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New medical therapies result in symptoms of various skin conditions

Recognizing presentations of conditions linked to new medical therapies is an emerging clinical trend, according to experts speaking at a symposium on what is new in dermatopathology held during the 73rd annual meeting of the American Academy of Dermatology (San Francisco, 2015). BRAF inhibitors, for example, are therapies that are producing cases of neutrophilic panniculitis, according to Nooshin Ketabchi Brinster M.D., assistant professor, department of dermatology, New York University School of Medicine/Langone Medical Center, New York. “The common theme is that they develop painful, non-ulcerating nodules that occur on the lower extremities,” she says. “They can mimic erythema nodosum, but patients can also develop lesions on the upper extremities and on the trunk. There is a 48-day delay in onset of this condition from the time treatment is initiated. More and more BRAF inhibitors are being used in patients with melanoma, so it may be something that you come across.” Patients do not need to stop BRAF inhibitor therapy, Dr. Ketabchi Brinster says. Rather, the dose can be reduced, she adds. “No patients thus far have required stopping treatment,” she says. Other relatively new phenomena that clinicians should be aware of are follicular papules on the face, particularly the forehead, that present with frontal fibrosing alopecia, Dr. Ketabchi Brinster says, noting this presentation can occur atypically in younger patients. Tammie C. Ferringer M.D., an associate in the department of dermatology at Geisinger Medical Center and director of the dermatopathology Fellowship Program, Danville, Penn., says dermatopathologists should be careful not to mistake a plaque type syringoma for microcystic adnexal carcinoma. “It (plaque type syringoma) stays superficial,” Dr. Ferringer says, in terms of looking at clues to differentiate a plaque-type syringoma from a microcystic adnexal carcinoma. Other presentations that Dr. Ferringer described include papules on the nose, which may prove to be spindle cell predominant trichodiscoma, and these presentations are CD34 positive, she notes. Jacqueline M. Junkins-Hopkins M.D., a dermatopathologist at the American Academy of Dermatopathology in New York, discussed variants of mycosis fungoides such as folliculotropic mycosis fundgoides, which can be an aggressive variant of cutaneous T-cell lymphoma. “Patients can still have an aggressive course of disease even though they don’t have tumors per se,” said Dr. Junkins-Hopkins. “The patients tend to be younger, and it tends to be an indolent disease but some can have systemic lymphoma. There can be some fatal disease with this, so these patients have to be watched.”
Modern medicine – dermatopathology

Infections and Conditions Common to Children

Vaccines have made a lot of the illnesses associated with childhood a rarity, but many others continue to be a fact of life. They range from such common infections as conjunctivitis and croup to the more mysterious ones, such as Kawasaki disease. In the following paragraphs, you will learn about a few of them. It doesn’t matter how much you learn though, be it here or anywhere else, you will still need to get in touch with a pediatrician so that your child can be properly diagnosed and treated.

Conjunctivitis

This is the common childhood ailment that is colloquially known as pinkeye. This is a very infectious ailment and it is spread easily through contact with others who have it. Basically, this is the inflammation of the conjunctiva, or the outer layer of the clear tissue that is what surrounds the eye. With this ailment, the whites of the eyes will appear red and there can be painful itching and burning. This ailment should be diagnosed by a doctor who can treat it with special drops that contain antibiotics for pink eye.

 

Fifth Disease

This is an actual rash, which means that it can be considered to be a skin condition. This one is also known as slapped cheek disease. It causes there to be a bright red rash right on the face of a child. This rash might also make an appearance on the legs, arms, and torso. It is caused by a virus known as parvovirus B19, which might cause there to be a few symptoms reminiscent of a cold right before the appearance of the rash. After the rash has appeared, the condition is no longer one that is contagious. Typically, it will go away within about 10 days.

Kawasaki Disease

This is actually one of the more rarely seen childhood illnesses. It affects the child’s blood vessels. Symptoms of this condition can be quite severe and alarming for several days. These symptoms can include a fever lasting as long as 5 days, redness of the eyes, a rash on the body, swelling of the lymph nodes in the neck, as well as swelling, redness, and cracking of the tongue and lips, hands, and feet. Because this is an issue involving the blood vessels, the heart is also involved. If your child presents these symptoms, get them to the pediatrician as soon as you can because if left untreated, Kawasaki Disease can possibly lead to heart problems in the future.

Croup

Croup is characterized by a cough that sounds a bit like a barking seal. This cough is caused by the upper airways being inflamed, and this is typically because of a virus. However, this condition can severely impair the child’s ability to breathe easily, and if this happens, you need to get the child to the emergency room. That being said, most of the time, the condition will go away once it has run its course in about a week.

Ear Infection

Younger children can be affected by ear infections due to the auditory tubes in their ears being so small. These are the tubes that connect the throat to the ears, and when a cold causes there to be inflammation, they can become blocked. This effectively traps fluid inside the middle of the ear right behind the child’s eardrum. This allows for the breeding of germs. Symptoms can include ear pulling, fussiness, and fever. Often, ear infections are caused by a virus and will go away on their own. That said, there are times when there needs to be a trip to the pediatrician.

Hand Foot and Mouth Disease

This affliction is characterized by a fever that is accompanied by the appearance of blisters on the soles of a child’s feet, on their buttocks, on the palms of the child’s hands, and inside the mouth. Here in the USA, this is typically caused by a virus known as coxsackievirus A16. This is a virus that seems to be more rampant in the summer as well as in the early autumn months. Most of the time, this is not something that is too serious and can last anywhere from 7 to 10 days.

talkhealth Blog

Ask the Expert: Children’s Skin Conditions

Last week saw the launch of our latest venture – Ask the Expert. The one day clinic, which took place Wednesday 18th January, was the first in a series of Ask the Expert sessions which will run in partnership with the British Skin Foundation. This first session focused on children’s skin conditions, and gave people the opportunity to put their questions directly to our specialist consultant dermatologist Dr Emma Wedgeworth, Dr Nisith Sheth, and Dr Anjali Mahto.

Over the course of the day, lots of questions were put to the panel, and covered issues such as psoriasis in the ears, sleep deprivation due to eczema and allergy induced urticaria. To read questions and answers visit the clinic page here. The clinic also received a lot of interest on social media.

We surveyed our talkhealth community after the clinic to get feedback. 80% of participants rated the response they received from experts as ‘excellent’, with 60% stating that they either have or will consult their doctor with this new information. They also shared some comments such as:

 

“I was very satisfied with my answer…thank you and keep up the good work!”

“It’s pushed me to go back to my GP and ask for dermatologist, Thank you”

Our next Ask the Expert session will take place on Thursday 16th February, and will focus on psoriasis. If you wish to be sent a reminder for this ask the expert session, please leave a comment below, or email us at info@talkhealthpartnership.com.

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