Objective To assess and compare physical and chemical properties of skin among different body areas of healthy children at different ages from Beijing.Methods A total of 116 healthy children were recruited from Beijing,China,and classified into four age groups.Tewameter TM300 was used to measure transepidermal water loss (TEWL) value,Corneometer CM825 to estimate stratum corneum hydration,and skinpH-Meter PH905 to determine skin surface pH,in the forehead,cheek and forearm.The Mexameter MX 18 probe to determine melanin index of the face.Analysis of variance was carried out to assess differences in these parameters among different measurement sites and age groups.Results TEWL value did not differ among different age groups or measurement sites (both P ＞ 0.05).The stratum corneum hydration value of forehead,cheek and forearm was 51.53 ± 15.70,39.88 ± 10.48 and 50.33 ± 17.54 respectively in the age group ＜ 1 year,49.95 ± 17.88,32.51 ± 12.09 and 36.10 ± 7.43 respectively in the age group 1-3 years,51.37 ± 10.60,31.65 ± 9.01 and 34.41 ± 8.21 respectively in the age group 4-6 years,49.74 ± 10.64,39.99 ± 50.43 and 29.35 ± 8.10respectively in the age group 7-12 years,with significant differences among different measurement sites (P ＜ 0.05) but not between different age groups (P ＞ 0.05).The cheek and forearm showed lower stratum corneum hydration value than the forehead.No statistical difference was observed in pH value at the same measurement sites between the age group ＜ 1 year (forehead 5.27 ± 0.60,cheek 6.12 ± 0.51 and forearm 5.48 ± 0.45),1-3years (forehead 4.68 ± 0.58,cheek 6.80 ± 0.55 and forearm 5.07 ± 0.58),4-6 years (forehead 4.58 ± 0.37,cheek 5.70 ± 0.48 and forearm 5.09 ± 0.49),and 7-12 years (forehead 4.87 ± 0.51,cheek 5.72 ± 0.49 and forearm 5.09 ± 0.51),but the cheek had significantly higher pH value than the forearm and forehead (both P ＜ 0.05).Melanin value on the face did not differ between different age groups (P ＞ 0.05).Conclusion Physical and chemical properties of skin vary with body sites in healthy children.

Objective To investigate clinical and pathological features of lupus erythematosus profundus (LEP)of the scalp in children.Methods A retrospective study was carried out on 5 children with LEP.The clinical and histopathological features,treatment and prognosis of LEP were analyzed.Results The 5 children with LEP included 2 boys and 3 girls with a median age at onset of 5 months (range,2-38 months) and a median clinical course of 15 months (range,4-72 months).Clinically,the patients presented with arc-shaped or circular purple atrophic plaques on the scalp complicated by alopecia.The occipitalia and tempora were the most commonly involved sites.Antinuclear antibodies (ANA) and extractable nuclear antigens (ENAs) were negative in all the patients.Main histopathological changes were hyaline degeneration of the fat,mucin deposition and local aggregation of lymphocytes in fat lobules.Of the 5 patients,2 were treated with oral prednisone (1.5-2 mg/kg/day),1 with oral hydroxychloroquine (5 mg/kg/day),1 with oral prednisone (1.5 mg/kg/day) combined with hydroxychloroquine (5 mg/kg/day),and another 1 with topical halometasone cream and 0.03％ tacrolimus ointment.Lesions were remissed after 2-3 months of treatment,and subsided with growth of new hairs after 6 months.No recurrence was observed during a 1.5-year follow-up.Conclusion Prednisone and hydroxychloroquine are markedly effective for LEP,and pediatric patients with LEP may be treated by topical highpotency glucocorticoids and calcineurin inhibitors.

A 13-year-old girl presented with multiple recurrent cutaneous plaques for more than six months,which had been aggravated with intermittent fever for five months.No obvious systemic abnormality was found.Dermatological examination revealed multiple,non-ulcerative,painless,infiltrative,indurated,poorly marginated,purple subcutaneous plaques measuring 3-1 1 cm in diameter with slight squamation in bilateral buttocks and lower limbs.Laboratory investigations showed bicytopenia with the white blood cell count being (0.03-3.7) × 109/L and red blood cell count being (2.8-4.4) × 1012/L,a normal platelet count,hypofibrinogenemia (1.79 g/L) and low proportion of natural killer cells (4.6％).Bone marrow smear showed active proliferation of cells,decreased proportion of granulocytes,presence of a few indefinitely classified cells,and phagocytosis.Reticulocytes were easily seen in the bone marrow smear.Pathologically,no obvious abnormality was observed in the epidermis or dermis,while the subcutaneous adipose tissue,especially fat lobules and some interlobular septa,was extensively infiltrated by large-to medium-sized lymphoid cells with pleomorphic and twisted nuclei as well as a small amount of cytoplasm; necrosis and phagocytosis of nuclear debris and lymphocytes were visible.The atypical lymphoid cells stained positive for CD3,T-cell intracellular antigen-1,granzyme B and TCRγδ with partial loss of CD5 and CD7,but negative for CD56,CD4,CD8 and TCRαβ.No Epstein-Barr virus-encoded RNA (EBER) was detected by in situ hybridization.Based on these findings,a diagnosis of primary cutaneous γδ-T cell lymphoma with hemophagocytic syndrome was made.

Objective To investigate the efficacy and safety of sirolimus 0.1% ointment in the treatment of facial angiofibromas in children with tuberous sclerosis complex. Methods Sirolimus 0.1% ointment was prepared. Twenty children with tuberous sclerosis complex who had facial angiofibromas were enrolled in this study. Facial angiofibromas were topically treated with the self?prepared sirolimus 0.1% ointment twice a day for 12 weeks. The facial angiofibroma severity index(FASI)was calculated, the degree of satisfaction with the treatment was evaluated, and adverse reactions were analyzed at weeks 4 and 12. Plasma sirolimus concentrations as well as blood biochemical and immunological parameters were measured, blood coagulation activity was evaluated, and routine blood tests as well as urine tests were performed at baseline and week 12. Results The FASI of patients significantly decreased at weeks 4(4.400 ± 1.284)and 12(2.975 ± 1.543)compared with that at baseline(5.750 ± 1.175, both P<0.000 1), and was significantly lower at week 12 than at week 4(P < 0.000 1). The efficacy index was 49.87% ± 22.08% at week 12, significantly higher than that at week 4(24.43%± 10.18%, t=7.338, P<0.01). The color, size and number of lesions significantly decreased in all the patients, and facial angiofibromas completely disappeared in 2 patients at week 12. At week 4, 10 parents were satisfied with the improvement of erythema, 3 parents with that of lesion volume, and 3 parents with that of lesion area. The degree of parent satisfaction increased at week 12 in all the cases. The blood concentration of sirolimus was lower than 1.0μg/L both before and after the treatment. No severe systemic or local adverse reactions were noted in these patients. Conclusion Sirolimus 0.1%ointment is markedly effective and safe for the treatment of facial angiofibromas in patients with tuberous sclerosis complex.

T lymphocyte subset and NK cells in the blood of SCI patients were measured by APAAP(Alkaline Phosphatase Antialkaline Phosphatase) in order to study the change of immune function in SCI patients.The results showed that cell mediated and non specific immune function in SCI patients was decreased. It plays a role in the rehabilitation of SCI patients to increase immune function.

Objective To analyze factors associated with the relapse of propranolol-treated infantile hemangioma.Methods The clinical data were collected from 235 children with infantile hemangioma who had discontinued propranolol for 6 months,and retrospectively analyzed.Factors for the relapse of propranolol-treated infantile hemangioma were analyzed by univariate and multivariate unconditional logistic regression analyses.Results Of 235 patients followed for 6 months after drug withdrawal,66 (28.1％) were identified to have recurrence of infantile hemangioma,of whom,15 (22.7％) had severe recurrence.The risk of recurrence was significantly increased in patients taking propranolol at a daily dosage of 1.5 mg/kg compared with those taking propranolol at a daily dosage of 2 mg/kg (OR =3.566,95％ CI:1.306-9.739),in patients aged ＞ 8 weeks at the initial drug treatment compared with those aged ≤ 8 weeks at the initial drug treatment (OR =5.043,95％ CI:1.248-20.376),in patients with the course of medication ≤ 6 months compared with those with the course of medication ＞ 6 months (OR =17.661,95％ CI:4.899-63.665),as well as in patients aged ＜ 1 year at drug withdrawal compared with those aged ≥ 1 year at drug withdrawal (OR =6.089,95％ CI:1.835-20.204).Conclusion There are many risk factors associated with the relapse of propranolol-treated infantile hemangioma,so some measures aimed at these risk factors should be taken to reduce the recurrence rate.

The key technology of the device for the viviperception of the animal mesenteric microcirculation is to simulate the celiac environment in the device. The technical requirements of the device for microcirculation viviperception are that the observation box should be able to "keep warm, preserve moisture, continually perfuse, and fix the sample"; and the lighting should be "intense", "convergence", and "cool". After actual application, it was found that the newly designed and developed the device by research personnel of Wannan Medical College for the viviperception of the animal mesenteric microcirculation can meet the technical requirements, which is able to "keep warm, preserve moisture, continually perfuse, and fix the sample", and using LED lamp as the microscope light source is "intense", "convergence", and "cool". This device is ingenious and reasonable in design, stable in technology, convenient in operation, and competent in microcirculation viviperception. It solves the technical problem to simulate the celiac environment for mesenteric microcirculation viviperception. The device provides convenience to observe and study the microcirculation, which is worth to be applicated widely.

Objective To investigate clinical manifestations,pathological features and outcomes of primary osteoma cutis in children.Methods Eleven children with confirmed primary osteoma cutis diagnosed in Department of Dermatology,Beijing Children's Hospital between 2011 and 2018 were included into this study.The clinical manifestations,histopathological features,and outcomes were analyzed retrospectively.Results Among the 11 patients,7 were males and 4 were females.Primary osteoma cutis occurred within 22 months after birth in all the children,the median age of onset was 1 month,and the disease occurred during the first 6 months of life in 10 children.The skin lesions were characterized by skincolored or reddish indurated papules,plaques or nodules of varying size with slight epidermal atrophy.Three patients had local skin lesions,and 8 had multiple skin lesions.Serum calcium and parathyroid hormone levels were within normal limits in all the children,and no developmental deformity was observed at birth in any of the children.Histopathological examination revealed the formation of mature lamellar bone in the dermis in all the cases,which involved the subcutaneous adipose tissue in 5 cases.The skin lesions became stable 8-18 months after the occurrence in 10 patients,which was consistent with primary plaquelike osteoma cutis.Only 1 patient underwent a slowly progressive course,and the skin lesions involved subcutaneous deep tissues,leading to dyskinesia,which was consistent with progressive osseous heteroplasia.Conclusions Primary osteoma cutis in children mostly occurs in infancy,whose clinical manifestations are atrophic,indurated plaques or nodules,and its main pathological feature is the formation of mature lamellar bone.Long-term follow-up is needed,and attention should be paid to the occurrence of progressive osseous heteroplasia.

Objective To investigate the efficacy and safety of ultrapulsed fractional CO2 laser in the treatment of porokeratosis in children.Methods Clinical data were collected from 9 children with porokeratosis in the Department of Dermatology of Beijing Children's Hospital from January 2014 to December 2015,and analyzed retrospectively.These patients were all treated with ultrapulsed fractional CO2 laser in a dynamic superficial stripping (Active FX) mode.The initial energies were 100,200 and 300 mJ/cm2,and the frequencies ranged from 100 to 300 Hz.Before and after the treatment,as well as during the follow-up,confocal laser scanning microscopy was used to evaluate the severity and recovery of skin lesions.Results Of the 9 patients,7 were male,and 2 were female.Their average age was 4.19 ± 3.97 years.After the treatment with ultrapulsed fractional CO2 laser,all of the patients were considered to be cured based on the clinical standard.Some adverse reactions such as erythema,edema and erosion occurred in the 9 patients immediately after the treatment,but all completely regressed within 3-7 days.At 3,6 and 12 months after the treatment,no scars or skin discoloration was observed.The average duration of follow-up was 1 year,and the longest duration of follow-up was 2 year and 4 months.No relapse occurred during the follow-up.Conclusion Ultrapulsed fractional CO2 laser is effective and safe for the treatment of porokeratosis in children.