Chromosome 22q11.2 deletion syndrome associated with severe eczema

A Patient with 22q11.2 Deletion Syndrome Presenting with Systemic Skin Rash and Dermatopathic Lymphadenitis of Unusual Histology

Patient: Male, newborn

Final Diagnosis: 22q11.2 deletion syndrome

Symptoms: Congenital heart disease • eczema

Medication:—

Clinical Procedure: —

Specialty: Immunology • Pathology • Pediatrics and Neonatology

Guidance for assessment of erythroderma in neonates and infants for the pediatric immunologist

Neonatal and infantile erythroderma (NIE) represents the common clinical phenotype of heterogeneous diseases ranging from benign and transient skin conditions to fatal multiorgan disorders. NIE regularly demands a comprehensive diagnostic workup in a multiprofessional setting, especially if newborns and young infants with the disease develop a failure to thrive and concomitant infectious, neurologic, or metabolic complications. By obtaining a detailed medical history and performing a thorough clinical examination, targeted diagnostic steps can be scheduled for most affected children. If NIE occurs in the early neonatal period, lesional skin biopsy and histology are often indicated. Likewise, if monogenic skin or immunologic diseases are suspected, genetic testing with customized panels of potentially underlying genes is mandatory. Of note, if acute symptoms such as severe infections, metabolic acidosis, or seizures occur, rapid microbiologic and metabolic investigations are warranted to rule out immunodeficiency and inborn errors of metabolism.

Psoriasis first presenting around an enteral feeding tube in three pediatric patients: an important consideration for timely diagnosis and management

Pediatric dermatologists may care for patients with percutaneous enteral feeding tubes. Although ostomy complications such as allergic contact and irritant dermatitis are common, psoriasis may be misdiagnosed. We report three novel cases of childhood psoriasis first presenting around an enteral feeding tube site. Localized psoriasis is an important clinical consideration in children with ostomy site eruptions to ensure timely diagnosis and effective management.