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Biomedical subjects

S D Resnick

Publications and source records attributed to S D Resnick.

At least 19 recordsLinked to original sources
PubMed2001

Skin signs of sexually transmitted diseases in adolescents.

Sexually transmitted diseases (STDs) continue to be a significant and prevalent problem among adolescents. One in four sexually active teenagers are infected with one or more STDs. Certain STDs, including gonorrhea, chlamydia, and possibly human papillomavirus infections have the highest prevalence in this age group. The determinants of risk for STDs in adolescence encompass a range of behavioral, biological, and social factors. This review focuses on the skin signs of STDs in adolescents. Recognition of these findings is important since they may represent the most prominent, earliest, or only evidence of an STD. The recognition of the non-AIDs STDs has the added importance of identifying a population at high risk for HIV infection. Although recent data suggest encouraging trends in sexual risk behaviors among high school students in the United States, great challenges remain in the efforts to expand primary and secondary prevention strategies for STDs in adolescents. Expertise in the recognition and treatment of STDs in adolescents remains important for clinicians who care for adolescents.

Adolescent↗
PubMed1997

New aspects of exanthematous diseases of childhood.

The childhood exanthems include a spectrum of common and uncommon disorders caused by a variety of pathogens. In this article, timely issues relating to immunization for measles and varicella are discussed. Recently reported exanthematous illnesses, including papular-purpuric gloves and socks syndrome, unilateral laterothoracic exanthem, and eruptive pseudo-angiomatosis, are described. The current research and debate about bacterial toxins as the cause of Kawasaki syndrome are presented.

Chickenpox↗
PubMed1997

Hypophosphatemic vitamin D-resistant rickets, precocious puberty, and the epidermal nevus syndrome.

BACKGROUND: The association of multisystem pathologic conditions and epidermal nevi, known as the epidermal nevus syndrome, includes disorders of bone, central nervous system, eye, kidney, vasculature, body symmetry, and skin. Rarely, vitamin D-resistant rickets has been observed in association with this syndrome. Precocious puberty is another rare finding associated with epidermal nevus syndrome, having been observed in 3 patients. OBSERVATION: A female infant with an extensive epidermal nevus, hypophosphatemia, and precocious puberty is described. Despite medical therapy, the patient's phosphate levels continued to be very low (0.87-0.97 mmol/L), establishing the diagnosis of hypophosphatemic vitamin D-resistant rickets. At 21 months of age, areas of the nevus were excised. Laboratory values obtained shortly after the operation showed a significant, but transient, improvement in the serum phosphate level. After a second excision, maintenance of her serum phosphate level in the range of 1.29 to 1.61 mmol/L was possible. CONCLUSIONS: There is evidence that epidermal nevi produce a potent phosphaturic factor. We hypothesize that limited excision debulked the nevus sufficiently to allow medical management of the hypophosphatemia. Surgical intervention should be considered for patients affected with vitamin D-resistant rickets with epidermal nevi. The cause of the precocious puberty is unknown. It may be hypothesized that the nevus released a factor that induced puberty.

Abnormalities, Multiple↗
PubMed1996

A comparison of dermatologists and generalists. Management of childhood atopic dermatitis.

BACKGROUND AND DESIGN: To compare the approaches of generalist physicians and dermatologists in the management of childhood atopic dermatitis (AD), a 6-page questionnaire was developed to assess specific practice characteristics and therapeutic preferences. Surveys were mailed to all board-certified dermatologists in North Carolina (n = 173) and to a sample of pediatricians (n = 200) and family medicine physicians (n = 300) randomly selected from the North Carolina Health Professions Database. There were 307 eligible respondents, defined as those who see children with AD, and 112 ineligible respondents. The response rate of eligible respondents was 62%. The specialty-specific response rates were as follows: 76% for dermatologists, 70% for pediatricians, and 49% for family medicine physicians. RESULTS: Dermatologists reported seeing the largest number of patients with AD, followed by pediatricians and family medicine physicians. Dermatologists also reported seeing the highest percentage of pediatric patients with moderate or severe AD (59%), followed by pediatricians (27%) and family medicine physicians (19%). Regardless of the severity of the AD, dermatologists consistently indicated a greater preference for more intensive therapy compared with generalists, as demonstrated by their preference for prescribing more potent topical steroids. Also, dermatologists were more likely than pediatricians (22%) and family medicine physicians (8%) to report "frequent use" of oral antibiotics for AD (63%). CONCLUSIONS: These striking interspecialty differences are likely to affect the outcome and cost of care of childhood AD. The data support the argument for conducting further studies of generalists' and dermatologists' approach to childhood AD, correlating therapeutic approaches with clinical outcomes and costs.

Child↗
PubMed1995

Porphyria in childhood.

Porphyria in childhood is an uncommon problem but the recognition of these disorders is vitally important for affected children. Of the cutaneous porphyrias, erythropoietic protoporphyria, congenital erythropoietic porphyria, hepatoerythropoietic porphyria, and the hereditary form of porphyria cutanea tarda (PCT) can present in infancy or childhood. This article focuses on the porphyrias that present in infants and children along with a brief discussion of pathogenesis, cutaneous histopathology, and genetics of these metabolic disorders.

Adult↗
PubMed1993

Pulsed dye laser therapy for port-wine stains in children: psychosocial and ethical issues.

The port-wine stain is a disfiguring vascular birthmark that commonly occurs on the face. Amelioration of this condition in children was difficult or impossible until the introduction of the flashlamp-pumped pulsed dye laser in the late 1980s. This article provides an interdisciplinary social and ethical examination of pulsed dye laser therapy for port-wine stain in childhood. Specific issues raised relate to the management of pain during therapy, rationale for care, expectations of treatment, the high costs of care, equity, marketing pressures, and therapeutic activism. Laser therapy in the dermatologic care of children is an exciting innovation that has transformed clinical practice and raised important social, ethical, and health policy issues.

Analgesia↗
PubMed1993

Hemorrhagic complications in a rapidly growing, congenital hemangiopericytoma.

A 3-week-old infant had a massive hemangioma-like vascular neoplasm that had enlarged rapidly since being noted at birth. Less than a day after this initial evaluation the tumor underwent spontaneous ulceration and the infant had a near-fatal hemorrhage. Histologically, the tumor was a spindle cell neoplasm most consistent with the diagnosis of congenital hemangiopericytoma. Local excision appears to have been curative after almost two years of follow-up. The case is instructive in pointing out the importance of considering nonhemangioma vascular neoplasms in the evaluation of newborns with vascular tumors.

Female↗
PubMed1993

Dyskeratosis congenita or chronic graft-versus-host disease? A diagnostic dilemma in a child eight years after bone marrow transplantation for aplastic anemia.

A 12-year-old boy had striking reticulate hyperpigmentation of the neck and upper chest, dystrophic nails, patchy alopecia, and a white streak on the buccal mucosa. He was diagnosed as having chronic graft-versus-host disease (GVHD) based on clinical findings, skin biopsy findings, and his history of a bone marrow transplantation for aplastic anemia eight years earlier. Dyskeratosis congenita (DC) was not a diagnostic consideration, although the clinical findings and history of aplastic anemia made it a compelling possibility. This case highlights the clinical similarities between DC and chronic GVHD and the difficulty in arriving at an unequivocal diagnosis.

Anemia, Aplastic↗
PubMed1992

Staphylococcal toxin-mediated syndromes in childhood.

Staphylococcal toxic shock syndrome (TSS) and staphylococcal scalded skin syndrome (SSSS) are two distinct toxin-mediated syndromes with prominent cutaneous features. The exanthematous presentation of these syndromes places them in the broad category of childhood exanthems, and the ability to recognize these potentially devastating illnesses is essential for pediatricians and dermatologists who may encounter children with fever and rash. Recent advances in the understanding of the pathogenesis of these entities has helped to explain the distinctive clinical presentations of TSS and SSSS. Toxic shock syndrome toxin-1 (TSST-1) and enterotoxins are the secretory products of Staphylococcus aureus that lead to TSS. Many of the clinical features of TSS (fever, shock, multiple organ dysfunction) can be explained by the effects of cytokines (especially interleukin-1 and tumor necrosis factor) induced by TSST-1. TSS is not an exclusively menstrual event associated with tampon use. Nonmenstrual pediatric TSS may be associated with a wide variety of staphylococcal infections. Infected burn wounds in hospitalized children and bacterial tracheitis (in some cases following influenza B infection) are relatively high-risk settings for pediatric TSS. The epidermolytic toxins (A and B) directly produce subgranular epidermolysis leading to SSSS. SSSS encompasses a clinical spectrum from bullous impetigo to the widespread exfoliation of the Ritter disease variant of SSSS. This entity usually occurs in children under 5 years of age, and is primarily explained by lack of immunity to the toxins as well as renal immaturity leading to poor clearance of toxin. The newborn nursery is an important setting where epidemics of SSSS have occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1991

Childhood exanthems. Old and new.

Exanthems are a common cause of rashes in children. Several recent developments have sparked a renewed interest in this group of diseases, including the identification of parvovirus B19 and human herpesvirus 6 as the causative agents of erythema infectiosum and roseola infantum. The resurgence of measles as a childhood exanthem has caused a re-examination of current immunization practices. The most common and clinically significant exanthems are discussed, with an emphasis on new findings, origins, clinical manifestations, differential diagnosis, and management.

Adolescent↗