Abstract Carbon baby syndrome also known as universal acquired melanosis is one of the rare causes of diffuse and progressive hyperpigmentation of the skin. A case of a 9-year-old Nepali child was reported in whom darkening of the skin began at the age of 5 months. At presentation, generalized hyperpigmentation was observed with characteristic sparing of pressure areas over the palms and soles. The diagnosis was established by histopathological evidence of epidermal and dermal melanization after the exclusion of all cutaneous and systemic causes for such hyperpigmentation. This case is reported for its rarity and unusual clinicohistopathological features.

Abstract Pityriasis rosea (PR) is a common acute and usually self-limiting papulosquamous dermatosis that typically affects children and young adults. Fixed-drug eruption (FDE) is a type of cutaneous adverse drug reaction that reoccurs at the same site when the offending drug is reingested. We are presenting this case of a 2-year-old child because of the simultaneous presentation of both PR and FDE in the same individual at the same time.

Abstract Pyogenic granuloma (PG) is a benign vascular tumor removed surgically or by physical modalities, such as electrocautery and cryotherapy. Other treatment options may be warranted, especially in children, using nonsurgical approach. The study aims to determine the effectiveness and safety of topical treatments on PG in children in the clearance of lesions. Systematic literature search were done in February 2023 in the following database: PubMed, HERDIN, Cochrane Library, Hindawi, Directory of Open Access Journals, ScienceDirect, and Google Scholar. The search included studies involving PG treated with topical medications in the pediatric age group. Twenty-five studies (9 cohort studies, 6 case series, and 10 case reports) were included and utilized the following medications: timolol, propranolol, corticosteroids, common table salt, imiquimod, and ingenol mebutate. Among the medications, timolol was the most reported drug to provide partial to complete resolution in 62 out of 149 patients. All the reviewed topical medications provided partial to complete resolution with minimal adverse effects. Among them, topical timolol, propranolol, and table salt have demonstrated high response rates. Topical therapy in children with PG may be considered as a nonsurgical option. However, further clinical trials are warranted to determine its effectiveness.

Abstract Tuberous xanthomas are nontender, yellow to red papules to nodules that occur on the extensor surface, and trauma-prone areas such as the elbows, knees, Achilles tendon, and buttocks. A 10-year-old female child born out of second-degree consanguineous marriage presented with multiple skin-colored nodular lesions on axillary folds, both elbows, cubital fossa, medial side of the wrist, interphalangeal joints, buttocks, knees, popliteal fossa, and Achilles tendons. After complete evaluation, diagnosis of familial hypercholesterolemia type IIa with tuberous xanthoma was made. Tuberous xanthoma usually presents in combined type III dyslipidemias, but in our case, it is presented in type IIa familial hypercholesterolemia. Early diagnosis and treatment of familial hypercholesterolemia are important for preventing complications.

Abstract Insulin-induced panniculitis is a rare entity. It represents the early stage of development of lipoatrophy. The complex of insulin and insulin antibodies leads to the activation of macrophages, which is responsible for the initiation of autoimmune process and leading to panniculitis followed by subsequent development of lipoatrophy. Here, we report the case of insulin-induced panniculitis with lipoatrophy associated with Type 1 diabetes mellitus in an 11-year-old female child.