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Gurnani P, Monir RL, Schoch JJ. Diagnosis and Management of Common Pediatric Cutaneous Infections. Pediatr Ann 2024; 53:e138-e145. [PMID: 38574073 DOI: 10.3928/19382359-20240205-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Dermatologic concerns are common in the general pediatrician's practice. Herein, we review the most commonly encountered cutaneous bacterial, viral, and superficial fungal infections in the pediatric population. We describe clinical presentation, pathogenesis, and current treatments. The goal of this guide is to increase pediatricians' comfort in diagnosing and managing common skin infections, as well as determining when a dermatology referral may be necessary. [Pediatr Ann. 2024;53(4):e138-e145.].
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Saeidian AH, Youssefian L, Huang CY, Palizban F, Naji M, Saffarian Z, Mahmoudi H, Goodarzi A, Sotoudeh S, Vahidnezhad F, Amani M, Tavakoli N, Ajami A, Mozafarpoor S, Teimoorian M, Dorgaleleh S, Shokri S, Shenagari M, Abedi N, Zeinali S, Fortina P, Béziat V, Jouanguy E, Casanova JL, Uitto J, Vahidnezhad H. Whole-transcriptome sequencing-based concomitant detection of viral and human genetic determinants of cutaneous lesions. JCI Insight 2022; 7:156021. [PMID: 35316210 PMCID: PMC9089792 DOI: 10.1172/jci.insight.156021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Severe viral infections of the skin can occur in patients with inborn errors of immunity (IEI). We report an all-in-one whole-transcriptome sequencing–based method by RNA-Seq on a single skin biopsy for concomitantly identifying the cutaneous virome and the underlying IEI. Skin biopsies were obtained from healthy and lesional skin from patients with cutaneous infections suspected to be of viral origin. RNA-Seq was utilized as the first-tier strategy for unbiased human genome-wide rare variant detection. Reads unaligned to the human genome were utilized for the exploration of 926 viruses in a viral genome catalog. In 9 families studied, the patients carried pathogenic variants in 6 human IEI genes, including IL2RG, WAS, CIB1, STK4, GATA2, and DOCK8. Gene expression profiling also confirmed pathogenicity of the human variants and permitted genome-wide homozygosity mapping, which assisted in identification of candidate genes in consanguineous families. This automated, online, all-in-one computational pipeline, called VirPy, enables simultaneous detection of the viral triggers and the human genetic variants underlying skin lesions in patients with suspected IEI and viral dermatosis.
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Affiliation(s)
- Amir Hossein Saeidian
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson Univerrsity, Philadelphia, United States of America
| | - Leila Youssefian
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, United States of America
| | - Charles Y Huang
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College,Thomas Jefferson University, Philadelphia, United States of America
| | - Fahimeh Palizban
- Laboratory and Complex Biological Systems and Bioinformactics, University of Tehran, Tehran, Iran (Islamic Republic of)
| | - Mahtab Naji
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, United States of America
| | - Zahra Saffarian
- Imam Khomeini Hospaital, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - Hamidreza Mahmoudi
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - Azadeh Goodarzi
- Department of Dermatology, Iran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - Soheila Sotoudeh
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - Fatemeh Vahidnezhad
- UCSC Silicon Valley Extension, University of California, Santa Cruz, United States of America
| | - Maliheh Amani
- Department of Dermatology, Gonabad University of Medical Sciences, Gonabad, Iran (Islamic Republic of)
| | - Narjes Tavakoli
- Nobel Laboratory, Isfahan University of Medical Sciences, Isfahan Province, Iran (Islamic Republic of)
| | - Ali Ajami
- Nobel Laboratory, Isfahan University of Medical Sciences, Isfahan Province, Iran (Islamic Republic of)
| | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan Province, Iran (Islamic Republic of)
| | - Mehrdad Teimoorian
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran (Islamic Republic of)
| | - Saeed Dorgaleleh
- Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran (Islamic Republic of)
| | - Sima Shokri
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - Mohammad Shenagari
- Department of Microbiology, Guilan University of Medical Sciences, Rasht, Iran (Islamic Republic of)
| | - Nima Abedi
- Bioinformatics Department, University of Tehran, Tehran, Iran (Islamic Republic of)
| | - Sirous Zeinali
- Kawsar Human Genetics Research Center, Tehran, Iran (Islamic Republic of)
| | - Paolo Fortina
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, United States of America
| | - Vivien Béziat
- Human Genetics of Infectious Diseases Laboratory, Imagine Institute - INSERM U1163 (ex U980), Paris, France
| | - Emmanuelle Jouanguy
- St. Giles Laboratory of Human Genetics of Infectious Diseases, The Rockefeller University, New York, United States of America
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, The Rockfeller University, New York, United States of America
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson Univerrsity, Philadelphia, United States of America
| | - Hassan Vahidnezhad
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson Univerrsity, Philadelphia, United States of America
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Brazel M, Desai A, Are A, Motaparthi K. Staphylococcal Scalded Skin Syndrome and Bullous Impetigo. Medicina (Kaunas) 2021; 57:medicina57111157. [PMID: 34833375 PMCID: PMC8623226 DOI: 10.3390/medicina57111157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 12/21/2022]
Abstract
Staphylococcal scalded skin syndrome (SSSS) and bullous impetigo are infections caused by Staphylococcus aureus. The pathogenesis of both conditions centers around exotoxin mediated cleavage of desmoglein-1, which results in intraepidermal desquamation. Bullous impetigo is due to the local release of these toxins and thus, often presents with localized skin findings, whereas SSSS is from the systemic spread of these toxins, resulting in a more generalized rash and severe presentation. Both conditions are treated with antibiotics that target S. aureus. These conditions can sometimes be confused with other conditions that result in superficial blistering; the distinguishing features are outlined below.
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Affiliation(s)
- Morgan Brazel
- University of Florida College of Medicine, Gainesville, FL 32610, USA; (M.B.); (A.A.)
| | - Anand Desai
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL 32610, USA;
| | - Abhirup Are
- University of Florida College of Medicine, Gainesville, FL 32610, USA; (M.B.); (A.A.)
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL 32610, USA;
- Correspondence:
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