Facial changes in the mature patient
During the aging process, the appearance of the human face changes significantly due to fundamental alterations in the bones, soft tissues, and skin. Both endogenous and environmental factors are involved in age-related transformations of the face; however, facial skin is particularly influenced by environmental factors, and the risk of overexposure and consequent premature facial aging. This review summarizes the current state of knowledge of the most common facial skin changes in the mature patient, including pathogenesis of both intrinsic and extrinsic skin aging, as well as clinical and histologic features of skin agin...
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Zrinka Bukvi ć Mokos, Danijela Ćurković, Krešimir Kostović, Romana Čeović Source Type: research

Hair and nail diseases in the mature patient
The elderly population is growing, lifespans are increasing, and a greater emphasis on geriatric care is being implemented in hospital systems. With a higher percentage of the population living longer, hair and nail diseases associated with the advanced stages of life are becoming more prevalent. Common hair diseases in the elderly include androgenetic alopecia, senile alopecia, frontal fibrosing alopecia, and erosive pustular dermatosis of the scalp. Nail diseases associated with advanced age include onychomycosis, brittle nails, onychocryptosis, onychoclavus, onychogryphosis, subungual hematomas, subungual exostosis, myx...
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Austin John Maddy, Antonella Tosti Source Type: research

Epidemiology of skin cancer in the mature patient
Epidermal cancers include keratinocyte cancer, melanocyte cancer, and Merkel cell carcinoma. These cancers account for the vast majority of new cancers diagnosed in Australia, North America, and Europe. Keratinocyte cancer is the most common epidermal cancer and accounts for 7 out of 8 new cancers diagnosed in Australia. Melanoma and Merkel cell carcinoma are less common than keratinocyte carcinoma but are more important causes of mortality in Australia. Keratinocyte cancer has also been demonstrated to be a marker of cancer-prone phenotype. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Vivien Lai, William Cranwell, Rodney Sinclair Source Type: research

Nonsurgical treatment of nonmelanoma skin cancer in the mature patient
Nonmelanoma skin cancer (NMSC) is the most common cancer, with the median age at NMSC diagnosis is 71 years. Treatment options for NMSC include surgical therapy, which is usually the first-choice treatment, and nonsurgical modalities. Therapeutic modalities depend on tumor localization, histologic type, and biologic behavior, as well as patient comorbidities, age, and life expectancy. Nonsurgical treatments include cryotherapy, local therapies (imiquimod, 5-fluorouracil, ingenol mebutate, and diclofenac), photodynamic therapy, radiotherapy, and hedgehog inhibitors. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Romana Čeović, Mikela Petković, Zrinka Bukvić Mokos, Krešimir Kostović Source Type: research

Cutaneous infections in the mature patient
Dermatologists must be familiar with the peculiarities of the micro-organisms that may affect the elderly, in order to optimize the diagnosis and treatment of infections, which may affect their skin, especially because the world population is rapidly aging. It is estimated that there will be 434 million individuals over 80 years of age in 2050.Since the elderly population is rapidly increasing and their infections are usually more severe and different from those observed in younger adults, it leads to a statistical increase of the rates regarding hospitalization and mortality caused by infectious diseases among people over...
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Maria Cristina Ribeiro de Castro, Marcia Ramos-e-Silva Source Type: research

Genital diseases in the mature man
Elderly men are at higher risk of developing genital dermatologic problems, including inflammatory and neoplastic conditions due to age-related physiologic changes, immunosenescence, comorbidities, and iatrogenesis. Clinical manifestations of genital dermatoses in men are varied and may include itching, pain, redness, dermatitis, lumps, and ulcers. Even when asymptomatic, the psychologic impact may be significant. Sexual or urinary dysfunction may complicate genital dermatoses. Early and accurate diagnosis is essential to reduce morbidity and mortality from premalignant and malignant conditions and also to prevent sexual d...
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Richard E. Watchorn, Christopher B. Bunker Source Type: research

Genital diseases in the mature woman
Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Natalie Matthews, Vivian Wong, Joe Brooks, George Kroumpouzos Source Type: research

Psoriasis in the mature patient: Therapeutic approach in the era of biologics
Management of psoriasis in elderly patients may be challenging due to a small number of studies investigating this specific population. When treating a mature patient, special consideration should be given to multiple comorbidities, progressive functional impairment of several organs, immunosenescence, possible adverse effects, and polypharmacy. Due to the chronic nature of the disease and continuing rise in life expectancy, the prevalence of psoriasis among elderly is also expected to rise. Because many different therapies are available for treatment of psoriasis, we have reviewed those that have been investigated in the ...
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Kre šimir Kostović, Kristina Žužul, Romana Čeović, Zrinka Bukvić Mokos Source Type: research

Blistering diseases in the mature patient
Autoimmune blistering diseases (AIBD) are a group of chronic diseases affecting the skin and mucous membranes, with different presentation, clinical course, histologic and immunopathologic findings, and different therapeutic approach. Blisters develop as a result of autoantibodies directed against distinct adhesion structures within desmosomes or within the basement membrane zone. The most common AIBD that develops in the elderly is bullous pemphigoid (previously also named “pemphigoid senilis”), but mature patients can also present with other AIBD as mucous membrane pemphigoid, epidermolysis bullosa acquisita,...
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Ines Lako š Jukić, Sandra Jerković Gulin, Branka Marinović Source Type: research

Vascular diseases in the mature patient
Aging results in both anatomic and physiologic changes in the skin ’s structure and vascular system. These vascular changes result in a wide array of dermatologic findings, ranging from the benign to the highly morbid. Herein, we review the impact of both intrinsic and common extrinsic factors of aging on cutaneous vasculature and highlight the manifestations of microvascular, venous, arterial, lymphatic, and neuropathic alterations in the geriatric population. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Laura Buford, Rebecca Kaiser, Vesna Petronic-Rosic Source Type: research

Drug eruptions in the mature patient
The world ’s population is now ageing at an unprecedented rate. Declining fertility and improved health and longevity have generated rising numbers and proportions of the older population in most parts of the world. With advancing age, however, comes an increasing incidence of disease (comorbidity or multim orbidity), an increasing use of medications (polypharmacy), and consequently an increase in adverse drug reactions (ADRs). Age-related changes in pharmacodynamics and pharmacokinetics (eg, volumes of drug distribution, metabolism and clearance, altered drug responsiveness and toxicity) and greater v ulnerability t...
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Ronni Wolf, Branka Marinovi ć Source Type: research

Chronic immunosuppression in the mature patient
In the ever-aging population of the world, the field of geriatrics continues to grow in importance. As human beings age, the skin undergoes a unique array of changes that predispose it to a specific set of dermatoses, infections, and neoplasms. Some of these physiologic alterations are comparable to the changes that happen in immunosuppressed individuals. Given the importance of immunosuppressive medications in treatment of many common skin conditions, we have reviewed the current literature to assist the practicing clinician in using immunosuppressive medications in the geriatric population. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Artem M. Sergeyenko, David J. Rosenfeld, Maria M. Tsoukas Source Type: research

Signs of physical abuse and neglect in the mature patient
Neglect and physical abuse of elderly are worrisome health problems, which are expected to grow even further, considering the aging of the population. By 2060, the number of people aged above 65 years is expected to double, whereas birth rates are low. This trend will cause a significant imbalance between different age groups and put more senior adults at risk for abuse. Risk factors, associated with abuse and neglect, are well established and can be categorized in sociodemographic-, victim-, or perpetrator-related risk factors. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Karlijn Clarysse, Coleen Kivlahan, Ingo Beyer, Jan Gutermuth Source Type: research

Retraction notice to “Bullous pemphigoid: Associations and management guidelines: Facts and controversies” [Clin. Dermatol. 31(2013) 400-412]
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Authors: Eleonora Ruocco, Ronni Wolf, Stefano Caccavale, Gabriella Brancaccio, Vincenzo Ruocco, Ada Lo Schiavo Tags: Erratum Source Type: research

Editorial Board
(Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Source Type: research

Table of Contents
(Source: Clinics in Dermatology)
Source: Clinics in Dermatology - March 1, 2018 Category: Dermatology Source Type: research

A potpourri of dermatologic writings
The concept of psoriasis as a systemic disease might be considered an innovation of the 21st century, although more than 100 years ago, L. Duncan Bulkley (1845-1928), a New York dermatologist, alluded to the systemic nature of psoriasis.1 Louis A Duhring (1845-1913), pathfinder for American dermatology, titled his partially completed encyclopedia of skin disease Cutaneous Medicine,2 indicating that many skin diseases are more than “skin deep” in their manifestations. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Lawrence Charles Parish Tags: Book Review Source Type: research

Important considerations for legislation banning commercial tanning beds among minors
Madigan et al1 discuss the markedly increased risk of melanoma and nonmelanoma skin cancers associated with ultraviolet (UV) exposure at a young age. They advocate recent legislation that bans minors ( (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Daniel J. Lewis, Madeleine Duvic Tags: Letter to the editor Source Type: research

Skin and the metabolic syndrome
The metabolic syndrome (MetS), also termed syndrome X, the deadly quartet, and insulin resistance syndrome, has been of interest for many years; however, there has been a striking increase in the prevalence of MetS over the last few decades, coinciding with the global epidemic of obesity and diabetes mellitus.1,2 MetS is a constellation of several clinical and laboratory findings that have been reported to be associated with numerous medical and dermatologic conditions, such as psoriasis, hidradenitis suppurativa, and acne vulgaris; moreover, the severity of psoriasis is significantly associated with MetS at higher psorias...
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Ayse Serap Karadag, Michael Joseph Lavery Tags: Commentary Source Type: research

Historical perspectives of the metabolic syndrome
The metabolic syndrome (MetS) or insulin resistance syndrome is a constellation of obesity-related metabolic derangements predisposing to type 2 diabetes and cardiovascular disease. In 1998, WHO defined the first criteria of MetS. Three years later, the user-friendly National Cholesterol Education Program criteria of MetS were proposed. Different criteria were issued by the International Diabetes Federation in 2005, making abdominal obesity a necessary component. Several international societies, including The International Diabetes Federation, jointly adopted the revised National Cholesterol Education Program criteria as h...
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Eiji Oda Source Type: research

Genetics and the metabolic syndrome
Originally coined as “syndrome X” in 1988 by Gerald Reaven (1928), the metabolic syndrome (MetS) encompasses a constellation of risk factors, the coincidence of which amounts to an increased cardiovascular and diabetic risk. Rising numbers of dermatoses are being recognized as cutaneous markers of MetS. Dermatologis ts should look beyond treating the cutaneous condition and quantify the associated increase in cardiovascular risk. The original dermatosis associated with obesity was acanthosis nigricans—described in 1889 by Paul Gerson Unna (1850-1929) and Sigmund Pollitzer (1859-1937). (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Emma Fanning, Donal O ’Shea Source Type: research

Pathophysiology of the metabolic syndrome
The metabolic syndrome —otherwise called syndrome X, insulin resistance syndrome, Reaven syndrome, and “the deadly quartet”—is the name given to the aggregate of clinical conditions comprising central and abdominal obesity, systemic hypertension, insulin resistance (or type 2 diabetes mellitus), and atherogenic dy slipidemia. It is a prothrombotic and proinflammatory state characterized by increased inflammatory cytokine activity. In addition to inflammatory dermatoses such as psoriasis, lichen planus, and hidradenitis suppurativa, metabolic syndrome is also commonly associated with accelerated athe...
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Emma McCracken, Monica Monaghan, Shiva Sreenivasan Source Type: research

Psoriasis and the metabolic syndrome
Chronic plaque psoriasis is an immune-mediated inflammatory skin disease that is strongly associated with the clinical features of the metabolic syndrome (MetS), including abdominal obesity, hypertension, atherogenic dyslipidemia, type 2 diabetes, insulin resistance, and nonalcoholic fatty liver disease. The strength of these associations has been repeatedly confirmed by several observational studies. In particular, the prevalence of MetS in patients with psoriasis ranges from 20% to 50%, with a risk of having MetS is at least double in psoriatic patients compared with nonpsoriatic control individuals. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Paolo Gisondi, Anna Chiara Fostini, Irene Foss à, Giampiero Girolomoni, Giovanni Targher Source Type: research

Acne vulgaris: The metabolic syndrome of the pilosebaceous follicle
Acne vulgaris is an epidemic inflammatory disease of the human sebaceous follicle and represents the most common skin disease affecting about 85% of adolescents in Westernized populations. Acne vulgaris is primarily a disease of wealthy countries and exhibits higher prevalence rates in developed compared with developing countries. No acne has been found in non-Westernized populations still living under Paleolithic dietary conditions constraining hyperglycemic carbohydrates, milk, and dairy products. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Bodo C. Melnik Source Type: research

Hidradenitis suppurativa and the metabolic syndrome
The association of the metabolic syndrome (MetS) and its components with immune-mediated chronic inflammatory disorders has attracted much interest within the last two decades. In addition to the well-established association of psoriasis with MetS, recent data point to an association between MetS and hidradenitis suppurativa, as well. The association of hidradenitis suppurativa with MetS and its components, such as diabetes, obesity, and dyslipidemia, has been consistently identified in controlled studies. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Tulin Ergun Source Type: research

Acanthosis nigricans and the metabolic syndrome
Acanthosis nigricans (AN) describes clinically a darkly pigmented thickening skin, which produces epidermal and dermal hyperplasia with orthokeratotic hyperkeratosis and papillomatosis of the stratum spinosum with basal layer hyperpigmentation, in the absence of actual acanthosis and melanocytosis on histologic examination. It is a reactive cutaneous change closely associated with obesity, insulin resistance, and hyperinsulinemia; endocrinopathy; or malignancy, in particular gastrointestinal adenocarcinoma. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Ayse Serap Karada ğ, Yi You, Retno Danarti, Safaa Al-Khuzaei, WenChieh Chen Source Type: research

Alopecia and the metabolic syndrome
Hair loss is a common condition that affects most people at some point in their lives. It can exist as an isolated problem or with other diseases and conditions. Androgenetic alopecia (AGA) and its association with the metabolic syndrome (MetS) have received increasing interest since 1972, when the first link between cardiovascular risk factors and hair loss was raised. We have reviewed studies concerning the relationship between alopecia and MetS. Many studies have investigated the relationship among AGA and MetS and its individual components, particularly in men, where a disproportionately large number of these studies s...
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Cheryl Lie, Choon Fong Liew, Hazel H. Oon Source Type: research

Atopic dermatitis and the metabolic syndrome
Atopic dermatitis is a common chronic inflammatory skin disease affecting about 10% to 20% of the general population. Disturbances in lipid metabolism contribute to defective lipid lamellae of the stratum corneum. The relationship of the metabolic syndrome and atopic dermatitis, on the contrary, remains unclear, because there are contradictory results from various trials. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Uwe Wollina Source Type: research

Autoimmune skin diseases and the metabolic syndrome
The metabolic syndrome represents an important association of cutaneous maladies with cardiovascular illnesses. Chronic inflammation, shared risk factors (ie, smoking and alcohol consumption), treatment (ie, immunosuppressive agents and drugs that alter the lipid profile), and shared genetic risk loci have been proposed to the cause metabolic syndrome and cardiovascular morbidity of autoimmune diseases. There are many possible inflammatory mediators that are suggested to play a role in insulin resistance pathogenesis, such as tumor necrosis factor- α, interleukin-6, leptin, and adiponectin. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Beg üm Ünlü, Ümit Türsen Source Type: research

Gynecologic and andrologic dermatology and the metabolic syndrome
The relationship of sex hormones to obesity and inflammation has been extensively studied. Research on endogenous and exogenous sex steroids, including studies on animal models of metabolic syndrome (MetS), has indicated that sex hormones are involved in metabolic pathways relevant to MetS. Lower testosterone levels in men and higher levels in women increase risks of MetS and type 2 diabetes mellitus (T2DM). Lower levels of sex hormone –binding globulin increase risks of MetS and T2DM in both sexes. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Maria Magdalena Roth, Nicholas Leader, George Kroumpouzos Source Type: research

Cutaneous manifestations of obesity and themetabolic syndrome
The cutaneous manifestations of obesity and the associated metabolic syndrome (MetS) may present with a wide variety of cutaneous findings, including acanthosis nigricans, acrochordon, cellulitis, psoriasis, hidradenitis suppurativa, acne, and hirsutism. Being aware of such clinical signs and the underlying systemic disorders may facilitate earlier diagnoses, thereby permitting earlier of therapy initiation and prevention of long-term sequelae. In this process, dermatologists are key figures in the early detection of MetS and its clinical manifestations. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Tu ğba Kevser Uzuncakmak, Necmettin Akdeniz, Ayse Serap Karadag Source Type: research

Cutaneous manifestations of diabetes mellitus and the metabolic syndrome
Metabolic diseases are commonly encountered in the Western world. Cutaneous manifestations are common in metabolic disorders, such as diabetes mellitus (DM) and the metabolic syndrome (MetS), and metabolic diseases may manifest with specific skin findings. MetS and DM share a common mechanism in their etiopathogenesis. As a result, the skin findings associated with these two diseases partially overlap. Several skin findings in DM and MetS may be the first clinical features of the disease, and early diagnosis facilitates treatment, thereby helping in preventing long-term complications. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Ayse Serap Karadag, Emin Ozlu, Michael Joseph Lavery Source Type: research

Miscellaneous skin disease and the metabolic syndrome
The link between the metabolic syndrome (MetS) and skin diseases is increasingly important, with new associations being discovered. The association between MetS and psoriasis or MetS and hidradenitis suppurativa is well known, although the relationship between MetS and various autoimmune or inflammatory diseases has only recently attracted interest. Some inflammatory skin diseases, such as vitiligo, scleredema, recurrent aphthous stomatitis, Beh çet disease, rosacea, necrobiosis lipoidica, granuloma annulare, skin tags, knuckle pads, and eruptive xanthomas, have possible associations with MetS. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - December 12, 2017 Category: Dermatology Authors: Sila Seremet, Mehmet Salih Gurel Source Type: research

Alliances: fair or lethal
Alliances are necessary for the development of individuals, institutions, and civilizations. Optimally, alliances provide benefits to their components; nevertheless, gains are not always symmetrical. Some alliances may prove detrimental or even lethal to some or all of the allies. I analyze some types of covenants using examples of history to provide a framework for drawing salient features of the alliance between the legal and the medical professions. This joint effort should be inherently beneficial to both; yet, particularly in the United States, the equilibrium is skewed against the medical profession. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Mauricio Goihman-Yahr Tags: Clio DermatologicaEdited by Mauricio Goihman-Yahr, MD, PhD Source Type: research

Clinical and prognostic factors in the development of basal cell carcinoma
We investigated the environmental and personal risk factors associated with the development of basal cell carcinoma (BCC). This retrospective cohort study included a total of 997 patients whose diagnosis was confirmed by histopathologic examination between 2007 and 2014. A control examination was performed in 363 of these patients, who were accessed via telephone. A total of 1151 tumors were detected in 997 patients. During their follow-up, 13% of them developed subsequent tumors. The risk of developing subsequent tumor was 2.7-fold higher in patients with multiple BCCs at the time of diagnosis than those with single BCC. ...
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Sevil Savas, Asl ı V. Turgut Erdemir, Ayse E. Koku Aksu, Mehmet S. Gurel, Ezgi Ozkur Tags: Investigative Rounds Source Type: research

Predatory journals and dishonesty in science
Predatory magazines are created by unreliable publishers who, after collecting a fee, publish the submitted paper in the Open Access (OA) formula without providing substantive control. For the purpose of “encouraging” authors to submit their work, they often impersonate existing periodicals by using a similar-sounding title, a similar webpage, and copied names of editors of the editorial board. They also offer credits close in name to the Impact Factor. The purpose of such activity is to deceive authors and to earn money in an unfair manner. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Andrzej Grzybowski, Rafa ł Patryn, Jarosław Sak Tags: Clio Dermatologica Source Type: research

Editorial Comment
The paper by Grzybowski, Patryn, and Sak1 covers subjects of importance and of actuality. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Mauricio Goihman-Yahr Source Type: research

Approach to the total body skin examination in adults and children: Kids are not just little people
The indications, evidence for, and approach to performing a total body skin examination differs for adult versus pediatric patients. To provide optimal care to all of our patients, dermatologists should recognize these differences and feel comfortable and competent in performing a total body skin examination in patients of all ages. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Caroline LaRosa, Hanspaul Makkar, Jane M. Grant-Kels Source Type: research

Cutaneous sign of abuse: Kids are not just little people
Skin injury is the most common form of child physical abuse. Although the pattern and visual appearance of skin injury and the treatment needed for the injury is similar in children and adults, characteristics of infant and childhood skin may complicate the diagnosis of injury. A good understanding of normal developmental presentation of accidental injury from infancy to adulthood, locations for injury that should trigger consideration of abuse, and cutaneous mimics of abuse across the lifespan are critical to the identification of suspected abuse. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Sphoorthi Jinna, Nina Livingston, Rebecca Moles Source Type: research

Malignant skin tumors: Kids are not just little people
Skin tumors are a clinically heterogeneous group of dermatologic conditions that affect both children and adults. Although similar types of skin tumors can affect both children and adults, the epidemiology, pathogenesis, and treatment of these skin neoplasms can vary drastically in children compared with adults. Despite the clear need for literature elucidating the differences of skin tumors in children compared with adults, there is a serious dearth of scientific contributions addressing this area. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Reid A. Waldman, Jane M. Grant-Kels Source Type: research

Vasculitis: Kids are not just little people
Cutaneous vasculitis, inflammatory destruction of blood vessels, can present with a wide range of clinical and pathologic findings across a number of heterogeneous conditions. Although some vasculitides are present in both children and adults, some important differences exist in clinical presentation, etiology, management, and prognosis in childhood vasculitis versus adult vasculitis.Cutaneous vasculitis is rare in children, and most childhood vasculitides, of which Henoch-Sch önlein purpura is the most common, histologically are small vessel leukocytoclastic vasculitis. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Nikita Lakdawala, Flavia Fedeles Source Type: research

Neutrophilic dermatoses: Kids are not just little people
Neutrophilic dermatoses are a group of inflammatory skin disorders characterized by an overactive innate immune system with dysregulation of neutrophils without underlying infectious etiology. The major representative conditions discussed are Sweet syndrome; pyoderma gangrenosum; neutrophilic eccrine hidradenitis; palmoplantar eccrine hidradenitis; subcorneal pustular dermatoses; bowel-associated dermatosis arthritis syndrome; and synovitis, acne, pustulosis, hyperostosis, and osteitis. We will also discuss other neutrophilic conditions present almost exclusively in the pediatric population, including congenital erosive an...
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Grace L. Lee, Amy Y-Y. Chen Source Type: research

Granulomatous diseases: Kids are not just little people
Granulomatous diseases represent a heterogeneous group of conditions characterized by histiocytic inflammation that affect patients of any age. These diseases differ widely in their pathogenesis and include infectious and noninfectious conditions. This review focuses on noninfectious granulomatous conditions, with particular emphasis on age-related differences in the onset, epidemiology, clinical manifestations, prognosis, and age-specific management of specific granulomatous disorders. Knowledge of age-specific aspects of granulomatous conditions in adults and children improves both the extent of the diagnostic workup and...
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Nikita Lakdawala, Katalin Ferenczi, Jane M. Grant-Kels Source Type: research

Cutaneous adverse drug reactions: Kids are not just little people
Cutaneous adverse drug reactions are a common complication of drug therapy and affect patients of all ages. Despite the daunting frequency at which these reactions occur, there are no scientific contributions comparing cutaneous adverse drug reactions in adults to those occurring in children. Literature delineating such differences is important given that there are significant age-related differences in the pharmacokinetics of many drugs and that most of the package-insert data on adverse drug reactions are based on preclinical trials that do not include children as participants. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Reid Waldman, Diane Whitaker-Worth, Jane M. Grant-Kels Source Type: research

Clinical trials: Kids are not just little people
Clinical trials are the backbone of modern evidence-based medicine. They are the vital bridge between research-based discovery and cutting edge patient care. Randomized, controlled clinical trials are the gold standard of medical research, providing a method for evaluation and discovery of novel therapies that improve and even save lives. Despite an increase in the number of pediatric and adult clinical trials over recent decades, this growth has not been equal among these populations. The volume of clinical trials involving children lags substantially behind their adult counterparts. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Fludiona Naka, Bruce Strober, Mona Shahriari Source Type: research

Teledermatology: Kids are not just little people
Teledermatology has emerged as a promising solution for pediatric and adult patients accessing dermatologic care in a health care environment fraught with barriers to access. Teledermatology has been extensively evaluated in terms of diagnostic accuracy, clinical outcomes, patient and provider satisfaction, and costs, relative to traditional health care delivery models. Current research indicates that teledermatology is effective and efficient in diagnosis and management of skin diseases. The majority of studies on the subject, however, rely on adult patient data. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Fludiona Naka, Hanspaul Makkar, Jun Lu Source Type: research

How issues of autonomy and consent differ between children and adults: Kids are not just little people
Decision making in dermatology practice with adult patients is in most cases a relatively straightforward process, involving a back-and-forth exchange of information, ideas and opinions between the physician and patient. This process is more complex in the field of pediatric dermatology. It involves the triad of the patient, parent or guardian, and physician. It utilizes a model, common to many fields in pediatrics, whereby the physician seeks to obtain informed permission from the parent with the assent of the child, all the while endeavoring to act in the best interests of the child. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Sean Reynolds, Jane M. Grant-Kels, Lionel Bercovitch Source Type: research

Kids are not just little people: Part III
Part III of “Kids are not just little people” builds on the concept of pediatric versus adult dermatology put forth in part I1 and part II2 regarding how age affects the presentation and management of skin disease—with 11 additional contributions coauthored by pediatric and adult dermatologists. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Hanspaul S. Makkar, Jane M. Grant-Kels, Marti Jill Rothe Tags: Commentary Source Type: research

An age-based approach to dermatologic surgery: Kids are not just little people
Surgical dermatologic procedures in children pose unique challenges that differ from those in adults. Child and parental anxiety, along with procedural anxiety in adults, necessitate different approaches. Special considerations are reviewed in the application of topical anesthesia and administration of local anesthesia in children as opposed to adults, and the use and safety of general anesthesia in children is highlighted. In addition, management of postprocedural analgesia differs in children, largely due to concern for safety of opioids in children. (Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Authors: Breton Yates, James Whalen, Hanspaul Makkar Source Type: research

Editorial Board
(Source: Clinics in Dermatology)
Source: Clinics in Dermatology - November 1, 2017 Category: Dermatology Source Type: research