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Meet the Editors

Tina Tan, MD, FAAP, FIDSA, FPIDS—editor in chief of 

, professor of pediatrics at Northwestern University’s Feinberg School of Medicine, Infectious Diseases attending at Lurie Children's Hospital of Chicago, and president of the Infectious Diseases Society of America.

Articles

Editor-in-chief Tina Tan, MD, FAAP, FIDSA, FPIDS, highlights the April, 2025, issue of Contemporary Pediatrics, with a special focus on pediatric allergy awareness. 

A preview of the April Allergy Awareness issue of Contemporary Pediatrics

. He joined the brand in March of 2023 as an editor before being promoted to senior editor in January 2024. Fitch graduated from Youngstown State University in Youngstown, Ohio in 2020 with a degree in telecommunications and journalism. He started his career as a news and sports videographer before becoming an on-air sports anchor at the NBC-affiliated news station in Youngstown. Fitch briefly worked as a national content writer for a Chicago-based national television station before joining the 

team. He can be reached at: jfitch@mjhlifesciences.com.

A newly published Swedish study supports other research that suggests screen time displaces sleep in multiple ways. 

Sleep disruptions, depressive symptoms linked to screen time among girls

View our Q1 2025 recap of standout pediatric news from FDA regulatory updates, clinical trial results, and expert commentary.

Q1 2025: A recap of the top headlines and interviews

Flovent was discontinued in January 2024 due to the manufacturer electing to produce only an authorized generic version of the medication. 

Inhaled corticosteroid alternatives for young children after Flovent withdrawal

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Dr Still is a pediatric resident, University of Nevada School of Medicine, Las Vegas.

**Editor's Note** Please note that starting January 1, 2025, we will be switching to an online-exclusive publication process. This will allow us to publish case submissions quicker without having to deal with the variables that come along with print publication. All cases will still be eligible for print publication consideration, but publication in our print magazine is not guaranteed and will be up to the editor's discretion. 

Do you have a puzzling pediatric case that you’d like to share with the readers of 

We are looking for intriguing diagnoses that have stumped the experts—a diagnostic “Puzzler”—to help our physicians enhance their day-to-day practices. If you have such a story to tell, tell us.

Here’s what to do: Before you begin, we suggest that first you review the Puzzler 

https://www.contemporarypediatrics.com/case-studies

. Please note the specific style required for writing Puzzler manuscripts.

Next, prepare a draft of your case, including a summary of the presenting symptoms, a case overview, a 

table of the differential diagnosis (MANDATORY)

, and the special aspects of your case that qualify it as a Puzzler, and send it to us. Please note that the differential diagnosis table should also be discussed in the body text. We’ll review your draft and let you know what you need to add or revise before we send the manuscript to peer review for evaluation.

Puzzlers vary in length, and we suggest a minimum of 1,200 words up to a maximum of 2,000 words, but that is because of the complexity of some cases and whether some patients returned for many assessments before their diagnoses were determined. Also, some authors describe the pathophysiology of the differentials in great detail. Please also note no more than 3 authors are allowed per article.

What's most important is to show us the process that you used to analyze the case, including:

Why you decided to order certain tests and why you did not order others.

Peer consultations or why you elected to contact other specialists.

Lab values including vital signs or blood tests.

Labs and values if your patient was attended to in the emergency department or other hospital departments such as radiology or neurology.

Discussion related to the possible diagnoses.

Final diagnosis, treatment, prognosis, and follow-up.

Remember to indicate numbered citations within the body of the text and include a complete list of corresponding literature/references at the end of the manuscript. (Do not use any citation management programs or unlink them.) 

Limit references to 25. No references (unless it is a seminal study) can be older than 10 years.

We prefer primary research as references, but some cases are so obscure that authors will need to pull from a variety of sources. However, 

. Be advised that peer reviewers are adamant that the disease/disorder you describe was actually diagnosed and not determined by index of suspicion on the basis of ruling out various differentials. We use AMA11 as our publication style, which uses superscript citation numbers and a corresponding numbered reference list. Please create your citations and references in this style.  Check this recent article posted online at 

https://www.contemporarypediatrics.com/view/the-rx-of-adhd

 for examples of reference style. IMPORTANT NOTE WITH AMA 11TH EDITION: PLEASE PUT DOI OR WEBSITES/URLS AT THE END OF THE REFERENCE LINE.

When you send your draft manuscript, also 

. These image files must be high-resolution jpg or tiff files (minimum of 300 dpi) and as large in size as possible. We suggest a minimum of 7 horizontal inches. The images must be original photos with clear permissions to use, not images from copyrighted sources. Send as separate attachments with your e-mail submission; do not embed images into your manuscript document.

After we receive your manuscript, our editors and peer reviewers will review your draft and let you know if we accept your submission for publication. 

Puzzler is one of the departments for which we receive the most submissions, so it may be several months after submission before you receive feedback from us.

If we do accept your submission for publication, we will contact you with further instructions.

Send your submissions in Microsoft Word format to 

, via e-mail to mpetronelli@mjhlifesciences.com

Guidelines for PUZZLER, Contemporary Pediatrics

 poll. Take a look at the following case below. After reading through the description, choose a multiple choice answer and try to guess the correct patient diagnosis. 

 on Friday, April 4, 2025 at 12:00 PM ET or later for the full case presentation, differential diagnoses, and the correct patient diagnosis. The full case will be presented as a separate article on our home page. 

This case was presented by Rylee Moody, BS; Mary Gibney, MD;and Elaine Siegfried, MD

A 21-month-old girl presented with a history of "skin tags" involving her gluteal cleft,noted at birth (Figure 1A). She was otherwise healthy and developing normally. Notably, her older sister had a confirmed history of molluscum contagiosum (MC).

Skin exam featured three prominent2-4 mm soft, pedunculated papules within the superior aspect of hergluteal cleft, as well as sparsely scattered 1-2 mmpapulescharacteristic of MC on the gluteal prominences and in mirror distribution on the perianal mucosa.

 on Friday, April 4, 2025 at 12:00 PM ET or later for the full case presentation, differential diagnoses, and the correct patient diagnosis. 

The full case will be presented as a separate article on our home page. 

Can you diagnose this patient? Take our poll and find out! Then check back for the full case, differential diagnosis, and correct diagnosis. 

News

Case Studies

Diagnose this 21-month-old with history of “skin tags” on her gluteal cleft 

 on Wednesday, March 26, 2025 at 12:00 PM ET or later for the full case presentation, differential diagnoses, and the correct patient diagnosis. The full case will be presented as a separate article on our home page.

This case was presented by Ngozi I. Eboh, MD, FAAP, FHM, Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, Texas

A 13-year-old female with a history of iron deficiency anemia presented with altered mental status preceded by 5 days of headache, vomiting, nausea, and worsening somnolence that was not responsive to flumazenil, naloxone, or ammonia salts. She had a Glasgow coma scale of 12 and was drowsy with no cranial nerve deficits, or other abnormal physical examination findings. Laboratory evaluation showed microcytic anemia (hemoglobin 7.7 g/dL and MCV (mean corpuscular volume):64.7, lymphocytosis, and mildly elevated liver enzymes [Aspartate Aminotransferase (AST) 52, Alanine Transaminase (ALT) 110] otherwise her electrolytes and kidney function were normal. 

Urine toxicology, Tylenol level, Salicylate level, alcohol level thyroid studies, iron studies, hepatitis panel were normal. Urine pregnancy and COVID tests were negative. Head computed tomography (Head CT) showed mild hydrocephalus, and brain magnetic resonance imaging (MRI) showed increased signal folia and compression of the lower portion of the fourth ventricle and foramen of Magendie. 

She then had an emergency external ventricular drain placed (EVD) by pediatric neurosurgery, and the team started her on high-dose steroids and intravenous immunoglobulin (IVIG). On the third day of admission, she developed new onset left-sided facial drooping, drooling, downbeat nystagmus, and difficulty following commands. An emergent subcortical craniectomy and decompression, duraplasty, and cerebellar biopsy were performed. A cerebellar biopsy was performed due to findings on brain MRI.

Click here for the full case presentation, differential diagnoses, and the correct patient diagnosis.

Poll: Can you diagnose this 13-year-old female with altered mental status?

 – Pediatric primary care nurse practitioners, family nurse practitioners, psych-mental health nurse practitioners, and clinical nurse specialists seeking to address the growing mental health needs of children and adolescents now have a new option to satisfy eligibility for the 

Pediatric Primary Care Mental Health Specialist (PMHS)

Patient-Centered Mental Health in Pediatric Primary Care (PPP)

ealth, commonly known as The REACH Institute, is a 501(c)(3) nonprofit dedicated to expanding access to effective, evidence-based mental health care for children and families. The recognition by the 

 (PNCB) highlights the value of REACH’s PPP program in equipping its participants with specialty knowledge of pediatric behavioral and mental health in primary care.

The PMHS certification is a prestigious added-specialty credential that builds upon the nurse practitioner and clinical nurse specialist roles and validates advanced expertise in assessing, diagnosing, and managing developmental, behavioral, and mental health concerns of children, adolescents, and young adults in primary care settings. PNCB’s recognition of REACH’s PPP program means that alums of the program can now use their training to meet requirements for the Specialty Program pathway for the PMHS certification exam and take a crucial step in advancing pediatric mental health care.

, approximately 1 in 5 children in the U.S. have a mental, emotional, or behavioral disorder, yet only a small fraction of them (20%) receive the help they need. 

 projects the treatment gap to worsen as the demand for child and adolescent psychiatry will grow twice as fast as the supply of those physicians.

“We are dedicated to ensuring that the most effective, scientifically proven mental health care reaches all children and families,” said The REACH Institute CEO Lisa Hunter Romanelli, Ph.D. “With wait times for behavioral health services often months long, this recognition by PNCB will empower more advanced practice nurses to help pediatric patients and their families manage common mental health concerns in primary care and collaborate with local resources until specialized care is available.”

REACH’s PPP program is a one-of-a-kind, practice-transformation course that enables pediatric primary care providers, including pediatricians, family physicians, nurse practitioners, and physician assistants, to develop the skills needed to effectively diagnose, manage, and treat the common mental health conditions (ADHD, anxiety, depression, etc.) they encounter every day in their practice. The PPP program was developed by renowned experts in the field of youth mental health, is grounded in the science of behavior change, and is supported by rigorous program evaluation. Participants consistently rate REACH training programs in the top 10% of continuing medical education (CME) courses, citing presentation quality, content, and relevance to their practice. More information, including course dates and registration, is available 

The REACH Institute is a national 501(c)(3) nonprofit organization dedicated to ensuring that the most effective, scientifically proven mental health care reaches all children and families. Since 2006, REACH has trained more than 8,000 primary care providers in evidence-based mental health care. The organization addresses the critical shortage of pediatric mental health services, especially in underserved areas, by providing intensive training programs for healthcare professionals to better diagnose, treat, and manage mental health issues in children and adults. For more information, visit 

Nurse practitioners and clinical nurse specialists have new option to satisfy pmhs certification pathway requirement.

NOFOLLOW

NOINDEX

The REACH Institute’s patient-centered mental health in pediatric primary care (ppp) program now approved as pathway to pediatric primary care mental health specialist (pmhs) certification

 on Monday, March 24, 2025 at 12:00 PM ET or later for the full case presentation, differential diagnoses, and the correct patient diagnosis. 

This case was provided by Muhammad Aamir Anees and Bernard A. Cohen, MD

Want more puzzler and dermatology cases? 

A healthy 9-year-old girl developed an asymptomatic eruption of discrete and confluent, 2 to 3 mm, hypopigmented papules in a linear pattern along the lines of Blaschko on the back of her left thigh and leg over the past 3 weeks. The lesions cleared without treatment 4 to 5 months later. 

Inflammatory linear verrucous epidermal nevus

on Monday, March 24, 2025 at 12:00 PM ET or later for the full case presentation, differential diagnosis, and correct patient diagnosis.

Take your best guess and try to diagnose this 9-year-old girl's linear eruption on the back of her left thigh and leg. Stay tuned for the full case presentation and correct diagnosis! 

Poll: What's the diagnosis of this linear eruption on the leg of a 9-year-old girl?

Recent research detailed that a child was most likely to be killed in a mass shooting by a parent or family member vs a stranger or peer. Study investigator Stephanie Chao, MD, breaks down these data. 

Stephanie Chao, MD details relationships in mass shootings involving children

Stephanie Chao, MD, FACS, FAAP, associate professor of Pediatric Surgery at Stanford Medicine Children’s Health, has dedicated her research to understanding the true risks of firearm-related mass shootings involving children. Motivated by both her professional expertise and personal experience as a mother, Chao became concerned after her young daughter described an active shooter drill at school.

“She told me, ‘Well, the teacher said, in case there’s a bear outside, this is what we should do,’” Chao recalled. “I just thought that that was incredible in that the teacher had to create a story.” This experience led Chao to question the effectiveness of school-based active shooter drills and examine where the true threats to children exist.

Chao co-authored a recent study published in 

, which analyzed mass shootings involving child victims. The study defined pediatric mass shootings as incidents in which at least 4 people were killed, excluding the perpetrator, and at least 1 of the victims was under 18 years old.

Researchers reviewed 121 incidents between 2009 and 2020, which resulted in 308 child fatalities. The study found that 59.1% of these deaths were perpetrated by a family member, with parents alone responsible for 40.9% of all mass shooting deaths. In contrast, classmates accounted for just 6.8% of child fatalities.

“I was surprised by our findings,” Chao said. “We found in our study that 59% of mass shootings that involved children dying were committed by a relative, and 41% of those shootings were committed by a parent. Only a very small percentage, by comparison, was committed by a classmate.” 

Chao emphasized the role of pediatricians in addressing firearm safety. 

“I think pediatricians are really on the front lines with kids,” she said. “They see all the small booboos, they see the cold, but they also see the things that are the beginnings of lifelong trauma.” However, discussing firearm safety remains a challenge in clinical settings. Chao noted that even seasoned pediatricians find conversations about gun safety uncomfortable and difficult to fit into busy patient visits.

One of Chao’s ongoing research projects, PLEDGE, aims to bridge this gap by developing a school-based curriculum focused on gun safety, safe storage, and mental health awareness. 

“We are trying to create a common vocabulary that is nonpartisan,” she explained. “We need to know how to talk about it starting as children.”

Chao believes that treating firearm violence as a public health issue, rather than a political debate, is crucial for prevention. 

“Gun deaths in our country need to be treated as a public health problem, and the research needs to address it just like we do any other issue,” she said. “It’s not going to be a single solution. It’s going to be multifaceted.”

Gordon Gray Still, MD

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