bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surveillance Cameras and Resistance: A Case Study of a Middle School in China
Authors: Shi Chen , Xu Jianhua 
Published: January 2024

Abstract
China has rapidly evolved into a surveillance society. While much attention has been paid to describing the leviathan represented by the presence of surveillance cameras in China, empirical evidence on the mechanisms of the creep of surveillance remains limited. Using data collected through fieldwork and in-depth interviews, this study explores the spread of surveillance cameras and the resistance encountered in a middle school in northern China. We find that surveillance cameras were first introduced for security purposes, but their application was quickly expanded to discipline students and avoid responsibilities in school management. We further explore the resistance to the creep made possible by the existence of exempted spaces, the difficulty of self-surveillance, and what might be called the boomerang effect. Through the case study of a middle school, this research sheds light on the formation of the Chinese surveillance society from a bottom-up approach and contributes to the global literature on surveillance creep.
O03 Sarcoidosis in a Boy with Severe Eczema on Dupilumab
Authors: Shahid Musarat , Davis Penny , Taibjee Saleem , Moss Ceilia , Ogboli Malobi 
Published: January 2024

Abstract
Sarcoidosis, a systemic granulomatous disease of unknown aetiology, is rare in children. Presentation varies according to the extent and severity of organ involvement and is typically multisystem in older children. Drug induced sarcoidosis-like reaction (DISR) has recently been reported in patients taking Dupilumab. We describe a patient who developed sarcoidosis while on Dupilumab and question whether this was caused by the drug.
A 14-year-old boy with severe eczema developed widespread cutaneous nodules and papules after 30 months on Dupilumab. Histology showed non-caseating granulomas. A raised serum angiotensin converting enzyme level, asymptomatic coarse interstitial markings on chest x-ray and small lung nodules on CT scan were also consistent with sarcoidosis. Dupilumab was stopped and hydroxychloroquine and methotrexate commenced. Joint and liver involvement developed 4 months later so systemic glucocorticoids were and the methotrexate was changed to mycophenolate mofetil.
To our knowledge there have been 3 previous reports of DISR on Dupilumab. The clinical picture is almost indistinguishable from sarcoidosis. In this case continuing evolution of sarcoidosis 4 months after stopping Dupilumab argues against DISR. However, as Dupilumab becomes more widely used, it is important to be alert to the possibility of new adverse reactions.
O04 Vulval Psoriasis in Children: A Clinical Audit and Review of Literature
Authors: Wu Michelle , Fischer Gayle 
Published: January 2024

Abstract

Objective
Vulval psoriasis is frequently under-recognised, under-­diagnosed and under-treated in children due to its nonspecific presentation. This retrospective chart review is aimed to describe the symptoms, signs, and management of vulval psoriasis in children in a private vulval disease referral practice.

Materials and methods
A retrospective, single-centre cohort study of children was undertaken at a large, combined dermatology and gynaecology practice from January 2016 to January 2023. Clinical photographs and treatment data were systematically collected and recorded in an online patient database. Treatment regimens were individualised and titrated to clinical response.

Results
This seven-year retrospective cohort study included a total of 100 children with vulval psoriasis. The most common presentation was nonspecific erythema (85%) that is well-demarcated in one-third of children and appears as a raised plaque in one-fifth of children. In 78% of the patients, evidence of psoriasis was found on other parts of the skin. Initial induction treatment with potent topical corticosteroid followed by maintenance treatment with less potent topical steroids and topical tar creams. 5% of children required systemic treatment.

Conclusions and Relevance
Vulval psoriasis often presents as a nonspecific chronic erythematous vulvitis without vaginitis. It is a chronic relapsing skin condition that requires long-term management. Systematic treatment is required in a small proportion of children.
O05 A Qualitative Study of the Psychological Morbidity in Paediatric Survivors of Stevens Johnson Syndrome and Toxic Epidermal Necrolysis
Authors: Phillips Christopher , Mcniven Abigail , Yeung Michelle , McPherson Tess 
Published: January 2024

Abstract

Background
Steven Johnsons Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare but devastating skin conditions. In adults, the long-term psychological sequelae are known(1), however, there is no such research in the paediatric population(2).

Objective
Our study’s aim was to explore the experiences of children and young people (CYP) and their parents during and after their illness and the subsequent physical and psychological sequelae.

Method
A retrospective qualitative study with a grounded theory approach was undertaken using detailed semi-structured interviews. 13 CYP and families who had been admitted to a tertiary referral centre were interviewed. Interview transcripts were analysed by three different researchers and themes emerging were identified.

Results
Age range of those interviewed was 10-24 years. Following discharge, patients frequently had ongoing physical issues and psychological morbidity. Common themes included inadequate information on discharge and a desire for more psychological aftercare for both CYP and parents. SJS/TEN and its causes did not appear to have been clearly explained. While there was marked heterogeneity in the experiences and impact on CYP, all parents interviewed cited symptoms of health anxiety, and some believed they had developed subsequent mental health issues.

Conclusion
Subsequent physical disability, health anxiety, psychological morbidity and little understanding of SJS/TEN were themes that were prevalent from our interviews.
Families desire a more co-ordinated and holistic aftercare plan which may contribute to a better understanding of SJS/TEN as well as give opportunity to address the long-term physical and psychological morbidity of SJS/TEN.
O06 Clinical phenotype of the Klippel-Trenaunay syndrome with mosaic PIK3R1 mutations
Authors: Vabres Pierre , Engel Camille , Bessis Didier , Morice-Picard4 Fanny , Aubert Hélène , Isidor Bertrand , Phan Alice , Boccara Olivia , Mazereeuw-Hautier Juliette , Maruani-Raphaël Annabel , Puzenat Eve , Kuentz Paul 
Published: January 2024

Abstract
Segmental overgrowth syndromes with cutaneous vascular malformations (Klippel-Trenaunay syndrome (KTS), CLOVES syndrome) are mainly due to mosaic PIK3CA mutations, but the GNAQ, GNA11, HRAS, KRAS, MAP2K1, AKT1, AKT3, and PIK3R1 genes may also be involved. We sought to determine the frequency and phenotype of patients with PIK3R1-related segmental overgrowth.
Patients were ascertained nationwide in the French MUSTARD cohort of skin mosaic phenotypes. We searched for PIK3R1 mutations by next-generation sequencing on affected tissue in 297 patients with a clinical presentation suggestive of PIK3CA related overgrowth (PROS), but without PIK3CA variants. We retrospectively studied the clinical phenotype of PIK3R1-positive patients.
We identified three missense variants and six in-phase indels of PIK3R1 in 15 patients (5.0%), exclusively in affected tissue. Variant allele fraction was 2.0% to 12.0%. We found extensive pale or dark capillary malformations in 14 patients, segmental overgrowth in 11, venous truncal anomalies (varicose veins or persistent lateral marginal vein) in 10, lymphatic malformation in six and a café-­au-lait macule or naevus spilus in three, thus defining phacomatosis pigmento-vascularis (PPV). One patient had limb hypoplasia. None had MCAP (Megalencephaly-Capillary malformation).
PIKR1 mutations account for a minority of patients with KTS/CLOVES (5%). They are about 20 times less common than PIK3CA mutations. Truncal venous malformations, limb hypoplasia and PPV (spilorosea or melanorosea type) may be more common in PIK3R1-related KTS. No patient had severe or life-threatening involvement. Whether Sirolimus or Alpelisib are treatment options remains to be determined.
P01 Pigmented and purpuric patches in sun protected areas of a 9 year old child
Authors: Grechin Cristina , Law Ruth , Collins Sinead 
Published: January 2024

Abstract
Pigmented purpuric dermatosis-like mycosis fungoides (PPD-like MF) is a rare variant of paediatric mycosis fungoides (MF). Clinically, it can be challenging to diagnose and differentiate from pigmented purpuric dermatosis (PPD). Usually, has an indolent course if diagnosed in the early stage. The lesions often localize to sun-protected areas with three stages: patch, plaque, and tumour. Clinical features alone are insufficient for diagnosis and a skin biopsy is mandatory.1
We report a nine year old boy who presented with a three year history of a persistent, slowly progressing, mildly pruritic and scaling rash on the right buttock and medial thighs bilaterally. He was otherwise well with no other relevant medical or family history of note. The physical examination revealed erythematous to purpuric, mild scaly patches with confluent involvement on the right buttock extending to less defined involvement of the both inner thighs. The body surface area involved was less than &lt;10%. No other clinical findings on examination. A punch biopsy for haematoxylin and eosin (H&E) staining was consistent with mycosis fungoides. T cell receptor gene rearrangement testing detected a monoclonal T-cell population. A diagnosis of pigmented purpuric dermatosis-like mycosis fungoides was made.
The patient responded well to a potent topical steroid (mometasone furoate) daily which was gradually tapered to twice weekly/intermittent usage to maintain response.
P02 Erythrokeratodermia variabilis et progressiva due to a pathogenic variant in GJB3 gene
Authors: Bageta Maria , Balboa Pablo Lopez , Lomas Debra , Petrof Gabriela , Martinez Anna E 
Published: January 2024

Abstract
Erythrokeratodermia variabilis et progressiva (EKVP) is a clinically heterogeneous group of inherited disorders characterized by the coexistence of localized or generalized hyperkeratotic plaques and transient, stationary or migratory erythematous patches. EKPV is most often transmitted in an autosomal dominant manner. Causal pathogenic variants have been detected in the GJB3, GJB4, GJA1 KDSR and KRT83 genes encoding connexins 31, 30.3, 43, 3-ketodihydrosphingosine reductase and keratin 83, respectively. Connexins are expressed in almost all tissues and pathogenic variants in the connexin genes can cause skin diseases, cardiovascular disorders, myelin-related diseases, craniofacial disorders and hearing loss.
We present a 2-year-old girl who was referred to our centre with well-demarcated hyperkeratotic plaques symmetrically distributed with a predilection for the distal extremities and buttocks as well as erythematous plaques on her cheeks. The hyperkeratotic plaques were hyperpigmented, exhibited a geographic morphology and had prominent hypertrichosis. Her trunk and upper extremities were spared and her hair, teeth and nails were normal. There was family history of mild psoriasis in her mother and mild eczema in her father. Next generation sequencing confirmed she was heterozygous for the GJB3 c.625C&gt;T p.(Leu209Phe) pathogenic variant which is associated with erythrokeratodermia variabilis et progressiva-1 (MIM 133200) and autosomal dominant deafness-2B (MIM 612644).
Erythrokeratodermia variabilis is largely a skin-limited condition however GJB3 pathogenic variants can cause haring loss and neuropathy due to its expression in peripheral nerves and the cochlea. Our patient’s hearing and development have been normal to date and will be monitored.
P04 A Complex Case of Urticaria
Authors: Madhwapathi Vidya , Diba Vicky , Ogboli Malobi 
Published: January 2024

Abstract
An 11 year old female, with Type 1 diabetes and no previous atopy or allergy , presented with a 6 week history of facial swelling and a generalised urticaria on the trunk and limbs.
She had been seen privately by “Allergy” clinic and diagnosed with chronic spontaneous urticaria with angioedema. Blood tests for common allergens were negative, with a total IgE &lt;20 kU/L. Treatment with Loratadine, Cetirizine 10mg, Fexofenadine 120mg QDS, Acrivastine 8mg BD, Montelukast 10mg OD and prednisolone 20mg OD had only a limited effect.
Skin biopsy confirmed urticaria with no evidence of vasculitis. Immunology bloods were negative.
Despite reporting compliance, she continued to experience debilitating symptoms with raised UAS scores. Desloratadine 2.5mg BD and multiple intermittent short courses of prednisolone were needed.
Omalizumab was started at 300mg monthly for 6 months with partial improvement. However symptoms flared on cessation and following tertiary advice, a 2nd course of Omalizumab was commenced at 300 mg s/c monthly for 3 months & 300mg s/c fortnightly for 3 months with the addition of 100mg BD Ciclosporin and Famotidine 10mg BD. Ciclosporin was discontinued after 1 month due to side effects and substituted with Methotrexate 15mg OW.
If control is not obtained, management plans include Mycophenolate Mofetil, or trialing omalizumab 450mg S/C monthly.
This is a case of extremely difficult to control urticaria in a child highlighting available systemic treatment options1.
P06 Outcomes from a New Combined Allergy and Dermatology Clinic- A Retrospective Review
Authors: Liew Su Yi , Ahmed Samid , Abdul-Wahab Alya , Wells Rosy , Ferguson Leila 
Published: January 2024

Abstract
Early introduction to known allergens such as peanuts can reduce subsequent development of allergies [1]. In 2019, an audit in our department of 35 babies under age 1 referred with eczema showed that 4 were concomitantly referred to allergy and 20 were referred to allergy after dermatology consultation. The majority had moderate/severe eczema and 31% had implemented dietary restrictions before the dermatology consultation. In 2021, a combined allergy and dermatology clinic was introduced to provide a holistic approach, particularly for young children. Patients are triaged from GP referrals or as follow-up from either team. We conducted a retrospective notes review to explore the benefits/outcomes. 57 patients were included with an average age of 4.75 years and 58% were below age 2. 58% had their dermatology plans changed. Before the clinic, 81% had dietary exclusions but only 46% had new allergies confirmed. 29% of the patients who underwent testing tested negative to all allergens, which allowed parents to reintroduce foods at an early age. This review shows that the combined clinic allowed young patients early access to allergy testing due to streamlined services, preventing unnecessary dietary exclusions. Additionally, patients with severe eczema without allergies benefit from early dermatology intervention. In fact, 44% of patients were suitable for discharge from dermatology directly from the combined clinic or at first follow-up appointment.
P08 Shingles in two children with no history of chicken pox
Authors: Eisner Mark , Darné Sharmela 
Published: January 2024

Abstract
We present two cases of dermatomal, vesicular eruptions in young children. Both were otherwise well with no history of immunocompromise or prior chickenpox (varicella).
Child A was 3 years old and presented with painful erythema and pustules to the left side of his nose and cheek with a sharp midline demarcation. He was admitted by the paediatricians, unwell and treated with antibiotics and acyclovir for presumed impetigo or herpes simplex virus infection. However, the swab was positive for varicella zoster virus (VZV), which in this dermatomal distribution is in keeping with shingles.
Child B was an 18-month-old girl who was referred with a dermatomal vesico-pustular eruption on the left forehead, scalp and nose unresponsive to antibiotics. Despite the lack of varicella history, shingles was suspected, and the child was started on aciclovir. Swabs were positive for VZV.
Shingles is rare in children and usually associated with immunocompromise. It is especially rare in those with no prior history of chicken pox and of the cases in the literature, almost all have had previous vaccination to chicken pox resulting in latent infection and subsequent shingles. We surmise that our otherwise well patients, with no prior vaccination, had previous asymptomatic chicken pox. There was a delay in the diagnosis of patient A who went on to develop trigeminal trophic syndrome with recurrent paranasal ulceration over 18 months. We highlight these cases to make clinicians aware of the possibility of shingles even in very young, immunocompetent children with no prior history of chickenpox.
P09 A prospective study of Narrowband UVB (nb-UVB) Phototherapy for atopic dermatitis (AD) in children and adolescents.
Authors: Sambi Pavan , Warburton Katharine , Montgomery Rachel , Majeethia Parisha , Thompson Mia , Clark Sheila 
Published: January 2024

Abstract
We evaluated response to thrice weekly nb-UVB for AD (maximum 40 exposures), to assess outcomes immediately post-treatment and 12 months later. Post-treatment follow up was 3 monthly for 12 months. We sub-analysed response in different ethnicities.
58 patients were recruited: 37 (64%) male, 21 (36%) female, age-range 4.1-16.9 (mean 10.6) years. Ethnicities were: White Caucasian 22 (38%), Southern Asian (Pakistani/Indian/Bangladeshi) 17 (29%), Black African/Caribbean 9 (16%), Other 10 (17%).
Immediately post-treatment, EASI 75 was achieved in: Overall 49%, Caucasian 48%, Southern Asian 50%, African-Caribbean 44%, other 56%. Mean EASI reduction was: Whole group 10.0, Caucasian 12.4, Southern Asian 8.6, African-Caribbean 2.5, Other 7.5.
12 months post-treatment (compared to pre-treatment), EASI 75 was achieved in: Overall 28%, Caucasian 33%, Southern Asian 40%, African-Caribbean14%, other 13%. Mean EASI reduction was: Whole group 7.6, Caucasian 9.0, Southern Asian 8.6, African-Caribbean -2.1 (worsening), Other 8.0.
Erythema was the most common side effect noted in 33% of patients, the incidence in Caucasians 50% (n=11), other 30% (n=3), African-Caribbean 22% (n=2) and Southern Asian 12% (n=2).
A similar proportion achieved EASI 75 across the different skin types, however, more variation in EASI score reduction was noted in skin of colour. A lower incidence of post-treatment erythema noted in darker skin types may be due to erythema underscoring or treatment underdosing.
Our study showed sustained AD improvement up to a year after stopping treatment in 28% overall, highest in Caucasian and Southern Asian patients, with greater risk of relapse noted in African-Caribbean patients.
P10 New rash in a child of skin of colour
Authors: Aslam Muhammad Fawad , Hoey Susannah 
Published: January 2024

Abstract
A 7 year old Nigerian girl was referred by Haematology to the Paediatric Dermatology team with “suspected eczema”.
She had known sickle cell disease, for which she was on hydroxycarbamide, Mum reported an 8 month history of a new rash with no systemic features. She had marked indurated plaques on face, forehead and forearms which were associated with scarring and hyperpigmentation. She had a number of investigation including negative urine dipstick. ANA was positive with elevated RO and RNP antibodies. Inflammatory markers were normal. Skin biopsy results were consistent with discoid lupus erythematosus. Stringent photo protection and sun blocking creams were advised. She was commenced on potent topical steroids and hydroxychloroquine which is first line systemic treatment. Within 4 weeks of commencing hydroxychloroquine there was significant flattening of the plaques. She was referred to Paediatric Rheumatology for assessment, given her high risk features.
Clinical features of DLE in children are similar to adult DLE in presentation and chronic course. However it is rare in children with less than 2% of patients developing DLE before 10 years of age. DLE tends to be more common and severe in skin of colour. There are complications of scarring and pigmentation. It is important to be aware of the psychological impact on both parent and child’s quality of life. There is high risk of transition to SLE in children with DLE and hence screening bloods and early referral to Rheumatology should be considered.
P12 Teleconsultations for Eczema in CHildren (TECH) feasibility study: a UK online survey of young people and parents
Authors: Stokes Natalie King , Daly Aoife , McCusker Sarah , Hunjan Manrup , Vincent Ellen , Lowe Ashima , Charman Carolyn , George Susannah , Solman Lea , Burden-Teh Esther 
Published: January 2024

Abstract
Providing teleconsultations for appropriate patients is a priority for outpatient service transformation, yet little evidence exists on their effectiveness and acceptability in paediatric eczema. We conducted a UK-wide online patient and parent survey to explore experiences of eczema teleconsultations. Further objectives included determining patient preferences and costs incurred with different appointments.
Young people (13-16 years) and parents of children (0-16 years) with eczema, who had had a follow-up teleconsultation under secondary/tertiary care dermatology were eligible. Ethical approval was sought and a Jisc Online survey was advertised on social media for 12 weeks. Data was analysed descriptively in Microsoft Excel.
There were 51 responses (31 parents, 20 adolescents) from across the UK. Most participants were receiving topical treatment, with 8 on systemic therapy. Of those who had experience of face-to-face appointments, 31/42 (73.8%) were ‘satisfied or very satisfied’, compared with 19/46 (41.3%) for telephone, 10/14 (71.4%) for video and 4/10 (40%) for online/mobile messaging. 49 (96.1%) participants reported they would feel ‘happy or very happy’ if their next appointment was face-to-face, compared with 14 (27.5%) for telephone, 14 (27.5%) for video and 6 (11.8%) for online/mobile messaging. 34 (66.7%) participants’ first-choice consultation was face-to-face, followed by 8 (15.7%) preferring a combination of face-to-face and telephone. Many commented that face-to-face was better for assessing the skin.
These results, along with a qualitative interview study currently underway, provide an insight into the experiences and preferences of young people and parents regarding eczema follow-up and will help inform a future trial.