Alvin H. Jacobs

Pigmented lesions in newborn infants

1058 newborn infants were examined. Forty‐one (39%) had clinically discernible pigmented lesions compatible with melanocy tic naevi. Biopsy was performed on thirty‐four of the forty‐one and of these; eleven, representing 1.01% of the infants, proved to be melanocytic naevi. No giant (garment) naevi were seen in this series. Two of the eleven naevi pathologically examined showed histological changes similar to those that have been reported in some giant naevi, but the remaining nine were not only different from criteria usually assigned to giant naevi, but they also differed from the usual adult naevi, in that most were predominantly junctional. None of the melanocytic naevi in this series showed any suggestion of malignant change. In newborn infants it is often impossible clinically to distinguish naevi from other types of pigmented lesions, as only eleven out of the thirty‐four pigmen‐ted lesions were melanocytic naevi. Seven of the eleven melanocytic naevi were under 1.5 cm in diameter. No pigmented lesions were found on the palms, soles or genitalia.

Cutis marmorata telangiectatica congenita (congenital generalized phlebectasia)

Thirteen original examples of cutis marmorata telangiectatica congenita are presented and the English literature is reviewed. CMTC is a benign, distinct congenital cutaneous anomaly manifested by a reticulate vascular pattern at birth, which frequently improves with age, and may be associated with other abnormalities in at least 50% of the patients. Our data suggest that in contrast to previous reports, the sex distribution is equal, and the condition as a whole is more prevalent than previously recognized.

Infantile Psoriasis: A Follow‐up Study

Abstract: The appearance of psoriasis in infancy has been questioned by many dermatologists and pediatricians, although childhood psoriasis is a well‐recognized entity. To elicit further information on this matter, a follow‐up group of nine children who had been diagnosed initially as having infantile psoriasis was reexamined 6 to 13 years later to determine the course of the disease over time. Seven of the nine children had recurrent psoriatic lesions and two remained completely clear after the resolution of the initial eruption. The majority did not have a severe disease course; on the contrary, progression of the illness was mild for most of them. Familial aggregation was noted in almost all of the children. In fact, over the intervening years the number of relatives with psoriasis significantly increased. Most patients were not aware of the role of such factors as infections, injury, and stress in precipitating psoriasis. Participation in a self‐help workshop is recommended as a way for both parents and children to learn to cope with the clinical and psychologic aspects of the illness.

Eruptions in the Diaper Area

Emphasis is on the differential diagnosis of eruptions in the diaper area based primarily upon the morphology and location of the rash. Specific treatment based upon etiologic diagnosis is discussed.

Enterobiasis in children: Incidence, symptomatology, and diagnosis, with a simplifiedscotch cellulose tape technique

Summary 1. A new technique for the diagnosis of enterobiasis has been discussed, and the results of the use of this technique on 228 unselected clinic children have been presented. 2. Of the 228 children, 31.3 per cent were positive for pinworm eggs. 3. Of the positive patients, 41.3 per cent had repeated abdominalpains, 49.4 per cent were “nervous,” 41.4 per cent were underweight, 38.6 per cent were poor sleepers, 38.6 per cent had anorexia, 21.3 per cent had pruritus ani, and 17.3 per cent had enuresis. 4. Of the forty positive girls, 27.5 per cent had vaginal discharge. During the period of this study, fourteen girls were seen in the clinic with vaginal discharge. Eleven of them had oxyuris ova in both perianal and vulvar regions.

THE INCIDENCE OF BIRTHMARKS IN THE NEONATE

The presence of various types of birthmarks was determined in 1,058 newborn infants under 72 hours of age. Of these, 79.5% were white, 6.2% were black, 11.2% were ladinos, and 2.6% were Asiatic. Mongol spots were present in 9.6% of the white babies, 95.5% of the black babies, 81% of the Asiatic babies, and 70.1% of ladino infants. Pigmented lesions were present in 42 (4%) of the infants. Biopsies obtained in 34 (3.2%) revealed that only one-third (11) of these were melanocytic nevi. Salmon patches were present in 40.3% of the infants, recognizable early strawberry marks in 2.6%, and port-wine strains in 0.3%. In addition to birthmarks, it was determined that 30.3% of the 508 babies examined at one of the two hospitals had toxic erythema of the newborn.

Local Management of Atopic Dermatitis in Infants and Children

Successful management of the child with atopic eczema calls for careful attention to the many facets of this complex condition. The physician must evaluate psychologic, environmental and dietary factors, in addition to offering a plan for the local treatment of the skin. Forty-six children were treated by a modification of the Scholtz regime. Results were good to excellent in 85 per cent. The essentials of this treatment program consist of stopping all soap and water baths, cleansing and lubricating the skin with a nonlipid lotion, and applying fluocinolone acetonide in a nonlipid vehicle.