Shriners Hospitals for Children® – Boston is a pioneer in the treatment of burn injuries and scarring. We also provide treatment for other conditions and syndromes that affect the skin, including those described below. Patients receive care from a group of experts who are well-versed in the care of these conditions.
Congenital Hairy Nevus
Present at birth, congenital hairy nevus is a type of mole that can appear anywhere on the body and is categorized by size (small, medium or large). While often benign, it is possible for the mole to turn into a malignant melanoma (cancerous) and is best treated at an early age.
Hairy nevus moles differ from typical moles in that they often have coarse surface hairs. The presence of the mole at birth, or a mole that becomes more visible shortly thereafter, is also an indication that it may be a hairy nevus mole, as most moles develop later in life.
Congenital hairy nevi form in a variety of shapes and sizes. The borders of the mole can vary as well, appearing sharp, regular, irregular or blending into the surrounding skin. The surface of the mole is often textured and can appear either with or without hair. The moles generally appear in only one spot, but in about five percent of cases, are found in multiple areas. Some can be quite large.
The most common form of treatment for congenital hairy nevus is surgical removal of the mole. When the mole is small, one procedure can effectively remove it. In cases of large or multiple nevi, or when the nevi appears in delicate areas such as on the eyelids, nose or ears, surgeons may also include a skin graft after the removal process.
A surgical and medical consultation with a specialist at Shriners-Boston is the best way to ensure your child’s condition is treated promptly and with their unique case in mind.
Hydradentitis Suppurativa, or HS, is a chronic inflammatory condition of the skin that results from clogging of the apocrine sweat glands. Clogging of these glands can result in clusters of lesions, ranging in size from small (pimple-sized) to large (about the size of a golf ball). They typically appear in areas where the skin folds meet and rub together, such as the tops of the groin, between the buttocks, underneath the breasts (in females), in the genital area and in the armpits.
HS tends to begin after puberty and can become quite problematic if lesions become infected, particularly in individuals who have compromised immune systems.The cause of the condition is not certain. Family history and excessive perspiration (which aids in clogging the apocrine sweat glands) may be contributing factors. Stress or other conditions may play a role. Patients with Crohn’s disease or irritable bowel syndrome may be at increased risk of developing HS.
If your child suffers from frequent boils, a consultation may be advisable. Treatment options for HS varies widely according to the severity of the condition and may include skin hygiene, antibiotics and, in some cases, surgery.
Port Wine Stains
Port wine stains are reddish-purple birthmarks that can appear anywhere on the body, but most often occur on the face, neck, scalp, arms or legs. At birth, a port wine stain can appear pink, but it becomes darker as the child ages. Changes in texture may occur with growth. A smooth and flat birthmark in childhood can later thicken or become pebbled.
Port wine stains are neither dangerous nor painful, but can cause self-esteem and confidence issues, especially in children with darker-colored birthmarks in prominent places like the face. In rare cases, port wine stains have been associated with neurological disorders such as seizures, delays in development or learning disabilities.
Staged laser therapy is the most effective form of treatment. Local anesthesia can be used to minimize discomfort from the laser, and small children may be given general anesthesia while undergoing treatment.
Purpura fulminans is a rare condition that occasionally develops after another serious infection that causes septic shock. The condition begins quickly and generally progresses at a rapid rate, destroying tissue and causing severe hemorrhaging or bleeding of the skin.
Because of purpura fulminans’ quick progression and grave symptoms, fatalities can occur within 48 to 72 hours if left untreated. Children and babies who display symptoms of the condition should be treated at the hospital immediately. Symptoms of the conditions include small, bluish bruises on the extremities, shock, lethargy, fever, chills, and bleeding with minor trauma (such the site of an IV insertion).
The course of treatment will differ for each child, depending on the severity of the condition and its location on the body. Treatment may include medications, antibiotics, and surgery. Many children require intensive care.
Stevens-Johnson syndrome is a severe skin reaction to medication. Infection like HIV, influenza, typhoid or hepatitis can also bring about the syndrome. The syndrome begins as a rash with blisters, after which the top layers of skin may slough. Complications that may develop from Stevens-Johnson Syndrome include skin infection, eye inflammation, internal organ damage, and permanent skin changes.
Early onset symptoms may seem flu-like, including fever, sore throat, cough and burning eyes. These are followed by more serious symptoms that may include tongue and facial swelling, hives, a fast-spreading red or purple rash, blisters and shedding or sloughing of the skin.
The first step for treatment is to discontinue the use of any and all non-essential medications a child has been taking. Other treatment may include wound care and fluid replacement. Medication may be used to control the infection, manage pain and/or decrease inflammation. Many children will require intensive care.