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Clinical Insights from Day 4 of the Elevate-Derm PA-NP Conference in Boston, Massachusetts

- In: Clinical Practice, Professional Development

Diagnosis and Management of Infantile Hemangiomas (Jennifer Huang, MD)

    • ● Infantile hemangiomas are the most common benign soft tissue tumor of childhood.
    • ● Hemangiomas grow over the first year of life and then involute over several years. Most hemangiomas do not require intervention.
    • ● Work-up for underlying and vascular anomalies should be performed for any hemangiomas larger than five centimeters in diameter.
    • ● Use Vaseline to diaper area hemangiomas at every diaper change (about every 3 hours)
    • ● The peak growth of hemangiomas occurs at around 6-7 weeks of age, much earlier than we used to think. Treatment of problematic hemangiomas should occur at around 6-7 weeks of age.

Don't Miss It! Important Skin Conditions in Children. (Jennifer Huang, MD)

    • ● Non-infectious causes of neonatal blistering are genetic (epidermolysis bullosa, incontinentia pigmenti, bullous forms of ichthyosis) or autoimmune (pemphigoid gestationes, bullous pemphigoid).
    • ● In neonates with blisters, always rule out infection.
    • ● Bone (80%) followed by skin (33%) are the most common organs involved in Langerhans cell histiocytosis.
    • ● In children with diaper rash consider zinc deficiency if plaques are confluent, erosive and involve acral and perioral regions. Consider Langerhans histiocytosis if lesions are hemorrhagic and involve the scalp.
    • ● Red flags for malignant tumors in children are if the tumor was present since birth, the tumor is rock hard, the tumor has growth past 6-9 months of age or the tumor has rapid growth.
    • ● If you see blisters around the nails in a neonate, consider junctional epidermolysis bullosa.

Reducing Diagnostic Error in Dermatology: A Bayesian Approach (Adam Lipworth, MD)

      • ● Bayes Theorem is a means of determining conditional probabilities. It is the likelihood of what you want to know (hypothesized diagnosis) given data that you have available.
      • ● When inferring information from data, prior probabilities are critically important.
      • ● Confirmation bias occurs when we allow the patient's history to influence how we perceive the exam, which should be independent.