Impact of Pediatric Dermatologic Conditions on Child and Parent Quality of Life.

Dermatologic conditions can confer a negative effect on pediatric patients and their caretakers. We aim to study the relationship between child and parent quality of life among various dermatoses to further understand the psychosocial impacts of dermatologic disease. We conducted a cross-sectional study of 100 pediatric patients (aged 7-18) and 98 parents who presented to the Pacific Skin Institute, Sacramento, CA, from November 2020 to January 2022. Patients and their parents were evaluated using the Children's Dermatology Life Quality Index (CDLQI) and Family Dermatology Life Quality Index (FDLQI). The maximum score for both indices was 30, with a higher score indicating greater impairment on quality of life. From all the patients and parents identified for various dermatoses, FDLQI scores (mean, 7.8; n = 98) exceeded CDLQI scores (mean, 5.8; n = 100) in nearly every condition. Acne was the only diagnosis with greater CDLQI scores (mean, 9.2; n = 43) than FDLQI scores (mean, 8.8; n = 42). Psoriasis had the greatest difference between FDLQI scores (mean, 10.4; n = 9) and CDLQI scores (mean, 5.9; n = 9). Our study found that parents of children with dermatologic conditions often experience a greater impairment on quality of life compared to the patient. This is likely because parents are highly involved in the management of their child's condition and are burdened with the costs associated with dermatoses. These findings call for a more holistic evaluation by clinicians and the expansion of resources for patients and their parents.

Appendicitis Secondary to Obstructing Ascending Colon Malignancy.

Appendicitis classically presents in a young adult as periumbilical pain localizing to the right lower quadrant as a result of an obstruction of the appendiceal orifice from lymphoid hyperplasia, fecalith, or infection. Persistent obstruction predisposes the appendix to an increasing inflammation, which may manifest as peritoneal signs as the disease course progresses toward perforation. Rarely, this obstruction occurs secondary to neoplastic growth, such as colonic adenocarcinoma. Furthermore, in older patient populations, appendicitis may not present with strict right lower quadrant pain. In this case report, we discuss an atypical presentation of perforated appendicitis with an underlying etiology of colonic adenocarcinoma in a 68-year-old male.

Atypical Guillain-Barré Syndrome Presenting After COVID-19 Infection.

Guillain-Barré syndrome (GBS) is an acute autoimmune disease affecting the peripheral nervous system presenting as a symmetric, ascending polyneuropathy. The syndrome arises after a stimulus, such as infection or vaccination, and provokes an autoimmune response in the body. Common symptoms include rapidly progressive weakness in the extremities and generalized hyporeflexia or areflexia. However, GBS may have various presentations, which can make for a challenging diagnosis. We present a case of a 46-year-old female with asymmetric ascending weakness, paresthesias, and acute onset urinary retention occurring after Coronavirus Disease 2019 (COVID-19) infection. Of note, this patient did not present with albuminocytologic dissociation in cerebrospinal fluid (CSF) studies. The complex presentation of her symptoms prompted a diagnosis of atypical GBS. Her diagnosis was achieved through a series of diagnostic tests ruling out other etiologies, such as meningitis and spinal cord compression syndromes.