Article Text

PDF
A 23-month-old girl with chronic ‘seborrhoeic’ dermatitis, dehydration and failure to thrive
  1. Pierluigi Marzuillo1,
  2. Anna Grandone1,
  3. Stefano Guarino1,
  4. Andrea Apicella2,
  5. Iacopo Panarese3,
  6. Ludovica Picciano1,
  7. Maria Cristina Fedele1,
  8. Federica Palladino1,
  9. Silverio Perrotta1,
  10. Emanuele Miraglia del Giudice1
  1. 1Department of Woman, Child and General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Campania, Italy
  2. 2Pediatric Department, AORN Santobono-Pausilipon, Napoli, Italy
  3. 3Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Campania, Italy
  1. Correspondence to Dr Pierluigi Marzuillo, Department of Woman, Child and General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy; pierluigi.marzuillo{at}gmail.com

Statistics from Altmetric.com

A 23-month-old girl with poor growth and decreased appetite over the past year (figure 1) and increased thirst (including night-time) for the last month was admitted with dehydration and somnolence without vomiting/diarrhoea. She appeared to be miserable and in pain. Capillary refill time was about 2 s. A 1 cm liver edge was palpable. Ear discharge was not evident. Her blood pressure was 75/40 mm Hg and pulse was 115 beats/min. A ‘seborrheic’ dermatitis of the scalp and of the suprapubic region—persisting for 1 year despite topical steroids and antibiotics—was evident (figure 2A–C). On biochemical examinations sodium was 143 mmol/L, glucose 4.1 mmol/L, urea 5.7 mmol/L, total serum proteins 43 g/L, albumin 22 g/L, alanine aminotransferase 227 IU/L, aspartate aminotransferase 181 IU/L, γ-glutamyl transferase 397 IU/L, C-reactive protein 89.3 nmol/L, erythrocyte sedimentation rate 80 mm/hour and creatinine 31.8 µmol/L. Urinalysis was normal, as well as international normalised ratio, prothrombin time and partial thromboplastin time. The abdominal ultrasound revealed a splenic hypoechoic area of about 1 cm. The child’s liquid intake and diuresis …

View Full Text

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.