Summary Reduced bone mineral density (BMD) in childhood is a risk factor for osteoporosis in later life. This case–control study determined the prevalence of low BMD, calcium intake and physical activity in 62 haemophilic children and 62 sex‐, race‐ and age‐matched healthy boys as controls. Lumbar spine (L2‐L4) BMD was determined by dual‐energy X‐ray absorptiometry; BMD was considered to be low when Z‐score ≥2. Physical activity was assessed using a validated questionnaire and calcium intake with a standardized quantitative food frequency questionnaire. Twenty‐four patients (38%) had low BMD, whereas this was found in only 10 (16%) controls [odds ratio (OR) 2·86, 95% confidence interval (CI) 1·17–7·41; P = 0·014]. Lumbar BMD was significantly lower in the haemophilia patients than the controls (−1·6 ± 1·0 vs. −0·9 ± 0·9 respectively; P = 0·0004). Sedentary and low‐grade exercise predominated in haemophilia (77%) versus control (50%) (OR 3·2, 95% CI 1·36–7·79; P = 0·003). There were no differences between groups with regard to calcium intake. Our results suggest that low‐physical activity is a risk factor for reduced lumbar bone mass in the haemophilic group. This factor must be monitored to avoid a significant reduction in BMD that might contribute to further skeletal fragility.

Our series presents some clinical and histopathology differences with previously reported, such as the most frequent localization in the head and the presence of melanocyte colonization.

CAM use in Mexican children is common, most frequently with herbal therapies. The majority perceived benefits with its usage but in most cases, the treating physician was not informed about this practice.

Our results are similar to those previously published-the diagnosis was suspected in only half of the cases. We consider it important that odontogenic cutaneous fistulas be included among the differential diagnosis of cutaneous facial lesions to avoid delaying appropriate treatment.

Our data suggest that pimecrolimus cream for discoid lupus erythematosus seems to be a safe and clinically effective option. However, this was an open and uncontrolled study, and double-blind, placebo-controlled studies are needed.