A fourth proposed subtype of EF is associated with HIV-negative hematologic disease. This subtype is distinguished by a predictable timeframe to presentation and a relatively rapid response to therapy. Although EF is an important consideration in all patients with hematologic malignancy, clinically heightened suspicion is warranted during the 2-3 months after transplant.

Idiopathic facial aseptic granuloma (IFAG), originally termed pyodermite froide du visage, describes a generally asymptomatic facial nodule presenting in childhood with clinical resemblance to pyoderma or cystic, granulomatous, or vascular lesions. Clinical understanding is constantly evolving, with recent observations indicating that IFAG may represent a subtype of childhood rosacea. We present a case of IFAG associated with eyelid chalazions in a 19-month-old boy. Although his clinical course paralleled previously reported IFAG cases, we observed a unique ultrasound variation during initial diagnostic examination. Further delineation of clinical, imaging, and histologic properties of IFAG may reveal insights into etiologic associations and ideal management.

Urticaria affects nearly 25% of the population at some time in their lives. In a subset of children, urticaria will develop into a chronic condition that can greatly affect quality of life. Although numerous causes and triggers are proposed for chronic urticaria (CU) in children, ranging from infections, allergens, and medications to physical factors and autoimmune disease, the exact etiology is not always identifiable. Accordingly, a large subset of cases are designated "chronic idiopathic urticaria." Because of the clinical complexities of CU, as well as the confusing literature on this topic, we have developed a conceptual framework based on the cumulative evidence to assist with the categorization, clinical evaluation, and treatment of CU in children.

Pediatric dermatologists may care for patients with percutaneous enteral feeding tubes. Although ostomy complications such as allergic contact and irritant dermatitis are common, psoriasis may be misdiagnosed. We report three novel cases of childhood psoriasis first presenting around an enteral feeding tube site. Localized psoriasis is an important clinical consideration in children with ostomy site eruptions to ensure timely diagnosis and effective management.

Objective The aim of this study was to compare the efficacy of halobetasol propionate 0.05% ointment administered once daily with that of the ointment administered twice daily in combination with 12% ammonium lactate lotion for treatment of plaque psoriasis. A second objective was to investigate the benefits of maintenance therapy with ammonium lactate 12% lotion. Design The study was a randomized, investigator-masked, parallel trial. In the first phase, subjects applied halobetasol 0.05% ointment either once or twice daily in combination with 12% ammonium lactate lotion twice daily for 2 weeks. In the second phase, subjects either continued ammonium lactate twice daily or discontinued all treatment for 4 weeks. Setting University of California San Francisco Psoriasis and Skin Treatment Center. Participants: The study comprised 40 patients with a target plaque of at least 1 cm2 and a Psoriasis Severity Assessment (PSA) score of at least 6. Measurements Plaque induration, scale, and erythema were recorded at weeks 0, 1, 2, 4, and 6. Paired t-tests compared improvement between the two groups; unpaired t-tests compared differences between the two arms. Results No significant difference was noted in efficacy between once- and twice-daily halobetasol application at weeks 0 and 2 for induration (respectively, P = 0.10 and P = 0.21), scale (P = 0.49 and 0.51), erythema (P = 0.42 and 0.14), and total PSA (P = 0.37 and 0.23). A significant difference was found in scale between weeks 2 and 4 (P = 0.04) and weeks 2 and 6 (P = 0.03) in favor of patients continuing ammonium lactate lotion. Conclusion Once-daily halobetasol ointment achieves results similar to those of twice-daily application when used with ammonium lactate lotion in plaque psoriasis treatment. Sequential therapy with 2-week halobetasol ointment followed by twice-daily ammonium lactate may enhance therapeutic duration.