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LAS VEGAS Too often faced with worrisome hemangiomas, grim genetic dermatoses, or serious drug eruptions, Dr. Fred Ghali relishes the chance to tell a family: "No worries."
Such is the case with three common but sometimes unrecognized diagnoses presenting to Dr. Ghali's pediatric dermatology practice in Grapevine, Tex.
He shared these benign conditions with his colleagues at a dermatology seminar sponsored by Skin Disease Education Foundation:
▸ Psuedo acne. Most parents recognize that children are maturing earlier these days, but they still tend to panic when they see what they think is acne developing in their 5- or 6-year-old. Take a good, hard look at the location and pattern of the small white papules on a young child's nose, suggests Dr. Ghali.
The papules are likely "pseudo acne," small milia created when a child constantly rubs his or her nose, often in response to nasal allergies. If these miniature cysts rupture, they may take on an inflammatory appearance that resembles acne.
Less nose-rubbing will help, and topical comedolytics and antibiotics may be prescribed if necessary. However, Dr. Ghali's treatment of choice is pretty simple: "Reassurance to the family."
▸ Striking striae. Mom may gasp when she sees deep, dark, horizontal marks lining the back of her 13- or 14-year-old son.
"It is quite impressive when you see this," Dr. Ghali acknowledged, pointing to the welt-like striations.
He first theorized that the bands of discoloration might be caused by the carrying of heavy backpacks, or might be the result of wacky skateboard maneuvers.
"The bottom line is [adolescents with this condition] have lots of vertical growth over a short period of time. They're usually [white] children who are extremely skinny," he said.
The striae will tend to fade over time, resolving far better than striae of pregnancy. No treatment is necessary.
▸ Retention keratosis. Darkly pigmented, nonpruritic regions in the flexural areas of a child's neck or underarm might point to a diagnosis of acanthosis nigricans. But what about when you see these symptoms in a child of normal weight, with no other signs of metabolic illness?
"You can look like a hero," said Dr. Ghali. "Just walk in with a little bit of alcohol and wipe it off."
Known by many names ("kitschy keratosis" when he was in training), this condition, common to young children, requires just two words to concerned parents: "No worries," said Dr. Ghali.
SDEF and SKIN & ALLERGY NEWS are subsidiaries of Elsevier.
LAS VEGAS Too often faced with worrisome hemangiomas, grim genetic dermatoses, or serious drug eruptions, Dr. Fred Ghali relishes the chance to tell a family: "No worries."
Such is the case with three common but sometimes unrecognized diagnoses presenting to Dr. Ghali's pediatric dermatology practice in Grapevine, Tex.
He shared these benign conditions with his colleagues at a dermatology seminar sponsored by Skin Disease Education Foundation:
▸ Psuedo acne. Most parents recognize that children are maturing earlier these days, but they still tend to panic when they see what they think is acne developing in their 5- or 6-year-old. Take a good, hard look at the location and pattern of the small white papules on a young child's nose, suggests Dr. Ghali.
The papules are likely "pseudo acne," small milia created when a child constantly rubs his or her nose, often in response to nasal allergies. If these miniature cysts rupture, they may take on an inflammatory appearance that resembles acne.
Less nose-rubbing will help, and topical comedolytics and antibiotics may be prescribed if necessary. However, Dr. Ghali's treatment of choice is pretty simple: "Reassurance to the family."
▸ Striking striae. Mom may gasp when she sees deep, dark, horizontal marks lining the back of her 13- or 14-year-old son.
"It is quite impressive when you see this," Dr. Ghali acknowledged, pointing to the welt-like striations.
He first theorized that the bands of discoloration might be caused by the carrying of heavy backpacks, or might be the result of wacky skateboard maneuvers.
"The bottom line is [adolescents with this condition] have lots of vertical growth over a short period of time. They're usually [white] children who are extremely skinny," he said.
The striae will tend to fade over time, resolving far better than striae of pregnancy. No treatment is necessary.
▸ Retention keratosis. Darkly pigmented, nonpruritic regions in the flexural areas of a child's neck or underarm might point to a diagnosis of acanthosis nigricans. But what about when you see these symptoms in a child of normal weight, with no other signs of metabolic illness?
"You can look like a hero," said Dr. Ghali. "Just walk in with a little bit of alcohol and wipe it off."
Known by many names ("kitschy keratosis" when he was in training), this condition, common to young children, requires just two words to concerned parents: "No worries," said Dr. Ghali.
SDEF and SKIN & ALLERGY NEWS are subsidiaries of Elsevier.
LAS VEGAS Too often faced with worrisome hemangiomas, grim genetic dermatoses, or serious drug eruptions, Dr. Fred Ghali relishes the chance to tell a family: "No worries."
Such is the case with three common but sometimes unrecognized diagnoses presenting to Dr. Ghali's pediatric dermatology practice in Grapevine, Tex.
He shared these benign conditions with his colleagues at a dermatology seminar sponsored by Skin Disease Education Foundation:
▸ Psuedo acne. Most parents recognize that children are maturing earlier these days, but they still tend to panic when they see what they think is acne developing in their 5- or 6-year-old. Take a good, hard look at the location and pattern of the small white papules on a young child's nose, suggests Dr. Ghali.
The papules are likely "pseudo acne," small milia created when a child constantly rubs his or her nose, often in response to nasal allergies. If these miniature cysts rupture, they may take on an inflammatory appearance that resembles acne.
Less nose-rubbing will help, and topical comedolytics and antibiotics may be prescribed if necessary. However, Dr. Ghali's treatment of choice is pretty simple: "Reassurance to the family."
▸ Striking striae. Mom may gasp when she sees deep, dark, horizontal marks lining the back of her 13- or 14-year-old son.
"It is quite impressive when you see this," Dr. Ghali acknowledged, pointing to the welt-like striations.
He first theorized that the bands of discoloration might be caused by the carrying of heavy backpacks, or might be the result of wacky skateboard maneuvers.
"The bottom line is [adolescents with this condition] have lots of vertical growth over a short period of time. They're usually [white] children who are extremely skinny," he said.
The striae will tend to fade over time, resolving far better than striae of pregnancy. No treatment is necessary.
▸ Retention keratosis. Darkly pigmented, nonpruritic regions in the flexural areas of a child's neck or underarm might point to a diagnosis of acanthosis nigricans. But what about when you see these symptoms in a child of normal weight, with no other signs of metabolic illness?
"You can look like a hero," said Dr. Ghali. "Just walk in with a little bit of alcohol and wipe it off."
Known by many names ("kitschy keratosis" when he was in training), this condition, common to young children, requires just two words to concerned parents: "No worries," said Dr. Ghali.
SDEF and SKIN & ALLERGY NEWS are subsidiaries of Elsevier.