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CLAPA Adults Conference
Adults Cleft Conference Camden Lock, London, England Saturday 17 November 2018 The Cleft Lip and Palate Association (CLAPA) is the only national charity supporting people and families affected by cleft lip and/or palate in the UK from diagnosis through to adulthood. Timetable • • • • • • • • • • • • • • • • What’s today all about? • • • • Some ground rules and caveats • • • • • About the Adult Services Project • There are an estimated 75,000 people over the age of 16 living in the United Kingdom who were born with a cleft. • Understanding and supporting the unique needs and experiences of adults affected by cleft is very important to CLAPA. • From March 2018-February 2021, CLAPA is undertaking an exciting project looking at improving services for adults who were born with a cleft funded by the VTCT Foundation. • The goals are to research and understand the experiences, challenges and unmet needs of adults in the UK who were born with a cleft lip and/or palate. • The Adult Services Coordinator is the primary contact for this piece of work. What we did in Year One • • • • • So…what did we find at the roadshow? • We were humbled by how candidly people shared some of their most pivotal moments with us. • As you would expect, there were many different (oftentimes unique) experiences in the community, however there were some common themes that came up many times – these included: • The struggle of obtaining a successful referral to the cleft team as an adult • Being unsure what to expect at cleft team appointments • Not knowing (and health -
Oral Lichen Planus: a Case Report and Review of Literature
Journal of the American Osteopathic College of Dermatology Volume 10, Number 1 SPONSORS: ',/"!,0!4(/,/'9,!"/2!4/29s-%$)#)3 March 2008 34)%&%,,!"/2!4/2)%3s#/,,!'%.%8 www.aocd.org Journal of the American Osteopathic College of Dermatology 2007-2008 Officers President: Jay Gottlieb, DO President Elect: Donald Tillman, DO Journal of the First Vice President: Marc Epstein, DO Second Vice President: Leslie Kramer, DO Third Vice President: Bradley Glick, DO American Secretary-Treasurer: Jere Mammino, DO (2007-2010) Immediate Past President: Bill Way, DO Trustees: James Towry, DO (2006-2008) Osteopathic Mark Kuriata, DO (2007-2010) Karen Neubauer, DO (2006-2008) College of David Grice, DO (2007-2010) Dermatology Sponsors: Global Pathology Laboratory Stiefel Laboratories Editors +BZ4(PUUMJFC %0 '0$00 Medicis 4UBOMFZ&4LPQJU %0 '"0$% CollaGenex +BNFT2%FM3PTTP %0 '"0$% Editorial Review Board 3POBME.JMMFS %0 JAOCD &VHFOF$POUF %0 Founding Sponsor &WBOHFMPT1PVMPT .% A0$%t&*MMJOPJTt,JSLTWJMMF .0 4UFQIFO1VSDFMM %0 t'"9 %BSSFM3JHFM .% wwwBPDEPSg 3PCFSU4DIXBS[F %0 COPYRIGHT AND PERMISSION: written permission must "OESFX)BOMZ .% be obtained from the Journal of the American Osteopathic College of Dermatology for copying or reprinting text of .JDIBFM4DPUU %0 more than half page, tables or figurFT Permissions are $JOEZ)PGGNBO %0 normally granted contingent upon similar permission from $IBSMFT)VHIFT %0 the author(s), inclusion of acknowledgement of the original source, and a payment of per page, table or figure of #JMM8BZ %0 reproduced matFSJBMPermission fees -
4Th Annual Texas Children's Hospital Advanced Practice Provider
A Potpourri of Pediatric Dermatology 4th Annual Texas Children’s Hospital Advanced Practice Provider Conference April 2017 MOISE L. LEVY, M.D. DELL CHILDREN’S MEDICAL CENTER DELL MEDICAL SCHOOL/UT, AUSTIN AUSTIN, TX Conflicts of Interest Ø Anacor Ø Scioderm Ø Castle Creek Pharmaceuticals Ø Up to Date None Should Apply For This Presentation One way we are viewed… It’s just a birthmark 9 month old with asymptomatic scalp lesion noted in NICU; increases in size with straining But maybe something else… Sinus Pericranii Ø Communication between intra- and extracranial venous drainage pathways Ø Most are midline and non.pulsatile Ø Connect pericranial veins with superior sagittal sinus Ø TX depends on flow pattern/direction -Dominant; main flow via SP -Accessory; small flow via SP Neuroradiology 2007;49:505 Neurology 2009;72:e66 Case History 5 y/o girl w celiac disease Seen for evaluation of perianal growth Present, by hx, x 2 yrs No prior tx Case History Was seen by pediatric surgery Excised Condyloma - HPV 6, 16 Management? ARS – Pediatric Anogenital Warts When seeing a 5 yo with anogenital warts A. HPV testing should be done B. All cases are due to abuse C. All cases should be treated with imiquimod D. History and physical examination are key for suspicion of abuse E. Call Dr Eichenfield; he’ll know what to do Pediatric Anogenital Warts Age of onset and abuse - 6.5 ± 3.8 yrs (5.3 yrs) - 37% 2-12 yrs; 70% > 8 yrs - 4 yrs 8 months (83% female) HPV testing felt not of use… high subclinical History and PE key - physical findings abuse rare Arch Dermatol 1990;126:1575 Pediatrics 2005;116:815 Arch Dis Child 2006;91:696 Pediatr Dermatol 2006;23:199 J Pediatr Adolesc Gynecol 2013;26:e121 Age of Onset and Abuse Pediatr Dermatol 2006;23:199 ARS – Pediatric Anogenital Warts When seeing a 5 yo with anogenital warts A. -
Nevus Sebaceous
Nevus Sebaceous A nevus sebaceous (NEE vuhs sih BAY shus) is a type of birthmark that usually appears on the scalp. It may also appear on the face but this is less common. It is made of extra oil glands in the skin. It starts as a flat pink or orange plaque (slightly raised area). Hair does not grow in a nevus sebaceous. Typically, these are fairly small areas of skin. However, they can sometimes be larger and more noticeable. These birthmarks usually look the same until puberty. Hormonal changes cause them to become more raised. During adolescence (teen years) they can become very bumpy and wart-like. This can make them bothersome when brushing, combing or cutting the hair. A nevus sebaceous does not go away on its own. The cause is unknown. As a person gets older, typically after adolescence, abnormal changes to the area can sometimes occur. Your child’s doctor will monitor it over time. Diagnosis Your child’s doctor can usually diagnosis this kind of birthmark. If unsure, the doctor may take a small piece of the birthmark as a biopsy. The doctor will send it to a lab to be looked at under a microscope. This can confirm the diagnosis. Treatment Generally, it is very safe for your child’s doctor to simply watch a nevus sebaceous over time. This is especially true while your child is young (before puberty). A nevus sebaceous will not affect your child’s health, but you or your child may still want it to be taken off. If your child’s nevus sebaceous is large or becomes bothersome, it may be removed. -
Genes in Eyecare Geneseyedoc 3 W.M
Genes in Eyecare geneseyedoc 3 W.M. Lyle and T.D. Williams 15 Mar 04 This information has been gathered from several sources; however, the principal source is V. A. McKusick’s Mendelian Inheritance in Man on CD-ROM. Baltimore, Johns Hopkins University Press, 1998. Other sources include McKusick’s, Mendelian Inheritance in Man. Catalogs of Human Genes and Genetic Disorders. Baltimore. Johns Hopkins University Press 1998 (12th edition). http://www.ncbi.nlm.nih.gov/Omim See also S.P.Daiger, L.S. Sullivan, and B.J.F. Rossiter Ret Net http://www.sph.uth.tmc.edu/Retnet disease.htm/. Also E.I. Traboulsi’s, Genetic Diseases of the Eye, New York, Oxford University Press, 1998. And Genetics in Primary Eyecare and Clinical Medicine by M.R. Seashore and R.S.Wappner, Appleton and Lange 1996. M. Ridley’s book Genome published in 2000 by Perennial provides additional information. Ridley estimates that we have 60,000 to 80,000 genes. See also R.M. Henig’s book The Monk in the Garden: The Lost and Found Genius of Gregor Mendel, published by Houghton Mifflin in 2001 which tells about the Father of Genetics. The 3rd edition of F. H. Roy’s book Ocular Syndromes and Systemic Diseases published by Lippincott Williams & Wilkins in 2002 facilitates differential diagnosis. Additional information is provided in D. Pavan-Langston’s Manual of Ocular Diagnosis and Therapy (5th edition) published by Lippincott Williams & Wilkins in 2002. M.A. Foote wrote Basic Human Genetics for Medical Writers in the AMWA Journal 2002;17:7-17. A compilation such as this might suggest that one gene = one disease. -
Cutaneous Manifestations of Newborns in Omdurman Maternity Hospital
ﺑﺴﻢ اﷲ اﻟﺮﺣﻤﻦ اﻟﺮﺣﻴﻢ Cutaneous Manifestations of Newborns in Omdurman Maternity Hospital A thesis submitted in the partial fulfillment of the degree of clinical MD in pediatrics and child health University of Khartoum By DR. AMNA ABDEL KHALIG MOHAMED ATTAR MBBS University of Khartoum Supervisor PROF. SALAH AHMED IBRAHIM MD, FRCP, FRCPCH Department of Pediatrics and Child Health University of Khartoum University of Khartoum The Graduate College Medical and Health Studies Board 2008 Dedication I dedicate my study to the Department of Pediatrics University of Khartoum hoping to be a true addition to neonatal care practice in Sudan. i Acknowledgment I would like to express my gratitude to my supervisor Prof. Salah Ahmed Ibrahim, Professor of Peadiatric and Child Health, who encouraged me throughout the study and provided me with advice and support. I am also grateful to Dr. Osman Suleiman Al-Khalifa, the Dermatologist for his support at the start of the study. Special thanks to the staff at Omdurman Maternity Hospital for their support. I am also grateful to all mothers and newborns without their participation and cooperation this study could not be possible. Love and appreciation to my family for their support, drive and kindness. ii Table of contents Dedication i Acknowledgement ii Table of contents iii English Abstract vii Arabic abstract ix List of abbreviations xi List of tables xiii List of figures xiv Chapter One: Introduction & Literature Review 1.1 The skin of NB 1 1.2 Traumatic lesions 5 1.3 Desquamation 8 1.4 Lanugo hair 9 1.5 -
Child Abuse: Skin Markers and Differential Diagnosis
527 527 REVISÃO L Violência contra a criança: indicadores dermatológicos e diagnósticos diferenciais* Child abuse: skin markers and differential diagnosis Roberta Marinho Falcão Gondim 1 Daniel Romero Muñoz 2 Valeria Petri 3 Resumo: As denúncias de abuso contra a criança têm sido frequentes e configuram grave problema de saúde pública. O tema é desconfortável para muitos médicos, seja pelo treinamento insuficiente, seja pelo desconhecimento das dimensões do problema. Uma das formas mais comuns de violência contra a criança é o abuso físico. Como órgão mais exposto e extenso, a pele é o alvo mais sujeito aos maus- tratos. Equimoses e queimaduras são os sinais mais visíveis. Médicos (pediatras, clínicos-gerais e derma- tologistas) costumam ser os primeiros profissionais a observar e reconhecer sinais de lesões não aciden- tais ou intencionais. Os dermatologistas podem auxiliar na distinção entre lesões traumáticas inten- cionais, acidentais e doenças cutâneas que mimetizam maus-tratos. Palavras-chave: Contusões; Equimose; Queimaduras; Violência doméstica; Violência sexual Abstract: Reports of child abuse have increased significantly. The matter makes most physicians uncom- fortable for two reasons: a) Little guidance or no training in recognizing the problem; b - Not under- standing its true dimension. The most common form of child violence is physical abuse. The skin is the largest and frequently the most traumatized organ. Bruises and burns are the most visible signs. Physicians (pediatricians, general practitioners and dermatologists) -
Survey of Skin Disorders in Newborns: Clinical Observation in an Egyptian Medical Centre Nursery A.A
املجلة الصحية لرشق املتوسط املجلد الثامن عرش العدد اﻷول Survey of skin disorders in newborns: clinical observation in an Egyptian medical centre nursery A.A. El-Moneim 1 and R.E. El-Dawela 2 مسح لﻻضطرابات اجللدية لدى الولدان: مﻻحظة رسيرية يف حضانة يف مركز طبي يف مرص عبري أمحد عبد املنعم، رهيام عز الدولة الرشقاوي اخلﻻصة:مل َ ْت َظ اﻻضطرابات اجللدية لدى الولدان بدراسات جيدة يف مرص. وقد هدفت الباحثتان إىل دراسة أنامط التغريات اجللدية يف عينة من ِ الولدان املرصيني، وهي دراسة وصفية استباقية أترابية شملت ستة مئة وليد يف َّحضانة يف مستشفى جامعة سوهاج، َّوتضمنت الفحص اجللدي خﻻل اﻷيام اخلمسة اﻷوىل بعد الوﻻدة. وقد تم كشف اﻻضطرابات اجللدية لدى 240 ًوليدا )40%( ولوحظت الومحات لدى 100 وليد )%16.7(، ومعظمها من النمط ذي اخلﻻيا امليﻻنية )لطخات منغولية لدى 11.7% مع ومحات وﻻدية ذات ميﻻنية اخلﻻيا لدى 2.7%(. كام ُك ِش َف ْت العداوى الفطرية اجللدية، ومنها داء َّاملبيضات الفموية، وعدوى الفطريات يف مناطق احلفاظات أو َالـم َذح الناجم عن عدوى َّاملبيضات يف اﻷرفاغ )أصل الفخذ(، وذلك لدى 13.3%، ُوكشفت بعض العداوى اجلرثومية يف 1.3%من الولدان. وتشري املقارنات مع الدراسات اﻷخرى يف أرجاء العامل إىل معدل مرتفع للعدوى بالفطريات مع معدل منخفض للومحات الوﻻدية يف دراستنا للولدان، وتويص الباحثتان بإجراء تقييم روتيني جلدي للولدان، ّوﻻسيام يف ضوء املعدﻻت املرتفعة للعدوى اجللدية بالفطريات. ABSTRACT The frequency of neonatal skin disorders has not been well studied in Egypt. Our aim was to address patterns of dermatological changes in a sample of Egyptian newborns. In a descriptive prospective cohort study 600 newborns in Sohag University hospital nursery were dermatologically examined within the first 5 days of birth. -
The Birth-Mark Hawthorne, Nathaniel
The Birth-Mark Hawthorne, Nathaniel Published: 1843 Type(s): Short Fiction Source: http://gutenberg.org 1 About Hawthorne: Nathaniel Hawthorne was born on July 4, 1804, in Salem, Massachu- setts, where his birthplace is now a museum. William Hathorne, who emigrated from England in 1630, was the first of Hawthorne's ancestors to arrive in the colonies. After arriving, William persecuted Quakers. William's son John Hathorne was one of the judges who oversaw the Salem Witch Trials. (One theory is that having learned about this, the au- thor added the "w" to his surname in his early twenties, shortly after graduating from college.) Hawthorne's father, Nathaniel Hathorne, Sr., was a sea captain who died in 1808 of yellow fever, when Hawthorne was only four years old, in Raymond, Maine. Hawthorne attended Bowdoin College at the expense of an uncle from 1821 to 1824, befriending classmates Henry Wadsworth Longfellow and future president Franklin Pierce. While there he joined the Delta Kappa Epsilon fraternity. Until the publication of his Twice-Told Tales in 1837, Hawthorne wrote in the comparative obscurity of what he called his "owl's nest" in the family home. As he looked back on this period of his life, he wrote: "I have not lived, but only dreamed about living." And yet it was this period of brooding and writing that had formed, as Malcolm Cowley was to describe it, "the central fact in Hawthorne's career," his "term of apprenticeship" that would eventually result in the "richly med- itated fiction." Hawthorne was hired in 1839 as a weigher and gauger at the Boston Custom House. -
Prevalence of Non-Infectious Dermatoses in Patients Attending a Tertiary Care Center in Rajasthan
International Journal of Research in Dermatology Singh B et al. Int J Res Dermatol. 2019 Feb;5(1):192-196 http://www.ijord.com DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20190244 Original Research Article Prevalence of non-infectious dermatoses in patients attending a tertiary care center in Rajasthan 1 2 Bhagirath Singh , Indira Subhadarshini Paul * 1Department of Skin and V. D., 2Department of Paediatrics, Pacific Medical College and Hospital Udaipur, Rajasthan, India Received: 03 November 2018 Revised: 10 December 2018 Accepted: 12 December 2018 *Correspondence: Dr. Indira Subhadarshini Paul, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Pediatric dermatoses require a separate view from adult dermatoses as there are important differences in clinical presentation, treatment and prognosis. There is very little epidemiological study available on non-infectious childhood dermatoses in India. The aims of the study were to find the prevalence, clinical profile and various etiological factors associated with childhood non-infectious dermatoses and to determine the prevalence of most common non-infectious childhood dermatoses. Methods: This cross-sectional observational study conducted at tertiary care centre in Rajasthan, India. Children with age 13 years and below with clinical evidence of cutaneous disorders were studied. Parents who have not given consent for the study, acutely ill children, Children having infectious dermatoses (bacterial, fungal, viral, arthropods, parasitic and protozoal infection) were excluded from the study. -
Case Report of Giant Congenital Melanocytic Nevus
PEDIATRIC DERMATOLOGY Series Editor: Camila K. Janniger, MD Bathing Trunks Nevus: Case Report of Giant Congenital Melanocytic Nevus Ronald Russ, DO; Lisa Light, MS-IV Bathing trunks nevi, a subtype of giant congeni- 34 years. All maternal and prenatal history was unre- tal melanocytic nevi (CMN), are skin tumors that markable. Upon initial physical examination as a new- present by 2 years of age and occur in a low born (1 hour following delivery), the infant had a large percentage of all births. We report a case of (≥5% body surface area), circumferentially pigmented bathing trunks nevus that was initially suspected area from the umbilicus to mid thigh bilaterally to be melanoma, and describe the history, patho- (Figure 1). Interposed darkened lesions were pres- physiology, and treatment options for CMN. We ent, with 3 distinct, raised, lipomatous-type nodules also discuss the risk for neurocutaneous melano- (2 cm, 1.3 cm, and 3 cm in diameter from left to right) sis (NCM), which is a rare syndrome in patients over the lower lumbar spine (Figure 2). There were no with giant CMN. signs of jaundice, hemolysis, meningomyelocele, or Cutis. 2009;83:69-72. abnormal hair growth. The rest of the physical exami- nation was unremarkable, including cardiovascular, pulmonary, and abdominal systems, and genitourinary athing trunks nevus is a specific subtype of functioning was normal. Cord blood testing revealed giant congenital melanocytic nevus (CMN) A Rh-positive blood type, and a direct Coombs test B with spread resembling bathing trunks. This was negative for antibodies. Complete blood cell rare variant is clinically significant because of the count was within reference range, with the excep- increased risk for progression to melanoma and its tion of a low platelet count of 2343103/µL (reference association with neurocutaneous melanosis (NCM).1 range, 250–4503103/µL). -
Congenital Melanocytic Nevus
BCCH Pediatric Dermatology Clinic Joseph M Lam, MD CONGENITAL MELANOCYTIC NEVUS What is a congenital melanocytic nevus? A "congenital melanocytic nevus" (aka mole) is the name for a common brown birthmark which is made up of special pigment-producing cells. The size of the birthmark may range from a small 1 cm mark to a giant birthmark covering half of the body or more. How common are congenital melanocytic nevus? Small congenital pigmented moles (brown birthmarks) are seen in 1 percent of all healthy newborn babies. Giant congenital moles (larger than 8 inches) are rare, found in fewer than one in 20,000 newborn infants. Why are they special? Small- and medium-sized congenital moles may rarely develop melanoma, a worrisome form of skin cancer. However, the risk of this happening is less than 1% and in adults, the risk of developing skin cancer in any area of the skin is much higher than the risk of melanoma in a small or medium-sized congenital mole. However, depending upon the appearance of the mole, its location and the ease of removal, we may suggest that the mole be taken out or we may recommend keeping the mole and just paying attention to any changes in the mole. Rarely, mole cells can be present in the brain - this happens in patients with many ‘satellite’ moles. If this causes problems, the problems usually show up in the first few months of life. It is important to inspect congenital moles on a regular basis at home. We may also recommend that some moles be observed in the office with pictures.