Scurvy in a 10‐Year‐Old Boy

Abstract: Scurvy, or hypovitaminosis C, is an uncommon condition that exists today primarily within certain unique populations—particularly the elderly subjects, patients with neurodevelopmental disabilities or psychiatric illnesses, or others with unusual dietary habits. Vitamin C is an essential nutrient in the human body, and is important in synthesizing collagen factor whose faulty production is responsible for most of the clinical manifestations of scurvy. These clinical manifestations can include dystrophic or corkscrew hairs, gingival hyperplasia, and weakened blood vessel walls, causing bleeding in the skin, joints, and other organs. Although rare in the Unites States, the presence of scurvy should not be forgotten because of its presence among susceptible populations. Moreover, with its diagnosis, treatment and cure is one of the simplest in modern medicine. We report a case of scurvy in a 10‐year‐old autistic child.     

A Case of Pemphigus Herpetiformis Occurring in a 9‐Year‐Old Boy

Abstract: Pemphigus herpetiformis (PH) is a rare autoimmune vesiculobullous disease. It clinically mimics dermatitis herpetiformis and has immunofluorescent findings typical of pemphigus. PH occurs in adults more commonly than children and is often effectively treated with dapsone. We report a case of PH occurring in a 9‐year‐old boy that was refractory to dapsone and to various other steroid‐sparing medications but resolved with methotrexate.     

Post‐Chikungunya Rheumatic Disease in a 13‐Year‐Old Boy

Chikungunya is a mosquito‐borne viral infection that causes an acute febrile illness and can result in acute or chronic musculoskeletal disease. A 13‐year‐old boy presented with post‐Chikungunya rheumatic disease featuring connective tissue disease signs including digital ulcerations, cuticular dystrophy, dilated capillary loops, and digital tapering.     

Localized Secondary Erythromelalgia in an 11‐Year‐Old Boy

Abstract: We report an 11‐year‐old boy with localized secondary erythromelalgia on his left medial thigh. The episodes responded well to indomethacin and prednisone but recurred after the medications were stopped. The disease was stable after being treated for 5 months.     

Metastatic Spiradenocarcinoma Occurring in an 8‐Year‐Old Boy

We recently saw the case of an 8‐year‐old boy with histologic findings of spiradenocarcinoma. Malignant adnexal tumors in children are exceedingly rare, and cases of spiradenocarcinoma in children are absent in the literature. We report the case of an 8‐year‐old boy with metastatic spiradenocarcinoma. A biopsy 2 years before his presentation at our institution was interpreted as a benign lesion, but when the lesion regrew, a repeat biopsy was performed that demonstrated ominous findings, prompting a reexcision. This reexcision demonstrated an area with significant necrosis, many mitoses, and cellular pleomorphism apparently arising out of a sharply demarcated, adjacent, lower‐grade area. The histologic features of this patient's biopsies were those of spiradenocarcinoma, potentially arising out of a preexisting spiradenoma, a finding that has not been documented previously in this age group. Staging studies demonstrated multiple bilateral pulmonary nodules, which were confirmed using thoracoscopic biopsy to be metastatic disease. His chemotherapy regimen has included several cycles of cisplatin and 5‐flourouracil, with ongoing disease progression of pulmonary disease. It has been 16 months since he presented to our institution (>3 years since the appearance of his initial lesion). Imaging studies demonstrate a slowly increasing size and number of pulmonary lesions. The long‐term prognosis is guarded.     

Leser-Trélat Sign Associated with Sézary Syndrome

A 74-year-old Japanese male had developed generalized erythroderma and rapid growth of multiple verrucous lesions over the entire surface of his face, trunk, and extremities three months before he was seen. Histologically seborrheic keratoses were revealed. Laboratory examinations showed peripheral leukocytosis with atypical lymphocytes and high levels of IgE and IgG. On the basis of these clinical and histopathologic findings, we diagnosed the patient as having Leser-Trélat sign associated with Sézary syndrome. The erythroderma subsided after administration of oral predonisone, and no new formations of seborrheic keratosis were observed. However, because of subsequent aggravation of the generalized erythroderma, we administered chemotherapy. Six months after the initial examination, lung cancer was found, and the patient subsequently died of respiratory and renal failure.     

Periungual Bowen's Disease in a 12‐Year‐Old Boy Treated with Photodynamic Therapy

Bowen's disease (BD) usually occurs on sun‐exposed areas in elderly patients. BD rarely occurs in childhood and lesions of the nail unit and periungual area are likely associated with human papillomavirus infection. Herein, we report a case of BD presenting on the periungual area in a 12‐year‐old boy which was successfully treated with two sessions of photodynamic therapy.     

Erythema Multiforme Possibly Triggered by Rabies Vaccine in a 10‐Year‐Old Boy

Abstract: This report documents a possible rabies vaccine–induced erythema multiforme manifestation in a 10‐year‐old boy.     

Birt–Hogg–Dubé Syndrome Presenting as a Nevus Comedonicus–Like Lesion in an 8‐Year‐Old Boy

Birt–Hogg–Dubé syndrome is an uncommon genodermatosis characterized by hair follicle hamartomas and an increased risk of pneumothorax and renal cell carcinoma. Recognition of cutaneous manifestations is essential because it allows for early screening and management of systemic complications. We present the case of an 8‐year‐old boy with a recently described cystic and comedonal variant of the classic fibrofolliculoma, which had been present since birth.