Infantile psoriasis: a follow-up study

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.

Speech therapy after total laryngectomy and esophageal replacement in a preschool patient: a case study

This case study reports the development of a speech and language therapy program for a preschool boy laryngectomized at age two and three-quarters. Etiology was attributed to the accidental ingestion of lye, which caused severe burns and subsequent damage to both the larynx and esophagus. During the 20-month hospital stay, colon transplantation to the pharynx and laryngectomy were performed and a speech therapy program was initiated. The speech pathologist worked closely with the patient by stimulating his speech and language, developing his articulation skills, and finally providing him with a means of using expressive speech via an electrolarynx designed for him. In addition to the case study, this report reviews the different methods of alaryngeal speech, and suggests the need for further research in developing these methods as viable alternatives for the young laryngectomized child.

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

We report 14 infants younger than 2 years of age with psoriasis vulgaris in order to call attention to the existence of infantile psoriasis. Three of the patients were noted to have psoriasis in the neonatal period; the onset may have been prenatal in one. In 13 of the 14 patients the site of onset was determined by the isomorphic effect (Köbners phenomenon). Although nail pitting is usually said to be infrequent in childhood psoriasis, 11 (79%) of our patients had typical psoriatic nail changes. Psoriasis must be considered in the differential diagnosis of papulosquamous disorders in infants.

Recurring digital fibrous tumors of childhood: a review

Two new cases that conform to the clinical and histopathological features of recurring digital fibrous tumor of childhood, described by Reye in 1965, are reported. This tumor, which is considered a distinct entity among the juvenile fibromatoses, characteristically presents in infancy and early childhood, involves only the digits, recurs frequently following surgical excision without metastatic spread, and demonstrates the distinct histopathological finding of intracytoplasmic inclusion bodies within proliferated fibroblasts. This tumor is reviewed with reference to clinical features, histopathology, etiological considerations, and management.

Pigmented lesions in newborn infants

1058 newborn infants were examined. Forty-one (3-9%) had clinically discernible pigmented lesions compatible with melanocytic 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 pigmented 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.

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.