. Las alteraciones observadas con mayor frecuencia fueron alteraciones cutáneas, discapacidad intelectual, obesidad troncular, talla baja, hemihipertrofia, y manos pequeñas y estrechas con clino y camptodactilia. Las características fenotípicas de nuestros pacientes fueron similares a las de los casos comunicados previamente. Aunque no existe un fenotipo único y específico asociado al mosaicismo diploide/triploide, existen malformaciones características que conforman un síndrome malformativo bien definido. El cariotipo realizado en linfocitos de sangre periférica en las tres pacientes fue normal, y se logró el diagnóstico mediante cariotipo en fibroblastos cultivados tras biopsia de piel hipopigmentada. Conclusiones. La presencia de discapacidad intelectual asociada a obesidad troncular, talla baja, hemihipertrofia o clino y camptodactilia, además de las alteraciones cutáneas, debe hacer pensar en la posible existencia de un mosaicismo diploide/ triploide. En la mayoría de los casos, es necesario el estudio del cariotipo en los fibroblastos para llegar al diagnóstico (AU)

Introduction. Diploid/triploid mosaicism is a rare chromosomal abnormality. It is caused by a failure in the postzygotic division during embryonic development. It results in the coexistence of two genetically heterogeneous cell lines (46,XX and 69,XXX) in one individual. His clinical phenotype is characteristic. Pigmentary changes with a distribution pattern following Blaschko’s lines abnormalities in other ectoderm-derived tissues are the main diagnostic signs. Case reports. Three cases of diploid/triploid mosaicism are described, and compared to the previously reported cases. The most frequently observed symptoms were mental retardation, truncal obesity, short stature, hemihypertrophy, small and narrow hands with clino and camptodactyly. Phenotypic characteristics of our three patients were similar to those of previously reported cases. Although there is no single and specific phenotype associated with mosaicism diploid/triploid, there are some dysmorphic features that shape a recognizable malformative syndrome. Peripheral blood lymphocytes karyotype was normal in our patients. Diagnosis was reached performing a fibroblast karyotype from hypopigmented skin. Conclusions. Intellectual disability associated with truncal obesity, short stature, hemihypertrophy or clino/camptodactyly should suggest to clinicians the possible existence of a diploid/triploid mosaicism. In most cases, karyotype from fibroblasts is needed to reach the diagnosis (AU)

[Diploid/triploid mosaicism: a variable but characteristic phenotype]. / Mosaicismo diploide/triploide: un fenotipo variable, pero característico.

INTRODUCTION: Diploid/triploid mosaicism is a rare chromosomal abnormality. It is caused by a failure in the postzygotic division during embryonic development. It results in the coexistence of two genetically heterogeneous cell lines (46,XX and 69,XXX) in one individual. His clinical phenotype is characteristic. Pigmentary changes with a distribution pattern following Blaschko's lines abnormalities in other ectoderm-derived tissues are the main diagnostic signs. CASE REPORTS: Three cases of diploid/triploid mosaicism are described, and compared to the previously reported cases. The most frequently observed symptoms were mental retardation, truncal obesity, short stature, hemihypertrophy, small and narrow hands with clino and camptodactyly. Phenotypic characteristics of our three patients were similar to those of previously reported cases. Although there is no single and specific phenotype associated with mosaicism diploid/triploid, there are some dysmorphic features that shape a recognizable malformative syndrome. Peripheral blood lymphocytes karyotype was normal in our patients. Diagnosis was reached performing a fibroblast karyotype from hypopigmented skin. CONCLUSIONS: Intellectual disability associated with truncal obesity, short stature, hemihypertrophy or clino/camptodactyly should suggest to clinicians the possible existence of a diploid/triploid mosaicism. In most cases, karyotype from fibroblasts is needed to reach the diagnosis.

TITLE: Mosaicismo diploide/triploide: un fenotipo variable, pero caracteristico.Introduccion. El mosaicismo diploide/triploide es una alteracion cromosomica poco frecuente. La produce un fallo en la division poscigotica durante el desarrollo embrionario. Da lugar a la coexistencia de dos lineas celulares con diferente constitucion cromosomica (46,XX y 69,XXX) en un mismo individuo. Su fenotipo clinico es caracteristico. Las alteraciones pigmentarias con un patron de distribucion que sigue las lineas de Blaschko son el principal signo guia, asi como las alteraciones de otros tejidos derivados del ectodermo. Casos clinicos. Describimos las caracteristicas clinicas de tres pacientes afectos de mosaicismo diploide/triploide y realizamos una comparacion de su fenotipo clinico con el de los casos publicados previamente en la bibliografia. Las alteraciones observadas con mayor frecuencia fueron alteraciones cutaneas, discapacidad intelectual, obesidad troncular, talla baja, hemihipertrofia, y manos pequeñas y estrechas con clino y camptodactilia. Las caracteristicas fenotipicas de nuestros pacientes fueron similares a las de los casos comunicados previamente. Aunque no existe un fenotipo unico y especifico asociado al mosaicismo diploide/triploide, existen malformaciones caracteristicas que conforman un sindrome malformativo bien definido. El cariotipo realizado en linfocitos de sangre periferica en las tres pacientes fue normal, y se logro el diagnostico mediante cariotipo en fibroblastos cultivados tras biopsia de piel hipopigmentada. Conclusiones. La presencia de discapacidad intelectual asociada a obesidad troncular, talla baja, hemihipertrofia o clino y camptodactilia, ademas de las alteraciones cutaneas, debe hacer pensar en la posible existencia de un mosaicismo diploide/triploide. En la mayoria de los casos, es necesario el estudio del cariotipo en los fibroblastos para llegar al diagnostico.

Aeromonas hydrophila folliculitis associated with an inflatable swimming pool: mimicking Pseudomonas aeruginosa infection.

Aeromonas species are ubiquitous, facultative, anaerobic, gram-negative flagellated rods, mainly found in aquatic ecosystems worldwide. Skin and soft-tissue infections, including cellulitis and wound infections, are the second most frequent location of isolations of Aeromonas spp. in clinical samples, after the gastrointestinal tract. All three major Aeromonas species (A. hydrophila, A. caviae, and A. veroni biotype sobria) have been associated with wound infections, but A. hydrophila predominates. Typically, infection occurs after trauma and subsequent exposure to contaminated fresh water or soil. However, Aeromonas folliculitis has been rarely reported. We report the first two pediatric cases of Aeromonas hydrophila folliculitis associated with the use of recreational water facilities that clinically and epidemiologically mimic Pseudomonas folliculitis. Clinical and microbiological studies may be necessary to clarify the role of Aeromonas spp. in this newly-reported infection.