Mario Cutrone

Transient neonatal hair loss: a common transient neonatal dermatosis

For many years the aetiology of neonatal occipital alopecia (NOA) has been reported to be friction. We have made a retrospective check to see if the incidence of NOA has increased since the new paediatric tendencies of putting children back to sleep in the safest way have been used (APP guidelines). The results of this study in 301 neonates demonstrated that it has not. The aetiology of this phenomenon is the physiological shedding of hair in the first weeks of life. The pillow, which is often blamed, only aids this shedding. Parents should be informed that there is no relationship between the sleep position and the onset of this problem, to prevent them from changing the position of the sleeping child, which could lead to a fatal outcome.

The True and the False: Pixel‐Byte Syndrome

The possible use of retouched images for fraudulent purposes in scientific articles, posters, and conferences is not a future but a present possibility (probably already used) that poses serious questions as to the need for additional control mechanisms other than scientific peer quality review in evaluating and accepting articles. We propose the term “pixel‐byte syndrome” to illustrate how easy it might be to electronically create a new syndrome for fraudulent purposes. The aim of this article is to stimulate discussion among professionals, add some examples of easy‐to‐realize frauds and sow the seeds of doubt in the minds of some of the referees of journal articles and the scientific secretariat of congresses in reviewing digitally retouched images.

Orange-Brown Chromonychia and Kawasaki Disease: A Possible Novel Association?

A 4‐year‐old girl with clinical and laboratory signs of Kawasaki disease (KD) was hospitalized and given intravenous immunoglobulin plus aspirin therapy, with rapid defervescence and clinical improvement, and was discharged 48 hours after admission. At the time of her follow‐up echocardiography on day 14, orange‐brown pigmentation of the nail beds was noticed and confirmed with dermoscopy. No clear association between KD and orange‐brown chromonychia has been demonstrated, although reports and case series suggest a possible link between these two entities. We suggest that this particular finding might be encompassed in late (subacute) changes of extremities as part of KD diagnostic criteria.

Dermatological image search engines on the internet : do they work?

Backgroundu2002 Atlases on CD‐ROM first substituted the use of paediatric dermatology atlases printed on paper. This permitted a faster search and a practical comparison of differential diagnoses. The third step in the evolution of clinical atlases was the onset of the online atlas. Many doctors now use the Internet image search engines to obtain clinical images directly.

Rapid containment of nosocomial transmission of a rare community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clone, responsible for the Staphylococcal Scalded Skin Syndrome (SSSS)

BackgroundThe aims of this study were to identify the source and the transmission pathway for a Staphylococcal Scalded Skin Syndrome (SSSS) outbreak in a maternity setting in Italy over 2xa0months, during 2014; to implement appropriate control measures in order to prevent the epidemic spread within the maternity ward; and to identify the Methicillin-Resistant Staphylococcus aureus (MRSA) epidemic clone.MethodsEpidemiological and microbiological investigations, based on phenotyping and genotyping methods, were performed. All neonates involved in the outbreak underwent clinical and microbiological investigations to detect the cause of illness. Parents and healthcare workers were screened for Staphylococcus aureus to identify asymptomatic carriers.ResultsThe SSSS outbreak was due to the cross-transmission of a rare clone of ST5-CA-MRSA-SCCmecV-spa type t311, exfoliative toxin A-producer, isolated from three neonates, one mother (from her nose and from dermatological lesions due to pre-existing hand eczema) and from a nurse (colonized in her nose by this microorganism). The epidemiological and microbiological investigation confirmed these as two potential carriers.ConclusionsA rapid containment of these infections was obtained only after implementation of robust swabbing of mothers and healthcare workers. The use of molecular methodologies for typing was able to identify all carriers and to trace the transmission.

The Trichoscopic “Golf Club Set” Sign for Bullous Aplasia Cutis Congenita

Bullous aplasia cutis congenita (BACC) is a rather uncommon entity. The diagnosis can be quite tricky as the entity is not very frequent. Trichoscopy might in these cases be helpful to achieve the correct diagnosis. In this article, we describe for the first time a new sign for BACC that we believe can be useful to arrive at the correct diagnosis.

The Dermoscopic “Pluck Out Sign” for Beard Trichotillomania

Beard trichotillomania (TTM) is a rather uncommon entity. Hair is not easily plucked from the beard area, as patients need forceps or tweezers to perform their task. The diagnosis of beard TTM can be quite tricky as the location is not the most frequent one. Dermoscopy might in these cases be helpful to achieve the correct diagnosis. In this article, we describe for the first time the “pluck out sign” for beard TTM.

Unusually Large Patch-Type Noninvoluting Congenital Hemangioma of the Shoulder: A Report of Two Cases

Noninvoluting congenital hemangiomas (NICHs) are vascular tumors that are fully formed at birth and do not regress. Clinically, NICHs persist indefinitely over time. Histologically they are characterized by deep dermal lobules of small vessels with endothelial cells that do not stain with glucose transporter 1 (GLUT1). Two similar cases of unusually large, patch‐type NICHs of the shoulder in neonates were observed in the past 20 years in two pediatric dermatology units in Italy. In both cases, histopathology showed lobular collections of small vessels that did not stain with GLUT1. The clinical features of the two cases remained unchanged over a follow‐up period of 10 and 4 years, respectively. The large size and flat appearance of the lesions could be due to their early onset during embryogenesis.

Neonatal Hairy Ear Pinnae and Gestational Diabetes: Just a Coincidence?

A newborn girl of 36 weeks gestation was noted to have several anomalies, including bilateral low ear attachment with ear pinnae hypertrichosis, left preauricular pit, micrognathia, short lingual frenulum, and short neck. Pregnancy history revealed poorly controlled maternal gestational diabetes (GD). Localized hypertrichosis of the ear pinnae may represent a potential marker of GD and thereby alert physicians to suspect other potentially GD‐associated conditions such as macrosomia, asphyxia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia, hypertrophic cardiomyopathy, and congenital anomalies, particularly those involving the central nervous system.

Split Median Raphe: Case Series and Brief Literature Review

We describe three cases of split median raphe of the penis (SMR) from our hospital newborn records from 2004 to 2013. One case was associated with median raphe cyst, one with skin hypochromia, and one with a scar‐like aspect of the region of interest. SMR is thought to be the result of defective fusion of ectodermal tissue in the urethra and scrotum area or of defective growth of the perineal mesoderm around the urethra during gestation. Although SMR associated with other major penile congenital defects (epispadias, hypospadias, penile torsion, bifid scrotum, chordee) is common, isolated SMR is probably an underdiagnosed (although not rare) malformative condition. Recognizing SMR in a newborn may be of educational value to neonatologists because it leads to the search for and exclusion of the above‐mentioned pathologic conditions.