Apocrine hidrocystoma on the genitalia of a 9‐year‐old girl

Apocrine hidrocystomas are mostly found on the cheeks and eyelids but also on the scalp and neck. The age distribution is from 30 to 70 years old. We report a case of an apocrine hidrocystoma on the genitalia of a 9‐year‐old girl.     

UVB 308‐nm excimer light and bath PUVA: combination therapy is very effective in the treatment of prurigo nodularis

Background Prurigo nodularis (PN) is a chronic inflammatory skin disease with nodular itching lesions. UV therapy – both PUVA and NUVB – are known to clear up PN temporarily due to the antipruritic effect of UV light. However, relapse after treatment is common in PN, which means that either long‐term therapy is necessary or the treatment protocols have to be optimized to minimize side‐effects. Objective The aim of this study was to evaluate the effect that combining bath PUVA and targeted UVB 308 nm excimer radiation has on recalcitrant nodular prurigo. Methods In a prospective trial, 22 patients with PN were treated with either PUVA alone or with a combination of PUVA and excimer UVB. The end point was complete or almost complete remission of PN. Results Adding a 308‐nm excimer UVB to the treatment of the pruritic nodules sped up the healing process; 30% less PUVA radiation was needed. Conclusion The combination of PUVA and excimer UVB in PN appears to be very efficacious. Reducing psoralen UVA doses by 30% offered long‐term benefits in phototherapy of chronic recalcitrant diseases like PN.     

Excellent response to ustekinumab in a 9‐year‐old girl with severe psoriasis

We report the case of a 9‐year‐old girl with severe plaque psoriasis refractory to multiple topical and systemic therapies. Physical examination revealed extensive, erythematous plaques with overlying thick scales that covered more than 80% of her body surface area, which included the face, scalp, trunk, and limbs. Because of the severity of the disease and lack of treatment response to other systemic therapies, she was treated with ustekinumab. Three weeks after ustekinumab was initiated, her psoriatic lesions fully cleared.     

Tularemia‐induced erythema multiforme minor in an 11‐year‐old girl

Tularemia is a rare and potentially life‐threatening infection caused by the highly infectious gram‐negative coccobacillus Francisella tularensis. We present the case of an 11‐year old girl who presented with erythema multiforme minor in the setting of an indolent but progressive soft tissue infection and was found to have tularemia. We review the role of dermatologists in identifying the features of and complications associated with this rare zoonosis and discuss the potential effect of climate change on its incidence.