Objective: The objective of this study is to determine the frequency of physiologic and pathologic skin findings in the neonates admitted in the neonatal intensive care unit. Materials and Methods: A total of 60 neonates with cutaneous lesions, hospitalized in the NICU of Subharti Medical College, Meerut from November 2011 to August 2012, were examined. All physiological as well as pathological skin changes were observed and recorded. Mother's gestational history as well as relevant family history was taken. Results: The most common 10 diagnoses were: Lanugo hair (78.33%), miniature puberty (70%), sebaceous hyperplasia (68.33%), iatrogenic bruises (48.33%), physiological desquamation (48.33%), Mongolian spot (45%), salmon patch (31.67%), seborrheic dermatitis (28.33%), miliaria (28.33%) and erythema toxicum neonatorum (23.33%). One case each of natal teeth, suckling blister, preauricular skin tag and micrognathia were also found. Conclusion: The pattern of dermatoses as well as their correlation with various birth and maternal factors was studied. Data was analyzed and the same is being presented.

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Background: Reports from different parts of the world have revealed wide variation in the prevalence of various skin disorders. Variations exist with respect to age, sex, dwelling and socio-economic status. Prevalence studies of skin disorders in children and adolescents are meager. Aim: The aim of the present study was to determine the prevalence of various skin disorders in school going children of Kashmir valley of North India. Materials and Methods: This cross-sectional study was designed to find the prevalence of skin disorders in the age group of 6-19 years. Kashmir valley of North India was stratified into North, Central and South Kashmir and among them one district was selected. Educational institutions were stratified as per levels of education, i.e. primary, middle, secondary, higher secondary and college. Each strata was sub-grouped sex-wise. From each educational institution, 10% of students were selected through the systematic random sampling. A specially designed questionnaire was framed and information regarding any of dermatological ailments was noted. A total of 5000 students were examined and prevalence of all types of skin disorders was noted. Results: Eczemas formed the largest group followed by acne vulgaris. In the eczema group, pityriasis alba was most frequent type followed by hand eczema, irritant and allergic contact dermatitis taken together. Individually, acne vulgaris was the most prevalent skin disorder in the study group. Conclusion: The study found that skin disorders were more common in males than females, in urban than in rural dwellers, in students from government schools than private schools and in students belonging to the low socioeconomic group.

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We report a term, small for gestational age, female neonate presenting at birth with generalized reddish blue papulonodular lesions, thrombocytopenia, hepatosplenomegaly, cataract, sensorineural hearing loss, patent ductus arteriosus and subependymal cyst. A diagnosis of blueberry muffin rash in a child with congenital rubella syndrome was made based on the clinical and laboratory findings. The rash disappeared by 2 weeks of life.

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The aim is to report a case of fatal hemophagocytic syndrome (HS) which developed in a patients with sepsis and Stevens-Johnson syndrome (SJS). A 12-year-old girl with chronic renal failure was admitted for catheter site infection related sepsis. Patient was treated with meropenem, vancomycin and sodium valproate. After this, she developed purpuric skin lesions and mucosal erosions consistent with SJS. Further investigations were performed due to rapid clinical deterioration, hepatosplenomegaly and resistant pancytopenia. We found elevated serum triglyceride and serum ferritin and evidence of hemophagocytosis in bone marrow aspirate. She was diagnosed as sepsis related HS with coexistent SJS and started on injection methylprednisolone. Despite treatment, she expired on the eighth day of admission. HS or hemophagocytic lymphohistiocytosis comprises a heterogeneous group of primary and secondary disorders characterized by the proliferation of activated macrophages, associated with generalized hemophagocytosis. The fact that HS is being reported with an ever-increasing list of dermatological and rheumatological diseases should make us vigilant to this immunological complication. Treatment of the precipitating events and timely administration of immunosuppressive drugs could be life-saving in this situation.

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Erythroderma in neonates is a rare but a well established life threatening entity. Though it has been studied extensively in adults, the literature is lacking in the paediatric age group. The underlying etiological causes of neonatal erythroderma are pre-existing cutaneous diseases, infections, immunodeficiency disorders, metabolic and nutritional disorders and drugs. It is a challenge to diagnose the underlying etiology of neonatal erythroderma due to the rare specific presentation of the characteristic clinical signs and histopathological changes. In this review we discuss the incidence, etiology, specific points in history and examination which can be useful at arriving at the diagnosis and outline of management.

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Henoch-Schonlein purpura (HSP) is an Immunoglobulin A mediated vasculitis and mainly affects skin, joints, gastrointestinal tract and kidneys. Skin lesions usually present as erythematous maculopapular, petechiae and purpura and often involve lower extremities and buttocks. Dermatological complications are rarely seen in HSP. Herein, we described a 4-year-old girl with typical skin lesions of HSP and hemorrhagic bullous lesions in her thighs.

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Klippel-Trenaunay syndrome and neurofibroma type I (NF1) are rare disorders with cutaneous and neurological features and not reported to be associated together. We report an 11-year-old female child who presented with extensive skin lesions, giant hemangioma and left lower limb hypertrophy. Her father had features of NF1. We report this case because of its rarity and need for long-term follow-up.

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Job syndrome (JS) is a rare primary immunodeficiency disorder characterized by the triad of raised serum immunoglobulin E levels, recurrent skin and pulmonary infections. A 6-year-old boy presented with the characteristic triad of JS and left leg swelling, which on evaluation was found to be tuberculous osteomyelitis. JS being an immunocompromised state can predispose to tuberculous infections and one has to be vigilant enough for early diagnosis and treatment to prevent deformity.

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LEOPARD syndrome is a rare congenital disorder characterized by the constellation of skin, facial and cardiac abnormalities. Most cases with this diagnosis have only a few of the features described and patients with full clinical spectrum are very rare. We report a case of 15-year-old rural school going teenage girl born to non-consanguineous parents with lentigines, cardiac abnormality (mild mitral regurgitation with ischemic heart disease), hypertelorism, kyphoscoliosis and presentation of exudative eosinophilic pleural effusion.

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Sturge-Weber syndrome (SWS), also known as encephalotrigeminal angiomatosis, is a rare vascular neurocutaneous alteration. It is characterized by facial nevus - usually unilateral, seizures, hemiparesis, intracranial calcification, mental retardation and ocular involvement. Nevertheless each case of SWS is unique and exhibits the characteristic features to a varying degree. We report here a case of SWS who presented with features suggestive of this syndrome, and having bilateral facial nevus as well.

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The purpose of the following study is to convey the range of current understanding in relation to atopic dermatitis (AD) and tacrolimus. A brief structured description is given starting with introducing the subject and continuing with the discussion of the etiology of AD, a comparative evaluation of the diagnostic criteria, presents management algorithm, structure, pharmacodynamics and pharmacokinetics of topical calcineurin inhibitors (TCI) and the comparative efficacy and safety of available TCIs. Etiological hypothesis is still evolving. Until date, no single universally applicable diagnostic Criteria or scoring system exists. Diagnostic Criteria and scoring system are to adopt according the design and population of any study. TCIs provide a safe alternate to the present topical steroid dependent system of management of AD. This is not a systemic review or meta-analysis. The studies cited were not compared statistically. Beneficial to practitioners of pediatric dermatology to get an idea about the range of current understandings.

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