Pediatric Annals

editorial 

Cases, We've Got Cases

Stanford T Shulman, MD

Abstract

For something different this month, Pediatrie Annals is presenting a series of dermatologie case unknowns. Each case is accompanied by an erudite discussion of the condition illustrated. If you identify all of these cases correctly, you certainly deserve to be a bona-fide pediatrie dermatologist. We're very interested in your opinions of this format. Please email Managing Editor Shannon O' Connor at soconnor@slackinc. com with your thoughts.

I find it amazing how often a dermatologie manifestation in a child can be the key to a systemic disorder of real significance. Whether it is Langerhan's cell histiocytosis, bacterial endocarditis, celiac disease, Kawasaki disease, or something else, the skin manifestations can provide an early clue to the correct diagnosis. With respect to Kawasaki disease, it is worth noting that very exciting advances are being made related to this fascinating disorder. Efforts to identify the triggering infectious agent (or is it agents?) and to characterize genetic markers of susceptibility may hit paydirt in the near future. One goal, of course, will be the development of a Kawasaki diagnostic test to aid all clinicians who evaluate febrile children.…

For something different this month, Pediatrie Annals is presenting a series of dermatologie case unknowns. Each case is accompanied by an erudite discussion of the condition illustrated. If you identify all of these cases correctly, you certainly deserve to be a bona-fide pediatrie dermatologist. We're very interested in your opinions of this format. Please email Managing Editor Shannon O' Connor at soconnor@slackinc. com with your thoughts.

I find it amazing how often a dermatologie manifestation in a child can be the key to a systemic disorder of real significance. Whether it is Langerhan's cell histiocytosis, bacterial endocarditis, celiac disease, Kawasaki disease, or something else, the skin manifestations can provide an early clue to the correct diagnosis. With respect to Kawasaki disease, it is worth noting that very exciting advances are being made related to this fascinating disorder. Efforts to identify the triggering infectious agent (or is it agents?) and to characterize genetic markers of susceptibility may hit paydirt in the near future. One goal, of course, will be the development of a Kawasaki diagnostic test to aid all clinicians who evaluate febrile children.

I must confess that stamps with a dermatologie theme are truly few and far between, in fact almost nonexistent. As well, I published one with the editorial some months ago. However, I have found several other stamps for which a dermatologic connection can be claimed (tenuous in some circumstances, to be sure).

The stamp from Sudan shows a child's foot. If one looks carefully, a long, linear, string-like object can be seen emerging from the dorsum of the foot. In a few parts of the world, dracunculiasis (guinea worm infestation) is endemic. Ingestion of drinking water that is contaminated with the Cyclops copepod (a crustacean) containing the parasitic larvae leads to infection. After a period of about a year, a mature female guinea worm erodes through the skin, usually of the foot or ankle, and can be gradually pulled out of the skin. These worms are up to several feet in length. The good news is that an active effort to control the vector has led to likely elimination of this debilitating parasitic illness in the near future.

A number of dermatologic conditions emphasizes activities including mobilizing communities to fight HTV/AIDS and providing nutritional support to children.

Lastly, the multicolored stamp from St. Kitts in the Caribbean celebrates World AIDS Day and states AIDS (in gray on the left, with serpents) or LIFE (in yellow, symbolized by a red rose).

emphasizes activities including mobilizing communities to fight HTV/AIDS and providing nutritional support to children.

Lastly, the multicolored stamp from St. Kitts in the Caribbean celebrates World AIDS Day and states AIDS (in gray on the left, with serpents) or LIFE (in yellow, symbolized by a red rose).

have a genetically determined susceptibility, and some in fact are important components of a genetic syndrome. Some of the cases presented in this issue fell into this category. The green stamp from Germany was issued in 1984 to honor the 100th anniversary of the death of Gregor Johann Mendel (1822-1884). Many recall the story of this 19th Century scientist, who was the abbot at the Augustinian monastery in Brunn, Austria. Mendel carried out hybridization breeding experiments with the garden pea and discovered the mathematical laws that govern the inheritance of dominant and recessive characteristics in hybrids. This work was published in 1866 in an obscure journal in Brunn and was re-discovered only in 1900, after Mendel's death. It has since led to the basic laws of heredity and really serves as the scientific foundation of modern genetics. He was able to explain how the two (heterozygous) red flowers, shown at the bottom of this stamp, could yield both red and white flowers, shown at the top.

Two stamps illustrated here represent the more than 100 countries that issued stamps in 2005 to honor the 100th anniversary of the founding of Rotary International. This Chicago-based service organization has supported in a major way the efforts that have nearly eradicated polio from the world. The blue Argentinean stamp shows two healthy children running, while the background shows a child receiving the oral polio vaccine developed by Dr. Albert Sabin. At the bottom are the words "For a world free of polio." The gray and green stamp from Papua New Guinea also celebrates 100 years of Rotary but emphasizes activities including mobilizing communities to fight HTV/AIDS and providing nutritional support to children.

Lastly, the multicolored stamp from St. Kitts in the Caribbean celebrates World AIDS Day and states AIDS (in gray on the left, with serpents) or LIFE (in yellow, symbolized by a red rose).

10.3928/0090-4481-20060601-01

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