Animal Allergies

Food Allergies

Allergy, Immunology, and ENT

Cardiovascular Diseases

Cardiology

Acne

Atopic Dermatitis

Dermatology

Emergency Medicine

Diabetes

Endocrinology

Formula

Nutrition

Obesity

Gastroenterology

Antibiotic Resistance

Bacterial Conjunctivitis

COVID-19

Influenza

Pneumonia

Sexually Transmitted Diseases

Vaccination and Immunization

Vaccines

Infectious Diseases

ADHD

Addiction

Antisocial Personality Disorder

Anxiety

Autism

Depression

Developmental/Behavioral Disorders

Psychiatry

Mental, Behavioral and Development Health

Concussion

Epilepsy

Headache

Neurology

Neonatal/Perinatology

OB/GYN

Pain

Drug Pipeline News

Pharmacology

Telemedicine

Practice Improvement

Asthma

Cystic Fibrosis

Respiratory

Rheumatology

News 

All News

PNP Corner

AAP News

Media

Around the Practice

Cure Connections

Expert Interviews

Insights

Medical World News

Peer Exchange

Peers & Perspectives

Podcasts

Webinars

Puzzler

Publications

Contemporary Pediatrics Journal

Supplements And Featured Publications

CME/CE

Resources

Handouts

Job Board

Conferences

Conference Coverage

Conference Listing

Partnerships

Subscribe

Editorial

Editorial Advisory Board

Writer’s Guidelines

Reference Guidelines

Meet the Editors

. 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.

Articles

Robert Frenck, MD, explained why 2024 was a big step in the right direction for RSV prevention, and emphasized the importance of vaccination against preventable diseases.

Robert Frenk, MD: 2024 was big year for RSV prevention

Susan Carnell, PhD explains social media addiction symptoms, but not time on social media, were cross-sectionally and prospectively associated with binge eating.

Social media use and binge eating in early adolescence

Medical advice was sought on the fifth day of symptoms, and by this time, the child was improving clinically. 

Case study: Boy, aged 10 years, has painful nodules on his feet

The photos in this case were taken soon after the painful and red papules appeared.

Can you diagnose this boy with painful nodules on his feet?

About Us

Advertise

Contact Us

Terms and Conditions

Privacy

Do Not Sell My Personal Information

Contemporary Pediatrics

Facebook

LinkedIn

Instagram

Clinical

Gynecology

Infectious disease

Mental Health

Oncology

Rheumatoid Arthritis

Sexual Health

View More

1rem

Authors

Can you diagnose this month's dermatology case? 

1-month-old boy with annular, red plaques on his scalp and face

**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

Contemporary Pediatrics' editorial advisory member Russell Libby, MD, FAAP, highlights 2024 FDA approval of epinephrine nasal spray (Neffy) in this video interview. 

Discussing FDA approved neffy with Russell Libby, MD, FAAP

A new needle-free epinephrine delivery method may transform the management of anaphylaxis in pediatric patients. Russell Libby, MD, FAAP, founder and president of Virginia Pediatric Group, expressed enthusiasm about epinephrine nasal spray (neffy; ARS Pharmaceuticals), 

approved by the FDA for type I allergic reactions, including anaphylaxis on August 9, 2024.

“I think this is really cool. I think it's going to really just float way to the top as soon as it becomes an option and people are aware of it. And I'll tell you, there are a number of reasons,” said Libby. "One of the most significant advantages is that the spray it's a needle-free, stable solution.”

“When you look at EpiPens, you have a real narrow window of temperatures where it stays stable. What does that mean? Well, sometimes it can become impotent, but more often, the potency just diminishes. So you might get 90% or  70%, whatever it is. I don't think we have a lot of data on it, but we know that it is very specific to be stored within basically room temperature 60 to 90 degrees,” Libby explained. In contrast, neffy remains stable even in extreme conditions, providing a more reliable option for patients.

Shelf life also presents a key benefit. Libby highlighted that “no drug I can imagine on the market that is prescribed more often and used less than EpiPen.” With auto-injectors typically expiring within 12 to 15 months, parents frequently seek refills.

“Now you have something that gives you a 2-plus-year duration that's pretty impressive, that, in and of itself, is reason enough to say, 'hey, we have an alternative,'” Libby said. 

The nasal spray design also simplifies administration, an important factor during emergency situations. “When we think of a nasal administration, we think, 'Oh, you have to sniff it.' No, you don't. You just deploy it. It'll spray in, and that's all that needs to be done,” Libby explained. 

Libby hopes the new option will be affordable and widely available. 

“I hope that it ends up on the formularies with that $25 copay, and that patients can have this as an option to carry as well as to store in places where they might end up needing that,” he said. 

Fitch, J. Epinephrine nasal spray now available to treat type I allergic reactions, anaphylaxis. 

. September 24, 2024. Accessed December 24, 2024. https://www.contemporarypediatrics.com/view/epinephrine-nasal-spray-now-available-to-treat-type-i-allergic-reactions-anaphylaxis 

Contemporary Pediatrics' editorial advisory member Russell Libby, MD, FAAP, highlights 2024 FDA approval of epinephrine nasal spray (Neffy) in this video interview.

News

Greg Forlenza, MD, highlights data from the CLVer trial that included advanced diabetes technology in newly diagnosed T1D patients. 

Greg Forlenza, MD, discusses CLVer trial among newly diagnosed type 1 diabetes patients

Greg Forlenza, MD, a pediatric endocrinologist at the Barbara Davis Center for Diabetes at the University of Colorado, recently discussed findings from the CLVer (NCT04233034) study, which evaluated the use of advanced diabetes technology in children with new-onset type 1 diabetes. 

“Our goal in that study was to see if really intensive blood sugar control at diagnosis would preserve the cells that make insulin,” Forlenza explained. “And we found that it did not, which is not what we were aiming to find, but it is a finding.” 

Despite not achieving the intended outcome, the study revealed critical insights into the effectiveness of next-generation diabetes management systems.

The CLVer study utilized the MiniMed 780G and Tandem Control-IQ insulin pumps. Forlenza highlighted the significant results achieved by using these technologies early in the disease process. 

“We were able to achieve over 80% of blood sugar time in target range during the first year after diagnosis,” he said. Historically, individuals with type 1 diabetes spent approximately 50% of their time with blood sugar levels in the target range, with newer tools increasing that percentage to around 65%, said Forlenza. 

“We believe that is a tremendous benefit, just for the common reasons that having your blood sugar in range is better than not,” he added.

“It gets to something that we want to study more, which is the psychological benefit of families being able to say, 'this is, for me, I can do this,'” Forlenza said. “'80% time and range is my normal, and I’m able to do that.' That is something that I want all kids to be able to achieve." 

The CLVer (NCT04233034) study underscores the importance of integrating advanced diabetes technologies early in treatment, offering improved glycemic control and enhancing quality of life for children and their families.

“The kids doing well and being successful and being happy with their therapy was very positive. And so that, to me, was a worthwhile reason for doing the study," said Forlenza. 

McVean J, Forlenza GP, Beck RW, et al. CLVer Study Group. Effect of Tight Glycemic Control on Pancreatic Beta Cell Function in Newly Diagnosed Pediatric Type 1 Diabetes: A Randomized Clinical Trial. 

. 2023 Mar 28;329(12):980-989. doi: 10.1001/jama.2023.2063. PMID: 36826834; PMCID: PMC9960023. 

Greg Forlenza, MD, highlights data from the CLVer trial that included advanced diabetes technology in newly diagnosed T1D patients.

 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 Monday, January 6 at 12:00 PM ET for the full case presentation, differential diagnoses, and the correct patient diagnosis. 

This case was provided by Amar Davé, MD, FAAP and Pahroul Davé, APRN

A boy aged 10 years presented to the outpatient office with a history of painful nodules on the plantar surface of his bilateral feet 8 to 10 hours after spending time in a hot tub. He was unable to bear weight or put on socks and shoes due to his pain. The photos were taken soon after the painful and red papules appeared. The lesions affected the whole plantar aspect of both feet. Over the following 4 days, the nodules became less painful and red. 

Medical advice was sought on the fifth day of symptoms, and by this time, the child was improving clinically. He was stable with subcutaneous, mildly painful, fleshy nodules mostly populating the medial arch of the foot. His remaining clinical examination results were within a normal range. Further questioning of the child’s mother revealed that other children exposed to the hot tub experienced painful feet but without lesions. 

Due to the patient’s improving symptoms and the self-limiting nature of the illness, no tests or labs were ordered as the child was not acutely ill. No peer consultations or specialists were utilized.

Click here for the full case presentation, differential diagnoses, and the correct patient diagnosis, in a separate article.

Case Studies

"Tapinarof comes in with that mixture of the short-term studies and longer-term studies intermittently, giving us a nice, effective alternative non-steroid for eczema across the ages." 

Lawrence Eichenfield, MD, talks tapinarof cream, 1%, nemolizumab FDA approvals for atopic dermatitis

Lawrence Eichenfield, MD, professor of dermatology and pediatrics at the University of California, San Diego, recently highlighted significant advancements in the treatment of 

 FDA approvals of tapinarof cream, 1% (VTAMA; Organon)

 to treat AD in patients 2 years and older, as well as 

 to treat patients aged 12 years and up with moderate-to-severe AD in combination with topical corticosteroids (TCS) and/or calcineurin inhibitors (TCI), when disease is not adequately controlled with topical prescription therapies,

Speaking about recent FDA approvals, Eichenfield emphasized the importance of these developments for both patients and clinicians.

“This is the first approval for tapinarof for atopic dermatitis,” he stated. “We get [approval] from age 2 [years] upward through adults at the same time with the same formulation that we’ve had experience with in psoriasis.” 

Eichenfield noted that the safety profile for pediatric patients was favorable, with good tolerance and minimal absorption concerns. 

Click here for full approval details, including clinical trial data highlights, as well as additional commentary from John Browning, MD, FAAD, FAAP, a board-certified pediatric and adult dermatologist in San Antonio, Texas, and is an assistant professor at the Baylor College of Medicine, as well as the chief of Dermatology at the Children's Hospital of San Antonio.

“I think it’s exciting to get newer non-steroidals in our hands,” said Eichenfield. “We certainly have patients who are very concerned about topical corticosteroids, and also many patients where we can’t necessarily treat with just topical corticosteroids long term. So tapinarof comes in with that mixture of the short-term studies and longer-term studies intermittently, giving us a nice, effective alternative non-steroid for eczema across the ages.” 

In addition to tapinarof, he discussed the approval of nemolizumab, a novel biologic targeting interleukin-31 (IL-31), for patients aged 12 years and older.

“It’s a totally novel drug... IL-31 is an important layer in pathophysiology of AD,” Eichenfield explained. “I think this gives us another systemic biologic, and we’ll see how it plays out in terms of sequencing or relationship to other biologics. People have these stories of incredible responsiveness that seems to be different than with other biologic agents.” 

Click here for full nemolizumab FDA approval details, including clinical trial data highlights

1. Fitch, J. FDA approves tapinarof cream, 1% for atopic dermatitis patients 2 years and up. 

. December 16, 2024. Accessed December 19, 2024. https://www.contemporarypediatrics.com/view/fda-approves-tapinarof-cream-1-for-atopic-dermatitis-patients-2-years-and-up

2. Fitch, J. FDA approves nemolizumab to treat atopic dermatitis in patients 12 years and up. 

. December 16, 2024. Accessed December 19, 2024. https://www.contemporarypediatrics.com/view/fda-approves-nemolizumab-to-treat-atopic-dermatitis-in-patients-12-years-and-up 

"Tapinarof comes in with that mixture of the short-term studies and longer-term studies intermittently, giving us a nice, effective alternative non-steroid for eczema across the ages."

This week, our experts weigh in on treatments not specifically indicated for COVID-19 treatment, including metformin, and concerns around using medications in this way.

Sana Suhail, BS

Articles

Latest Updated Articles