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Biomedical subjects

Richard J Antaya

Publications and source records attributed to Richard J Antaya.

12 recordsLinked to original sources
PubMed2006

White piedra in children.

BACKGROUND: White piedra is a fungal infection of the hair shaft caused by species of Trichosporon. Rarely has this infection been reported in the United States. Historically, infected individuals required shaving of their hair to achieve clearance of the infection. OBJECTIVE: We sought to describe 8 cases of Trichosporon scalp infections seen in the northeastern United States. METHODS: We conducted chart review and prospective evaluation of 7 girls and 1 boy seen in two dermatology practices in New Haven, Conn, and New York, NY. RESULTS: Seven girls, ages 4 to 16 years old, and one 4-year-old boy were determined to have Trichosporon scalp infection, all through culture. Of the 8 children who were available for follow-up, 7 had clearance of their infection with a combination of oral azole antifungal medication and azole antifungal shampoo, without shaving the scalp hair. LIMITATIONS: This was a sample of patients from a localized region of the United States. CONCLUSIONS: White piedra is emerging as a commonly seen hair and scalp infection in the northeastern United States. Contrary to prior publications, scalp and hair infection may be successfully treated with a combination of oral azole antifungals and shampoos without shaving the scalp.

Administration, Oral↗
PubMed2006

Keratosis pilaris rubra: a common but underrecognized condition.

BACKGROUND: Keratosis pilaris is a common skin disorder of childhood that often improves with age. Less common variants of keratosis pilaris include keratosis pilaris atrophicans and atrophodermia vermiculata. OBSERVATIONS: In this case series from dermatology practices in the United States, Canada, Israel, and Australia, the clinical characteristics of 27 patients with keratosis pilaris rubra are described. Marked erythema with follicular prominence was noted in all patients, most commonly affecting the lateral aspects of the cheeks and the proximal arms and legs, with both more marked erythema and widespread extent of disease than in keratosis pilaris. The mean age at onset was 5 years (range, birth to 12 years). Sixty-three percent of patients were male. No patients had atrophy or scarring from their lesions. Various treatments were used, with minimal or no improvement in most cases. CONCLUSIONS: Keratosis pilaris rubra is a variant of keratosis pilaris, with more prominent erythema and with more widespread areas of skin involvement in some cases, but without the atrophy or hyperpigmentation noted in certain keratosis pilaris variants. It seems to be a relatively common but uncommonly reported condition.

Adolescent↗
PubMed2005

Short anagen syndrome.

Short anagen syndrome is an uncommon, probably underreported, condition whose clinical characteristics are poorly recognized and whose incidence is poorly documented in the medical literature. We describe the clinicopathologic features of a child with short anagen syndrome and propose methods for diagnosing this entity by clinical examination, trichogram, light microscopic examination of the hair shaft, scalp biopsy, and measurement of scalp hair growth rate.

Child↗
PubMed2005

Minocycline hyperpigmentation isolated to the subcutaneous fat.

We present a 15-year-old girl with bilateral lower extremity discoloration of one-year duration while taking minocycline for acne vulgaris. The clinical characteristics best supported type II minocycline hyperpigmentation, but the histology revealed that the pigmentation was solely limited to the subcutaneous adipose tissue, completely sparing the dermis. Special stain for iron was negative. This is the first case to our knowledge with pigment exclusively located in the subcutaneous fat and with the unusual finding of a negative stain for iron.

Acne Vulgaris↗
PubMed2004

Tacrolimus ointment: utilization patterns in children under age 2 years.

Atopic dermatitis (AD) is a common eczematous skin condition; as many as 10-17 percent of all children are affected, and 35-60 percent of affected patients manifest symptoms manifest during the first year of life. Treatment principles for AD in young children involve conservative measures such as avoidance of hot water and environmental irritants, combined with liberal use of emollients after bathing. Low potency topical corticosteroids (TCS) are the current standard of therapy for AD in young children, reserving mid- and high-potency TCS for severe disease. However, complications of long-term use of TCS include skin atrophy, stria formation, telangiectasia, hypopigmentation, secondary infections, steroid acne, allergic contact dermatitis, and miliaria. The pediatric population is also at increased risk for systemic absorption because of their high ratio of skin surface to body mass. Systemic absorption may result in hypothalamic-pituitary-adrenal axis suppression and ultimately growth retardation. Although most topical and systemic corticosteroids are not approved by the Food and Drug Administration for use in children less than 2 years of age, conservative treatment often fails in this age group and frequently patients are treated with TCS, antibiotics, and antihistamines.

Administration, Cutaneous↗
PubMed2003

Henoch-Schonlein purpura following a meningococcal vaccine.

We report a 17-year-old girl who developed Henoch-Schonlein purpura 10 days after receiving a meningococcal vaccine (Menomune). To our knowledge, this is the first case report of Henoch-Schonlein purpura temporally associated with the tetravalent serogroups A, C, W-135, and Y meningococcal vaccine administered in the United States.

Adolescent↗
PubMed2002

Subcutaneous fat necrosis of the newborn presenting as a large plaque with lobulated cystic areas.

Subcutaneous fat necrosis of the newborn (SFN) usually occurs in the first few weeks of life in full-term infants and presents as indurated, distinct nodules with a predilection for the cheeks, shoulders, back, buttocks, and proximal extremities. Most cases are related to some form of fetal distress, including obstetric trauma. Some cases are associated with hypercalcemia. We report a case of SFN with an unusual clinical presentation, complicated by hypercalcemia.

Biopsy, Needle↗
PubMedDate not supplied

Nevus anelasticus, papular elastorrhexis, and eruptive collagenoma: clinically similar entities with focal absence of elastic fibers in childhood.

Focal absence of elastic fibers is a defining characteristic of three rare, clinically similar conditions: nevus anelasticus, papular elastorrhexis, and eruptive collagenoma. We present a 16-year-old with nevus anelasticus treated with intralesional steroid injections, resulting in erythematous atrophic depressions. We also review the English language literature on nevus anelasticus, papular elastorrhexis, and eruptive collagenoma. There may be sufficient clinical and histopathologic similarity to indicate that these three entities represent a single disease or disease spectrum. We believe that this entity should be referred to as papular elastorrhexis.

Adolescent↗
PubMedDate not supplied

Fatal childhood calciphylaxis in a 10-year-old and literature review.

Calciphylaxis is a rare but highly morbid disorder of vascular calcification and skin necrosis, affecting 1% to 4% of adults with end-stage renal disease. Only three affected children have previously been described. We report an unusual instance of fatal calciphylaxis involving a 10-year-old boy, in the setting of sarcoidosis-induced end-stage renal disease. A review of pediatric calciphylaxis cases suggests: (a) increased risk in boys with end-stage renal disease and secondary hyperparathyroidism; (b) frequent distal extremity and visceral organ involvement, (c) worse prognosis with acral necrosis, and (d) possible increased resistance to medical treatment compared to adult patients. Hyperesthetic pain is a common sentinel symptom, and soft tissue x-rays or xeroradiography or both may aid in the diagnosis of pediatric calciphylaxis. Parathyroidectomy in combination with supportive medical management may be the best treatment option in stopping the progression of disease in the pediatric population.

Calciphylaxis↗
PubMedDate not supplied

Yellow nail syndrome in three siblings: a randomized double-blind trial of topical vitamin E.

Yellow nail syndrome is an uncommon disorder characterized by dystrophic nails, lymphedema, and respiratory disease. It has rarely been reported in children and this is the first report of congenital yellow nails in siblings. The purpose of this study was to determine whether topical vitamin E applied to the nail plates and periungual skin would affect the growth rate or appearance of the fingernails in patients with congenital yellow nail syndrome. This study was the first trial of a treatment for this entity in children and the largest randomized double blind trial to date. We found that vitamin E solution had no significant effect (p = 0.84) on fingernail growth or the global appearance score (p = 1.0) when compared with placebo. The average growth rates and global assessment scores improved and onycholysis and onychomadesis decreased from baseline with both vitamin E and placebo treatment, although these were not primary end points of the study. Topical vitamin E did not result in a statistically significant improvement when compared with oil alone for the treatment of the nails in our three patients with yellow nail syndrome. However, it is interesting and perhaps clinically useful that both vitamin E and placebo oil improved the condition of the nails.

Administration, Topical↗