Susan M. Sweeney

Diaper Dye Dermatitis

Diaper dermatitis is a common problem in outpatient pediatric office settings. Although most diaper rashes represent a form of contact dermatitis in response to irritants in the diaper environment, other rashes may be the result of an allergen in the diaper. On the basis of clinical examination results for 5 patients and patch testing results for 2 patients, we suspect that the patients demonstrated allergic contact dermatitis in response to the various blue, pink, and green dyes in diapers. Although topically administered corticosteroids are useful in the treatment regimen, the preferred treatment for allergic contact dermatitis in the diaper area is the use of dye-free diapers for allergen avoidance. Patch testing may also be valuable in identifying the allergen, because allergen avoidance is the key to prevention of recurrent disease.

Guiding climate change adaptation within vulnerable natural resource management systems.

Climate change has the potential to compromise the sustainability of natural resources in Mediterranean climatic systems, such that short-term reactive responses will increasingly be insufficient to ensure effective management. There is a simultaneous need for both the clear articulation of the vulnerabilities of specific management systems to climate risk, and the development of appropriate short- and long-term strategic planning responses that anticipate environmental change or allow for sustainable adaptive management in response to trends in resource condition. Governments are developing climate change adaptation policy frameworks, but without the recognition of the importance of responding strategically, regional stakeholders will struggle to manage future climate risk. In a partnership between the South Australian Government, the Adelaide and Mt Lofty Ranges Natural Resource Management Board and the regional community, a range of available research approaches to support regional climate change adaptation decision-making, were applied and critically examined, including: scenario modelling; applied and participatory Geographical Information Systems modelling; environmental risk analysis; and participatory action learning. As managers apply ideas for adaptation within their own biophysical and socio-cultural contexts, there would be both successes and failures, but a learning orientation to societal change will enable improvements over time. A base-line target for regional responses to climate change is the ownership of the issue by stakeholders, which leads to an acceptance that effective actions to adapt are now both possible and vitally important. Beyond such baseline knowledge, the research suggests that there is a range of tools from the social and physical sciences available to guide adaptation decision-making.

Tattoos : a review of tattoo practices and potential treatment options for removal

Purpose of review The purpose of this review is to present an overview of tattoo practices, complications and treatment options relevant to the pediatric population. Recent findings Tattoos are popular among adolescents for a variety of reasons and may be associated with other high-risk behaviors. Research indicates that adolescents may not comprehend potential health risks and complications that are related to tattooing. Case reports of infection, tattoo-associated dermatoses, and allergic reactions to tattoos continue to be reported in the literature. Additional cases of allergic contact dermatitis are being reported with temporary henna tattooing and cosmetic tattoos. As the desire for tattoo removal increases, researchers continue to explore safe, innovative and efficacious methods of tattoo removal. Summary As the popularity of tattooing continues to rise, so do the potential complications and adverse effects. Treatment options for tattoos are well described and must be individualized to each patient. Lasers continue to be a reliable and efficacious tool in treating amateur, professional, cosmetic and traumatic tattoos.

Lumps and bumps in neonates and infants

ABSTRACT:  There are many developmental abnormalities that may appear in the neonate and in infants when critical steps in embryogenesis fail. These steps are often not fatal but can lead to signifi‐cant morbidity for those patients affected. A logical approach is needed in addressing both the diagnostic and therapeutic issues that arise when caring for these patients, as various lesions will warrant an observational approach, and others may require imaging studies or definitive surgical intervention. Additionally, there are other “lumps and bumps” that are seen in the neonatal and infantile age groups that include malignancies and cutaneous neoplasms with associated systemic sequelae.

The Elegant Ellipse—Running Subcuticular Closures

The perfect, aesthetic scar is a fine, minimally visible line that blends into the natural skin lines without affecting function or form. Over the past 3 years, we have almost uniformly adopted a technique of repair for defects on the trunk, arms, and legs that minimizes scar widening, eliminates track marks, and has improved our aesthetic results and patient satisfaction. After buried vertical mattress sutures, running subcuticular 4–0 or 5–0 poliglecaprone (Monocryl, Ethicon, Inc., Somerville, NJ) is used to complete the closure and left in place.

Columellar Advancement Flap for Midline Nasal Defects

Dermatologic surgeons frequently encounter nasal tip defects after Mohs micrographic surgery. Correction of these defects presents a unique challenge. Slight flaws in design or technique may induce functional and aesthetic penalty. We present the columellar advancement flap, a novel repair option for nasal tip defects. When used appropriately, this technique results in concealed incision lines, preserved nasal symmetry, and optimal color and texture match. Additional advantages include reduction of ‘‘columellar sag’’ and increase of the nasolabial angle, resulting in more aesthetically pleasing nasal appearance.