Sandy S. Milgraum

Alopecia areata, endocrine function, and autoantibodies in patients 16 years of age or younger

Forty-five children with alopecia areata were prospectively studied by means of both clinical and laboratory evaluation for evidence of endocrine diseases and autoantibodies. Twenty-four percent had an abnormality as determined by one or more thyroid function studies (thyroxine, triiodothyronine, and thyroid-stimulating hormone) and/or elevation of microsomal antibody levels. In 16%, smooth muscle antibody was present, and in 4%, parietal cell antibody was present. Routine thyroid function testing is recommended for all children with alopecia areata.

PHACE without Face? Infantile Hemangiomas of the Upper Body Region with Minimal or Absent Facial Hemangiomas and Associated Structural Malformations

Abstract:u2003 Infantile hemangiomas can be associated with congenital anomalies such as PHACE syndrome with facial hemangiomas and genitourinary and spinal anomalies in the setting of lower body hemangiomas. We describe five infants in whom segmental hemangiomas involving the upper torso and extremities with absent or small facial hemangiomas were associated with structural anomalies similar to those reported with PHACE syndrome, including three with structural arterial anomalies of the subclavian arteries, three with aortic arch anomalies (right sided or narrowed arch), two with congenital heart disease (atrial septal defect and ventricular septal defect; tetralogy of Fallot), one with a retinal scar, and one with a sternal defect (scar). Two of five had small facial hemangiomas of the lower lip, but none had large segmental hemangiomas of the face. Three of five would have met diagnostic criteria for PHACE but lacked a facial hemangioma of 5u2003cm in diameter or greater. Patients with segmental arm and thorax hemangiomas may have associated structural abnormalities with overlapping features of PHACE, suggesting that a similar syndrome can occur in this clinical setting.

Treatment of Chemical Leukoderma Using a 308-nm Excimer Laser

Chemical leukoderma, characterized by the destruction of melanocytes after chemical exposure, can be a stigmatizing skin condition. Its treatment with topical steroids, low-dose steroid pulse therapy, psoralens with exposure to solar radiation (PUVAsol), narrowband ultraviolet B (NBUVB) phototherapy, and skin grafting has demonstrated suboptimal results and inherent risks. We present a case of chemical leukoderma treated with the 308-nm excimer laser, a modality that has been effective in treating vitiligo that led to complete resolution of the lesions without apparent side effects.

Dermatologic Presentations of Orthopedic Pathologies

Dermatologic presentations of orthopedic diseases are commonly encountered in the dermatology clinic. These disorders often necessitate prompt recognition in order to properly refer for definitive treatment as well as to avoid unnecessary diagnostic procedures. As such, the presentations of these diseases as well as the treatments available deserve special attention. This review aims to identify orthopedic diseases with dermatologic presentations and discuss the diagnosis and treatment of these pathologies. In conducting this review, a comprehensive literature search was conducted. Our inquiry was limited to conditions with a unitary orthopedic etiology. By excluding syndromic dysfunctions with both orthopedic and dermatologic manifestations, we were able to create a consistent approach to the review. At the same time, such exclusions created an omission of many important disease processes that require the cooperation of orthopedists and dermatologists. In all, 19 orthopedic disorders and disorder classes with dermatologic findings were identified and carefully examined.The orthopedic pathologies identified require varying diagnostic and therapeutic approaches. While some do not warrant further work-up or referral, the disease course of certain pathologies is drastically altered by timely recognition, cautious diagnostic interrogation, and prompt referral.

Q-Switched Ruby Laser Treatment of Traumatic Tattooing Induced by Pencil Po Puncture in Children

Abstract: Traumatic tattoos induced by pencil point puncture in children may result in persistent disfigurement if left untreated. The Qswitched ruby laser effectively removes darkly colored cutaneous chromophores with minimal disruption of unaffected skin. We present a young patient with pencil point induced traumatic tattooing of the face, suffered 1 year prior to presentation, who was successfully treated with the Qswitched ruby laser with excellent cosmetic results.

Dermatologic presentations of orthopedic pathologies: a review of diagnosis and treatment.

Dermatologic presentations of orthopedic diseases are commonly encountered in the dermatology clinic. These disorders often necessitate prompt recognition in order to properly refer for definitive treatment as well as to avoid unnecessary diagnostic procedures. As such, the presentations of these diseases as well as the treatments available deserve special attention. This review aims to identify orthopedic diseases with dermatologic presentations and discuss the diagnosis and treatment of these pathologies. In conducting this review, a comprehensive literature search was conducted. Our inquiry was limited to conditions with a unitary orthopedic etiology. By excluding syndromic dysfunctions with both orthopedic and dermatologic manifestations, we were able to create a consistent approach to the review. At the same time, such exclusions created an omission of many important disease processes that require the cooperation of orthopedists and dermatologists. In all, 19 orthopedic disorders and disorder classes with dermatologic findings were identified and carefully examined. The orthopedic pathologies identified require varying diagnostic and therapeutic approaches. While some do not warrant further work-up or referral, the disease course of certain pathologies is drastically altered by timely recognition, cautious diagnostic interrogation, and prompt referral.