RESUMEN
Dermatologic reactions are among the most common adverse events of antiprogrammed cell death-1 (anti-PD-1) monoclonal antibodies agents and include maculopapular rash, psoriasiform rash, lichenoid eruptions, autoimmune bullous disorders, and vitiligo. Here, we present a case of a 12-year-old African American male with metastatic spitzoid melanoma treated with nivolumab who developed a mild lichenoid eruption that progressed to a severe case of lichen planus pemphigoides (LPP). Management was complex given the patient's age and history and included hospitalization for intravenous steroids, an intensive topical steroid regimen, methotrexate, and discontinuation of nivolumab. This case illustrates a rare but dramatic progression from a mild LP-like eruption to severe bullous lichenoid eruption, most consistent with LPP, as well as the diagnostic and treatment challenges in the setting of a pediatric patient on nivolumab.
Asunto(s)
Enfermedades Autoinmunes , Exantema , Liquen Plano , Erupciones Liquenoides , Melanoma , Enfermedades Cutáneas Vesiculoampollosas , Humanos , Masculino , Niño , Nivolumab/efectos adversos , Liquen Plano/inducido químicamente , Liquen Plano/diagnóstico , Erupciones Liquenoides/inducido químicamente , Melanoma/tratamiento farmacológico , Exantema/inducido químicamenteRESUMEN
OBJECTIVE: Diabetes camps are beneficial for campers and include benefits such as increases in diabetes knowledge, glycemic control, and psychological functioning. Racial/ethnic minority youth are likely to have poorer disease management and glycemic control. We hypothesized that minority youth with type 1 diabetes have reduced participation in diabetes summer camps. RESEARCH DESIGN AND METHODS: We analyzed deidentified data from 5,256 campers with type 1 diabetes who participated in a network of 48 American Diabetes Association-affiliated summer camps in 2018, and we compared participation rates by racial/ethnic category to the most recent SEARCH for Diabetes in Youth study prevalence rates. RESULTS: Camper demographics were significantly different than in the general population of children with type 1 diabetes (P < 0.001). Minority youth were more likely to attend day camp, be first-time campers, and request financial aid, and they were less likely to be on insulin pump therapy or use continuous glucose monitors. CONCLUSIONS: Racial/ethnic minority youth with diabetes are underrepresented in diabetes camps nationwide.
Asunto(s)
Acampada , Diabetes Mellitus Tipo 1/etnología , Diabetes Mellitus Tipo 1/terapia , Etnicidad/estadística & datos numéricos , Disparidades en el Estado de Salud , Grupos Raciales/estadística & datos numéricos , Adolescente , Acampada/economía , Acampada/estadística & datos numéricos , Niño , Preescolar , Estudios Transversales , Diabetes Mellitus Tipo 1/economía , Diabetes Mellitus Tipo 1/epidemiología , Femenino , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , Estudios Retrospectivos , Factores SocioeconómicosRESUMEN
The authors conducted a retrospective review of 60 children under the age of 16 years with femoral shaft fractures treated with compression plate fixation. All patients were followed to hardware removal. The 100% union rate and low complication rate after compression plate fixation of pediatric femur fractures compared favorably to the literature of other treatment options. Compression plate fixation is a safe and effective treatment in children with both isolated femoral shaft fractures and those associated with multiple injuries.