mohammad jafar ghahari

Acne vulgaris is a skin condition in children and has various presentations and differential diagnoses. 

The purpose of this review was to evaluate the therapeutic approaches of infantile acne.

In this narrative review, we searched articles published in English on infantile acne in Google Scholar, PubMed, and Scopus from 1981 to 2019. 

A total of 35 articles were selected for review. The treatment of acne often involves various medications that acne lesions. Different factors contribute to the pathogenesis of acne and its severity. The same principle and treatment strategy applies to all age groups diagnosed with acne.

The treatment strategy for infantile acne is similar to acne treatment at any age. Treatment is based on the severity of the acne and the risk of a future scar.

Context: 

Warts are benign cutaneous and mucosal growths caused by human papillomavirus. Warts are the most common skin diseases seen by pediatric dermatologists. Warts are often self-limited, especially in children, but some lesions are not resolved despite repeated treatments and referred to as recalcitrant warts.

Evidence acquisition: 

Electronic databases such as Google Scholar, PubMed, and Scopus were searched during 2000-2018 and a review was conducted for articles published in English on pediatric warts by focusing on recalcitrant warts.

If warts are asymptomatic and being in a location that causes no cosmetic or other problems, observation is the ideal management course. Most parents and children prefer treatment for their warts. There are three modalities of treatment: medical, surgical, and immunotherapy.

Treatment of warts is a therapeutic challenge that depends on the patient’s age and the type of warts. Despite treatment according to evidence-based guidelines, a significant proportion of warts are failed to respond. This condition is an unsolved problem in practice. The management for treating these lesions has remained unclear and a wide range of the second line of treatments has been developed.

Pediculus capitis, commonly known head lice, is prevalent among children. It caused by Pediculus humanus capitis. Although P.humanus capitis is not a vector of human disease, but infestation with head lice, is a frequent community health concern and can cause social distress. Incidence is rising related to increased resistance due to inadequate and unnecessary treatments. This review article can be used as a reference to common types of treatments in pediculosis. Treatments of Pediculosis capitis were searched in available online resources and databases such as PubMed, Science Direct, and Google Scholar, SID with Persian and English keywords including pediculosis, head lice, treatment, therapy and drugs during 1990 to 2018. The available treatment options for Pediculosis capitis include permethrin, Malathion, topical and oral ivermectin, benzyl alcohol, spinosad, dimethicone and mechanical remove of head lice and nits. Any of these treatments should be selected according to age and special conditions. It should be noted that the safest and most effective treatment selected for the patient and topical drugs are preferred as first line treatment. The use of systemic drugs should be limited to cases where there is no response or resistance to topical drugs. Screening and treatment of all close contacts will be helpful for adequate management of pediculosis.

Context: Scabies is a common infestation in children. Treatment of scabies in infants and children is a therapeutic challenge. Many prescribed drugs for adults cannot be used in children because of their side effects and safety profile. This review article studied the treatment of scabies in children and infants. Evidence Acquisition: In this review, electronic databases, including Google Scholar, PubMed, Cochrane and Scopus were searched based on the following MeSH terms: Scabies, Pediatric and Children. We included all articles related to scabies in children published from 2008 to 2018. Duplicated and irrelevant studies and abstracts were excluded. The management of scabies is focused on identification and treatment of cases and household contacts. We briefly discussed the clinical presentation of scabies with the currently used topical and oral treatments for this infestation. Topical treatments are effective and the most effective treatment is permethrin. Other treatment options may be less effective, poorly tolerated, or with adverse effects. Scabies is prevalent in children and causes considerable morbidity. Because of its complications, scabies should be managed properly in accordance with the guidelines.

Leptin, a 16-KDa peptide hormone secreted from the adipose tissue, plays an important role in the regulation of energyintake and expenditure and body weight regulation; furthermore, it has a regulatory function on the reproductive system. The aim of this study was to assess the relationship between serum leptin levels and sex hormones in psoriatic patients and control group and to determine the serum levels of leptin and sex hormones in patients and their association with disease severity. This cross-sectional study included 43 male patients with psoriasis and 42 age- and sex- matched healthy controls. We measured serum levels of leptin, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, and total testosterone in both groups. Psoriatic patients had significantly higher levels of leptin and lower levels of FSH than healthy controls. Psoriatic patients did not differ significantly in the serum concentrations of LH, total testosterone, SHBG, and PRL in comparison with healthy controls. The severity of the disease (PASI score) was positively correlated with leptin (p<.0001), Body Mass Index (p=0.001), and waist circumference (p=0.001), and was inversely correlated with serum LH levels (p=0.03). No significant associations were found between the severity of the disease and serum levels of FSH (p=0.38), total testosterone (p=0.14), SHBG (p=0.98), and PRL (p=0.76). Our results suggest that the serum leptin level is associated with psoriasis severity and duration; moreover, we found a relationship between LH and psoriasis severity. This association needs more extensive studies.