Sun May 30, 1999 12:40:33 PM Edlavitch:hi kim Glad you can make it
Sun May 30, 1999 12:41:31 PM kim:hi everybody
Sun May 30, 1999 12:41:53 PM Edlavitch:hi kim it is just us for now, holiday weekend
Sun May 30, 1999 12:43:11 PM kim:surely its raining somewhere else in the world
Sun May 30, 1999 12:43:39 PM Edlavitch:it is sunny and gorgeous here
Sun May 30, 1999 12:43:51 PM Edlavitch:i played golf and lost $3.00
Sun May 30, 1999 12:43:58 PM GUL:hi there :)
Sun May 30, 1999 12:44:22 PM Edlavitch:welcome Gulnur from Istanbul Glad you can make it this weekend
Sun May 30, 1999 12:44:40 PM Edlavitch:she is another sweety kim, I have lots of them here
Sun May 30, 1999 12:44:41 PM GUL:yes..:))
Sun May 30, 1999 12:45:07 PM Edlavitch:our slides are excellent for today I sure hope elaine shows ans figures it out
Sun May 30, 1999 12:45:19 PM GUL:so..this is our last session?
Sun May 30, 1999 12:45:25 PM Edlavitch:Kim is in Texas and it is raing like crazy there
Sun May 30, 1999 12:45:37 PM Edlavitch:yes our last session till next fall
Sun May 30, 1999 12:45:41 PM GUL:hi Kim:)
Sun May 30, 1999 12:45:43 PM kim:sorry- call from the ER BRB
Sun May 30, 1999 12:45:51 PM Andrei:Hi everyone. Andrei Zamfirescu, pediatrician, Bucharest, Romania
Sun May 30, 1999 12:45:55 PM Edlavitch:Welcome Andrei our faithful Romanian
Sun May 30, 1999 12:46:00 PM GUL:Hi Andrei.:)
Sun May 30, 1999 12:46:20 PM Andrei:Hi Julius and Gul
Sun May 30, 1999 12:46:39 PM Edlavitch:We need to make some changes for next year, our attendance has been terrible
Sun May 30, 1999 12:46:54 PM Edlavitch:I was thinking maybe this is wrong day
Sun May 30, 1999 12:47:29 PM Edlavitch:I was thinking of changing our season from November Though April
Sun May 30, 1999 12:47:47 PM Edlavitch:I am sad because there is a lot of work put in for a terrible attendance
Sun May 30, 1999 12:48:03 PM GUL:yes.:(
Sun May 30, 1999 12:48:24 PM Edlavitch:I need some help from our faithful few like both of you andrei and gul
Sun May 30, 1999 12:48:34 PM Andrei:It can be said that there are a few chosen
Sun May 30, 1999 12:48:41 PM kim:you know julius though this webtour is "prettier" it is harder to get into- ecpecially when you get to the web tour page- sort of cofusing- for us non-computer types- do you think its turnig people away?
Sun May 30, 1999 12:49:07 PM Edlavitch:You may be corrrect kim
Sun May 30, 1999 12:49:38 PM Edlavitch:I thought people would figure it out and with slides and such it makes our sessions more educational but you may be correct
Sun May 30, 1999 12:49:43 PM GUL:I think we had much more attendant while we were on mirc..but is it because this chat was new?
Sun May 30, 1999 12:49:49 PM Edlavitch:welocme len
Sun May 30, 1999 12:49:51 PM Andrei:The year before there were alsa 15-20 persons in the chat
Sun May 30, 1999 12:50:12 PM Edlavitch:i think you are correct but maybe the day and time
Sun May 30, 1999 12:50:17 PM Andrei:I don't think the web tour is wrong
Sun May 30, 1999 12:50:29 PM len:Hello everyone. Len Levy, Fayetteville NY general peds
Sun May 30, 1999 12:50:34 PM Edlavitch:maybe people came ou of curiosity and then decided not to come back
Sun May 30, 1999 12:50:41 PM GUL:hi Len.
Sun May 30, 1999 12:51:01 PM GUL:is it better saturday?
Sun May 30, 1999 12:51:09 PM GUL:what about lactation chat?
Sun May 30, 1999 12:51:14 PM Edlavitch:I just don't know, but we send out notice to over 2000 people and only 5-15 show
Sun May 30, 1999 12:51:27 PM kim:its not wrong once you figure it out but its not clear what to do private vs public- what do you write on "location" etc
Sun May 30, 1999 12:51:52 PM Edlavitch:lactation chat has excellent audience every week, we had as many as 35 for that
Sun May 30, 1999 12:52:02 PM Edlavitch:not sure what you mean Kim
Sun May 30, 1999 12:52:17 PM len:Sunday afternoon is the time for folks to do family things, etc.
Sun May 30, 1999 12:52:20 PM GUL:good..may be it would be better to change the time then.
Sun May 30, 1999 12:52:30 PM Edlavitch:hi len while we are waiting to start we are discussing why such a poor attnedance
Sun May 30, 1999 12:52:57 PM GUL:I was the only person with Vlady last chat.:)
Sun May 30, 1999 12:53:06 PM Edlavitch:saturday would eb bad because i doubt sat night people in europe or middle east would come rather than go out
Sun May 30, 1999 12:53:32 PM Edlavitch:I must check to see if elaine started her own chat
Sun May 30, 1999 12:53:44 PM Andrei:I think they are expecting something extraordinary to happen on the web tour. But when they don't seem to like sharing experience and ideas
Sun May 30, 1999 12:54:15 PM kim:when you go to the java tour site it its not clear what you are supposed to do to join the chat- i just kept pushing and writing in different things until it worked- several of my friends have said that they arent computer savy enough to understand it
Sun May 30, 1999 12:55:49 PM Edlavitch:on the java web tour page they need to join existing tour
Sun May 30, 1999 12:55:54 PM len:It seemed quite easy today, though.
Sun May 30, 1999 12:56:12 PM Edlavitch:some think they need to sart a tour so they do understand
Sun May 30, 1999 12:56:36 PM len:Perhaps folks think something is wrong when nothing happens on the screen, while the software loads.
Sun May 30, 1999 12:56:40 PM Edlavitch:maybe not so easy, elaine in st louis is not signed on yet
Sun May 30, 1999 12:56:48 PM Edlavitch:that is one possiblity
Sun May 30, 1999 12:57:06 PM Edlavitch:it could be on sunday afternoon people are doing family things too
Sun May 30, 1999 12:57:21 PM Edlavitch:Kim do you understand it now
Sun May 30, 1999 12:57:46 PM kim:maybe just a note saying that you are to join the exsisting tour wou
Sun May 30, 1999 12:57:47 PM kim:l
Sun May 30, 1999 12:57:56 PM Edlavitch:you higlight the name of the existing tour and click join exisitng tour it is that easy
Sun May 30, 1999 12:58:13 PM kim:would help
Sun May 30, 1999 12:58:24 PM Edlavitch:unfortunatley the soft ware has create new tour on top of page and i can not change it
Sun May 30, 1999 12:58:29 PM Andrei:I stick on my idea: people wnat to see something like the fourth of July; they are less interested in sharing experience and chat.
Sun May 30, 1999 12:58:54 PM Edlavitch:i hope you are not correct Andrei
Sun May 30, 1999 12:59:06 PM Edlavitch:i can not make the fourth of july every week
Sun May 30, 1999 12:59:44 PM Andrei:I know and I just want to speak with other pediatricians and share aour knowledge
Sun May 30, 1999 01:00:25 PM len:There are four choices of "chat.", or tour. Does that make it too complicated?
Sun May 30, 1999 01:00:40 PM len:Andrei, I agree with you.
Sun May 30, 1999 01:00:50 PM Edlavitch:i cut the choices out
Sun May 30, 1999 01:01:03 PM Andrei:Thank you, len
Sun May 30, 1999 01:01:11 PM Edlavitch:andrei you are correct and that is why i am doing this in a nutshell
Sun May 30, 1999 01:02:02 PM Andrei:Oh, Julius. please
Sun May 30, 1999 01:02:15 PM Edlavitch:I thougt others would like that concept to to meet other peds all over the would and develop friendships like this and we are doing
Sun May 30, 1999 01:02:48 PM JVA:hi I am Vlady
Sun May 30, 1999 01:03:06 PM len:Hi, Vlady!
Sun May 30, 1999 01:03:06 PM Edlavitch:hola vlady welome
Sun May 30, 1999 01:03:17 PM JVA:what´s going on
Sun May 30, 1999 01:03:28 PM Andrei:Julius and Vlady, I think that you are doing a wondeful job and we must keep on doing it
Sun May 30, 1999 01:04:17 PM GUL:Hola Vlady.:)
Sun May 30, 1999 01:04:40 PM Edlavitch:I would keep it going but need help from my friends like andrei and gul and len too
Sun May 30, 1999 01:05:01 PM kim:julius I think IPC is wonderful- I would be here more often if I had a little more time- it just takes me a while to get used to new things- i still miss the old print type in Pediatric Notes and they changed that 5 yrs ago
Sun May 30, 1999 01:05:59 PM Edlavitch:well if we all work together we could do better, like gulnur can she halp us get 2 people ever wee from turkey and andrei do the same
Sun May 30, 1999 01:06:15 PM Edlavitch:the places that are helping u will stop if no one shows
Sun May 30, 1999 01:06:17 PM GUL:I agree with Andrei.!!!!!!!
Sun May 30, 1999 01:06:28 PM len:I've announced IPC at department meetings, and even offered to help set folks up, but the time slot is tough.
Sun May 30, 1999 01:06:56 PM Edlavitch:What do you agree with andrei , the reason he comes or that many others are not interested in his reason
Sun May 30, 1999 01:07:22 PM GUL:this chat must go on!
Sun May 30, 1999 01:07:33 PM Edlavitch:any one know what this slides shows
Sun May 30, 1999 01:07:57 PM len:Hemangiomata
Sun May 30, 1999 01:08:03 PM Edlavitch:well only if we get some help from all of you out there, if so few come it won't
Sun May 30, 1999 01:08:16 PM Andrei:On the skull?
Sun May 30, 1999 01:08:19 PM Edlavitch:looks like hemangioma's t me too
Sun May 30, 1999 01:08:30 PM Edlavitch:they can be anywhere andrei
Sun May 30, 1999 01:08:30 PM len:In the scalp.
Sun May 30, 1999 01:08:49 PM kim:compound- strawberry plus cavernous maybe
Sun May 30, 1999 01:08:54 PM Andrei:in a newborn
Sun May 30, 1999 01:09:00 PM len:The one on the left is ulcerating.
Sun May 30, 1999 01:09:15 PM len:Oops, on the right.
Sun May 30, 1999 01:09:51 PM Edlavitch:yes it looks ulcerated
Sun May 30, 1999 01:10:13 PM kim:seems too easy- could it be anything else?
Sun May 30, 1999 01:10:17 PM GUL:yes.
Sun May 30, 1999 01:10:22 PM Edlavitch:how about this one
Sun May 30, 1999 01:10:35 PM Edlavitch:is this another hemangioma
Sun May 30, 1999 01:10:50 PM len:I would say so.
Sun May 30, 1999 01:10:57 PM kim:same- doesnt appear to be impinging on vision
Sun May 30, 1999 01:11:17 PM Edlavitch:yes looks like the same
Sun May 30, 1999 01:11:40 PM Edlavitch:you see this seems like the perfect way to help us do like andei said share our views together
Sun May 30, 1999 01:11:41 PM Andrei:It's like a chloroma just like in Non lymphoid leukemia?
Sun May 30, 1999 01:11:56 PM Edlavitch:i do not know this andrei
Sun May 30, 1999 01:12:02 PM Edlavitch:anyone else
Sun May 30, 1999 01:12:21 PM len:Does he mean skin infiltration with leukemic cells?
Sun May 30, 1999 01:12:52 PM Edlavitch:how about this one folks, could this be an ulcerated hemangioma
Sun May 30, 1999 01:13:03 PM len:Sure.
Sun May 30, 1999 01:13:09 PM kim:same
Sun May 30, 1999 01:13:16 PM Edlavitch:elaine
is here Haliluyah let us start form the beginning
Sun May 30, 1999 01:13:22 PM Andrei:Just
a hemorrhagic situation (due to thrombocytopenia
Sun May 30, 1999 01:13:30 PM kim:are
these all on the same kid?
Sun May 30, 1999 01:14:04 PM siegfrec:I
just got here, after 40 minutes of computer frustration
Sun May 30, 1999 01:14:19 PM siegfrec:I'm
sorry
Sun May 30, 1999 01:14:20 PM kim:are
you talking about kesselbeck merrit ? (spelling?)
Sun May 30, 1999 01:14:26 PM Edlavitch:wel
you are here so let us start from beginning
Sun May 30, 1999 01:14:36 PM Edlavitch:cute
photo
Sun May 30, 1999 01:14:41 PM Andrei:Kassabach-Merrit
Sun May 30, 1999 01:14:44 PM siegfrec:I
also sent :multiple choice
Sun May 30, 1999 01:15:01 PM Edlavitch:here
is ou first slide elaine
Sun May 30, 1999 01:15:09 PM siegfrec:questions
to Vlady
Sun May 30, 1999 01:15:15 PM Edlavitch:sorry
i d onot have them
Sun May 30, 1999 01:15:28 PM Edlavitch:vlady
left just now
Sun May 30, 1999 01:23:39 PM Edlavitch:server
crashed i rebooted it
Sun May 30, 1999 01:25:21 PM Edlavitch:server
froze i rebooted server and everyone will come back i hope
Sun May 30, 1999 01:25:22 PM bendetmr:my
name is moshe and I'm from Israel
Sun May 30, 1999 01:25:32 PM Edlavitch:unfortunately
buggy sometimes
Sun May 30, 1999 01:25:39 PM Edlavitch:Sholom
Moshe
Sun May 30, 1999 01:26:05 PM bendetmr:Shalom
Sun May 30, 1999 01:26:09 PM Edlavitch:Please
be patient and we wil start a gain
Sun May 30, 1999 01:26:26 PM Edlavitch:server
crashed and we will start now that eliane is back sorry everyone
Sun May 30, 1999 01:26:31 PM len:Hello
again.
Sun May 30, 1999 01:26:45 PM Edlavitch:welocme
jmymed
Sun May 30, 1999 01:26:51 PM Edlavitch:sorry
elaine
Sun May 30, 1999 01:27:10 PM jmymed:Hello
Sun May 30, 1999 01:27:12 PM siegfrec:that
was a ride!
Sun May 30, 1999 01:27:20 PM len:Hello
again.
Sun May 30, 1999 01:27:26 PM Edlavitch:yes
it was technology
Sun May 30, 1999 01:27:29 PM siegfrec:OK--to
slide 3
Sun May 30, 1999 01:27:48 PM Edlavitch:this
is the hemangioma slide
Sun May 30, 1999 01:28:05 PM siegfrec:correct
diagnosis
Sun May 30, 1999 01:28:15 PM Edlavitch:easy
one
Sun May 30, 1999 01:28:20 PM siegfrec:assoociated
risks?
Sun May 30, 1999 01:28:28 PM Edlavitch:infection
Sun May 30, 1999 01:28:40 PM jmymed:Bleeding
Sun May 30, 1999 01:28:42 PM Edlavitch:when
it degenerates
Sun May 30, 1999 01:28:43 PM siegfrec:low;
CNS anomaly?
Sun May 30, 1999 01:28:59 PM Edlavitch:what
kind cns anolmaly
Sun May 30, 1999 01:29:26 PM siegfrec:
No CNS anomaly, eiither, even for midline scalp lesionsBleeding is very,
very rare
Sun May 30, 1999 01:29:35 PM Edlavitch:ok
Sun May 30, 1999 01:29:39 PM siegfrec:So
for this kid
Sun May 30, 1999 01:29:51 PM siegfrec:you
only worry about
Sun May 30, 1999 01:30:03 PM Edlavitch:is
this a hemangioma near eye
Sun May 30, 1999 01:30:05 PM siegfrec:ulceration,
pain, scarring
Sun May 30, 1999 01:30:10 PM bendetmr:glaucoma
Sun May 30, 1999 01:30:12 PM Edlavitch:ok
Sun May 30, 1999 01:30:19 PM siegfrec:here,
you worry about
Sun May 30, 1999 01:30:29 PM siegfrec:strabismus
Sun May 30, 1999 01:30:35 PM siegfrec:not
glaucome
Sun May 30, 1999 01:30:39 PM Edlavitch:interesting
Sun May 30, 1999 01:30:47 PM siegfrec:yes--amblyopia
Sun May 30, 1999 01:30:49 PM Edlavitch:hemangioma
will affect eye muscle
Sun May 30, 1999 01:30:57 PM siegfrec:see
the eye doctor
Sun May 30, 1999 01:31:10 PM siegfrec:not
the muscle
Sun May 30, 1999 01:31:19 PM siegfrec:it
pushes on
Sun May 30, 1999 01:31:25 PM siegfrec:the
globe trypushing on yours
This is an :example
of
Sun May 30, 1999 01:31:59 PM Edlavitch:ulcerated
hemagioma
Sun May 30, 1999 01:32:01 PM siegfrec:a
common complication
Sun May 30, 1999 01:32:07 PM siegfrec:ulceration
Sun May 30, 1999 01:32:11 PM jmymed:Necrosis?
Sun May 30, 1999 01:32:14 PM siegfrec:much
more common than
bleeding , it
is very painfuland should
be treated aggressively
Sun May 30, 1999 01:32:57 PM Edlavitch:how
Sun May 30, 1999 01:32:59 PM jmymed:Degenration?
Sun May 30, 1999 01:33:08 PM siegfrec:this
is the same kid
Sun May 30, 1999 01:33:23 PM Edlavitch:another
hemangioma
Sun May 30, 1999 01:33:26 PM siegfrec:she
was treated with occlusive dressing
and became allergic to the adhesive
, after that
Sun May 30, 1999 01:33:57 PM bendetmr:do
U need to worry of connection to the vertebra
Sun May 30, 1999 01:34:06 PM jmymed:Why
occlusive dressing?
Sun May 30, 1999 01:34:12 PM siegfrec:we
had to excise the whole thing
Sun May 30, 1999 01:34:15 PM Edlavitch:good
questions
Sun May 30, 1999 01:34:24 PM siegfrec:in
this location
Sun May 30, 1999 01:34:31 PM bendetmr:to
hide it
Sun May 30, 1999 01:34:40 PM siegfrec:an
associated spinal anomaly
Sun May 30, 1999 01:34:45 PM jmymed:Ha
Ha
Sun May 30, 1999 01:34:48 PM siegfrec:would
be very rare
Sun May 30, 1999 01:35:12 PM siegfrec:This
ia a very worrisome :location
for a hemangioma
Sun May 30, 1999 01:35:27 PM Edlavitch:this
look bad
Sun May 30, 1999 01:35:33 PM siegfrec:it
is not a port wine stain
Sun May 30, 1999 01:35:36 PM Edlavitch:sturge
webber syndrome
Sun May 30, 1999 01:35:46 PM siegfrec:The
complications include
Sun May 30, 1999 01:35:48 PM Edlavitch:more
hemagiomas
Sun May 30, 1999 01:36:05 PM Andrei:seizures
Sun May 30, 1999 01:36:05 PM siegfrec:amblyopia/strabismus
Sun May 30, 1999 01:36:18 PM siegfrec:posterior
fossa anomalies
Sun May 30, 1999 01:36:27 PM siegfrec:cardiac
anomalies
Sun May 30, 1999 01:36:34 PM Edlavitch:what
does opthamologist have to do
Sun May 30, 1999 01:36:38 PM jmymed:CT
Scan or MRI as next step?
Sun May 30, 1999 01:36:39 PM siegfrec:mid
sternal clefting
Sun May 30, 1999 01:36:48 PM siegfrec:yes
MRI
Sun May 30, 1999 01:37:04 PM siegfrec:careful
cardiac exam
Sun May 30, 1999 01:37:19 PM siegfrec:this
kids CNS defect
Sun May 30, 1999 01:37:32 PM siegfrec:was
dismissed by his pediatrician as
"colic"
Sun May 30, 1999 01:38:00 PM Andrei:west
syndrome
Sun May 30, 1999 01:38:04 PM jmymed:Approriate
consults: Neuro, Ophtha, Cardio
Sun May 30, 1999 01:38:07 PM siegfrec:He
also had severe astigmatism
Sun May 30, 1999 01:38:20 PM Edlavitch:really
nice slides elaine
Sun May 30, 1999 01:38:30 PM siegfrec:sorry,
that's what I meant before--not strabismus
Sun May 30, 1999 01:38:33 PM Edlavitch:ok
this is struge webber
Sun May 30, 1999 01:38:38 PM jmymed:That's
got to be Sturge Weber
Sun May 30, 1999 01:38:39 PM siegfrec:yes
Sun May 30, 1999 01:38:40 PM Andrei:this
is more likely SSW
Sun May 30, 1999 01:38:54 PM siegfrec:only
25% of kids with facial
Port wine stains have
sturge weber the
risk increases
Sun May 30, 1999 01:39:26 PM jmymed:Interesting
info
Sun May 30, 1999 01:39:33 PM siegfrec:with
larger lesions laser works
well
Sun May 30, 1999 01:39:47 PM Edlavitch:ow
this looks sore
Sun May 30, 1999 01:39:53 PM siegfrec:here,
the risk is spinal dysraphism
Sun May 30, 1999 01:40:08 PM jmymed:Fistula
formation?
Sun May 30, 1999 01:40:15 PM siegfrec:and
painful ulceration ,:no
fistula .
Its a developmantal anomaly
Sun May 30, 1999 01:40:35 PM Andrei:Arnold
Chiari?
Sun May 30, 1999 01:40:50 PM Edlavitch:what
is this
Sun May 30, 1999 01:40:51 PM siegfrec:no,
just caudal a hemangioma
Sun May 30, 1999 01:41:11 PM Edlavitch:is
this a dermatis around anus
Sun May 30, 1999 01:41:12 PM siegfrec:sacral,
midline, flat
Sun May 30, 1999 01:41:27 PM Edlavitch:sacral
hemangioma
Sun May 30, 1999 01:41:48 PM siegfrec:these
exMPLES
Sun May 30, 1999 01:41:58 PM siegfrec:were
to show risks of vascular
biirthmarks
Sun May 30, 1999 01:42:37 PM siegfrec:anal
lesion--dx?
Sun May 30, 1999 01:42:49 PM Andrei:Sex
abuse
Sun May 30, 1999 01:42:54 PM Edlavitch:hemorhoid
or wart
Sun May 30, 1999 01:42:55 PM siegfrec:not
condyloma
Sun May 30, 1999 01:43:12 PM bendetmr:imperforated?
Sun May 30, 1999 01:43:16 PM siegfrec:not
condyloma lata, but that's a concern
Sun May 30, 1999 01:43:18 PM jmymed:Perianal
skin tag- Crohn's
Sun May 30, 1999 01:43:25 PM siegfrec:yes
, in this case
Sun May 30, 1999 01:43:43 PM Edlavitch:good
one jmymed
Sun May 30, 1999 01:43:46 PM siegfrec:the
kid was constipated
Sun May 30, 1999 01:43:57 PM siegfrec:no
evidence of crohns yet
Sun May 30, 1999 01:44:05 PM siegfrec:but
he needs monitooring
:
Sun May 30, 1999 01:44:38 PM siegfrec6
year old, recurrent prob
Sun May 30, 1999 01:44:43 PM Edlavitch:OW!!!
Sun May 30, 1999 01:44:44 PM siegfrec:dx?
Sun May 30, 1999 01:44:56 PM len:strep
A?
Sun May 30, 1999 01:45:02 PM Edlavitch:impetigo
and poor hygiene
Sun May 30, 1999 01:45:13 PM siegfrec:the
next slide show the flip side
Sun May 30, 1999 01:45:31 PM siegfrec:dx?
Sun May 30, 1999 01:45:38 PM Edlavitch:impetigo
Sun May 30, 1999 01:45:47 PM jmymed:Monilial
dermatitis
Sun May 30, 1999 01:45:48 PM len:H.
simplex?
Sun May 30, 1999 01:45:51 PM bendetmr:candida
Sun May 30, 1999 01:45:58 PM siegfrec:psoriasis;
annular, inverse pattern
Sun May 30, 1999 01:46:14 PM Edlavitch:ok
so we are all wrong
Sun May 30, 1999 01:46:19 PM bendetmr:so
young
Sun May 30, 1999 01:46:28 PM Edlavitch:what
should have clued us
Sun May 30, 1999 01:46:42 PM siegfrec:think
psoriasis in the differential
of annular
lesiond in the anogenitalarea
.that is, chronic lesions
Sun May 30, 1999 01:47:27 PM siegfrec:dx?
Sun May 30, 1999 01:47:40 PM Edlavitch:yeast
Sun May 30, 1999 01:47:48 PM bendetmr:condyloma
Sun May 30, 1999 01:48:17 PM siegfrec:this
is an unusual one, needs a biopsy to confirm, as does anything that is
not responding the way you think it should
Sun May 30, 1999 01:48:29 PM siegfrec:dx--syringomas
; autosomal dominant
Sun May 30, 1999 01:48:40 PM Edlavitch:what
is this
Sun May 30, 1999 01:48:59 PM siegfrec:prediliction
for the genitals :otherwise
benign
Sun May 30, 1999 01:49:22 PM Edlavitch:what
is syringomas I don';t know this word
Sun May 30, 1999 01:49:37 PM siegfrec:benign
familial skin tumors ; rare
Sun May 30, 1999 01:50:17 PM siegfrec:11
year old with dysuria , she
has other skin lesions
periungual plaques
,nail pits ,whiteish
oral lesions
Sun May 30, 1999 01:51:06 PM Edlavitch:yeast
Sun May 30, 1999 01:51:20 PM siegfrec:the
digital photo lacks cllarity
for this subtle process
Sun May 30, 1999 01:51:38 PM Edlavitch:some
ckind of ectoderaml dysplasia
Sun May 30, 1999 01:51:58 PM siegfrec:she
has significant adhesions obliterating
her urethra
Sun May 30, 1999 01:52:24 PM Edlavitch:from
Sun May 30, 1999 01:52:25 PM siegfrec:dx?
lichen planus
Sun May 30, 1999 01:52:30 PM bendetmr:lichen
Sun May 30, 1999 01:52:47 PM siegfrec:think
about lichen sclerosus, too
Sun May 30, 1999 01:52:53 PM Edlavitch:what
is this asocoaited with
Sun May 30, 1999 01:53:02 PM siegfrec:biopsy
is diagnostic
Sun May 30, 1999 01:53:24 PM siegfrec:no
significant
Sun May 30, 1999 01:53:33 PM siegfrec:extracutaneous
pprobs
Sun May 30, 1999 01:53:48 PM siegfrec:This
kid has multiple nevi,:what are the most important
melanoma risk factors?
Sun May 30, 1999 01:54:19 PM Edlavitch:is
this a child with other disease and neurologic finding
Sun May 30, 1999 01:54:24 PM Andrei:UV
Sun May 30, 1999 01:55:04 PM Andrei:sun
exposure
Sun May 30, 1999 01:55:11 PM siegfrec:family
member with melanoma; increased number of moles; atypical moles; freckles;
sunbuurns
Sun May 30, 1999 01:55:34 PM siegfrec:alopecia--dx?
Sun May 30, 1999 01:55:50 PM len:Trichotillomania.
Sun May 30, 1999 01:55:56 PM Andrei:Addison
Sun May 30, 1999 01:56:04 PM kim:traction
form hair bows
Sun May 30, 1999 01:56:04 PM bendetmr:how
do u follow someone with multiple freckles do u have a comuter pictures
of them and measure the freckles
Sun May 30, 1999 01:56:06 PM Edlavitch:am
i going to fast
Sun May 30, 1999 01:56:15 PM siegfrec:very
good--trichotillomania
Sun May 30, 1999 01:56:18 PM Edlavitch:should
i go back
Sun May 30, 1999 01:56:26 PM siegfrec:no,
were late
Sun May 30, 1999 01:56:32 PM siegfrec:dx?
Sun May 30, 1999 01:56:38 PM Edlavitch:ok
this slide
Sun May 30, 1999 01:56:50 PM bendetmr:verruce
Sun May 30, 1999 01:56:52 PM Andrei:linear
nevi
Sun May 30, 1999 01:56:56 PM Edlavitch:i
don't know
Sun May 30, 1999 01:57:07 PM siegfrec:very
good-epidermal nevus, the next several slides relate
Sun May 30, 1999 01:57:46 PM siegfrec:this
is another biiirthmark distriibuted
Sun May 30, 1999 01:57:48 PM Andrei:incontinentia
pigmenti
Sun May 30, 1999 01:57:58 PM siegfrec:in
Blashchko's lines
Sun May 30, 1999 01:58:09 PM siegfrec:a
nevus sebaceous
Sun May 30, 1999 01:58:37 PM siegfrec:what
is responsible for the changes in this nevus sebaceous?
Sun May 30, 1999 01:59:10 PM Edlavitch:BEATS
ME
Sun May 30, 1999 01:59:11 PM Andrei:tuberous
sclerosis
Sun May 30, 1999 01:59:35 PM siegfrec:not
nneoplasm, but that occurs in 20-30%; in this case, it's just puberty-associated
enlargement :of the sebaceous
glands . We generally excise
these around puberty
Sun May 30, 1999 02:00:19 PM Edlavitch:cosmetic
problem then
Sun May 30, 1999 02:00:33 PM siegfrec:no--the
risk of neoplasm
Sun May 30, 1999 02:00:54 PM siegfrec:incl
basal and squamous cell CA
Sun May 30, 1999 02:01:09 PM siegfrec:reason
for these naol changes?
Sun May 30, 1999 02:01:20 PM Edlavitch:do
pediatric patients get basal cell cancers
Sun May 30, 1999 02:01:35 PM Edlavitch:i
am not sure i'd ever recognize this
Sun May 30, 1999 02:01:39 PM bendetmr:water?
Sun May 30, 1999 02:01:58 PM kim:sorry-
one back do you wait to excise these at puberty or should it be done before
Sun May 30, 1999 02:02:11 PM siegfrec:trauma
an infection should be considered, bbut this is inflammation-associated
(paronychia)
Sun May 30, 1999 02:02:23 PM Edlavitch:hypothyroid
Sun May 30, 1999 02:02:31 PM siegfrec:nevus
sebaceous--good times to excise are
Sun May 30, 1999 02:02:43 PM siegfrec:in
the first 3 months of life or
Sun May 30, 1999 02:02:57 PM siegfrec:after
puberty when :it can be
done in the office
and when
the sebaceous glands are hypertrophic so
Sun May 30, 1999 02:03:36 PM Edlavitch:what
is cause of this slide elaine
Sun May 30, 1999 02:03:41 PM siegfrec:you
can see the margins
Sun May 30, 1999 02:03:45 PM Edlavitch:number
20
Sun May 30, 1999 02:03:46 PM siegfrec:the
youngest
Sun May 30, 1999 02:03:48 PM kim:so,
when do they become cancer prone- after puberty or always?
Sun May 30, 1999 02:04:02 PM siegfrec:carcinoma
in a NS is age 8
Sun May 30, 1999 02:04:17 PM siegfrec:the
riisk increases :with age
Sun May 30, 1999 02:04:23 PM Edlavitch:what
is ns
Sun May 30, 1999 02:04:36 PM siegfrec:nevus
sebaceous
Sun May 30, 1999 02:04:40 PM Edlavitch:ok
Sun May 30, 1999 02:04:45 PM len:what
slide are we talking about?
Sun May 30, 1999 02:04:56 PM Edlavitch:now
to the fingers
Sun May 30, 1999 02:05:15 PM siegfrec:We
went back to the forehead for a minute; OK now to nail dystrophy
Sun May 30, 1999 02:05:16 PM Edlavitch:what
is cause of these fingers red and peeling
Sun May 30, 1999 02:05:27 PM kim:fingers-
candida paronechia
Sun May 30, 1999 02:05:47 PM Edlavitch:good
one kim is this correct
Sun May 30, 1999 02:05:53 PM siegfrec:in
this case irritant--the kid is atipic
Sun May 30, 1999 02:06:06 PM len:eczema
Sun May 30, 1999 02:06:10 PM siegfrec:needs
topical steroids
Sun May 30, 1999 02:06:24 PM Edlavitch:itchy
and uncomfortable
Sun May 30, 1999 02:06:35 PM kim:is
this like a dyshydrotic eczema?
Sun May 30, 1999 02:06:37 PM siegfrec:this
is a different cause of nail dystrophy
Sun May 30, 1999 02:07:00 PM siegfrec:anything
that impinges on the nail matrix
under the proximal nail foldwill
cause nail dystrophy
Sun May 30, 1999 02:07:26 PM Edlavitch:what
is this kim
Sun May 30, 1999 02:07:30 PM siegfrec:in
this case warts :but also
treating warts
Sun May 30, 1999 02:07:44 PM kim:i
see it now
Sun May 30, 1999 02:07:50 PM Edlavitch:is
this warts aroung the base of the nail
Sun May 30, 1999 02:07:54 PM siegfrec:with
a destructive technique
Sun May 30, 1999 02:08:07 PM Edlavitch:what
is the rx for this
Sun May 30, 1999 02:08:28 PM siegfrec:warts
yes--the image didn't translate well
Sun May 30, 1999 02:08:45 PM siegfrec:more
warts--treatments?
Sun May 30, 1999 02:08:50 PM Edlavitch:more
warts
Sun May 30, 1999 02:09:01 PM Edlavitch:liquid
nitrogen
Sun May 30, 1999 02:09:12 PM kim:tagamet
Sun May 30, 1999 02:09:17 PM siegfrec:I
avoid painful alternatives in kids with wiidespread warts
Sun May 30, 1999 02:09:26 PM jmymed:Cautery
Sun May 30, 1999 02:09:31 PM siegfrec:I
like cimetidine
Sun May 30, 1999 02:09:40 PM Edlavitch:ok
then what I hate to treat widespread warts
Sun May 30, 1999 02:09:57 PM Edlavitch:cimetidine
does what
Sun May 30, 1999 02:10:00 PM siegfrec:I
believe efficacy of cimetidine is dose
related
Sun May 30, 1999 02:10:10 PM kim:how
do you dose it in the big teens
Sun May 30, 1999 02:10:31 PM siegfrec:Cimet
acts through the H2 receptors on T lymphocytes
Sun May 30, 1999 02:10:44 PM siegfrec:I
always use 40 mg/kg/d
Sun May 30, 1999 02:10:56 PM siegfrec:even
over 2400 mg/d
Sun May 30, 1999 02:11:09 PM kim:even
for the adult sized kids?
Sun May 30, 1999 02:11:13 PM siegfrec:its
a really safe drug except :for
the drug interactions
2nd
choice-- sensitizer
Sun May 30, 1999 02:12:02 PM Edlavitch:Before
we stop soon, Introduce yourselves to elaine, I am julius edlavithc MD
from Minnesota usa
Sun May 30, 1999 02:12:27 PM Edlavitch:how
long does one treat with the cimetidine and will you send me a reference
Sun May 30, 1999 02:12:27 PM bendetmr:moshe
from Israel
Sun May 30, 1999 02:12:29 PM kim:kim
burlingham, rural peds, texas, usa
Sun May 30, 1999 02:12:33 PM jmymed:Jose
Yuvienco, New Jersey
Sun May 30, 1999 02:12:35 PM Andrei:Andrei
Zamfirescu, pediatrician, Bucharest, Romania
Sun May 30, 1999 02:12:50 PM len:Len
Levy, Fayetteville NY
Sun May 30, 1999 02:12:51 PM siegfrec:nice
to chat with you
Sun May 30, 1999 02:13:12 PM siegfrec:even
on a beautiiful holiday weekend
Sun May 30, 1999 02:13:13 PM Edlavitch:thank
you all , how long does one treat for with cimetidine and what percentage
does it work
Sun May 30, 1999 02:13:29 PM bendetmr:hi
Len I graduate from Syracuse and Lives in De Witt
Sun May 30, 1999 02:13:55 PM Edlavitch:it
is memeorial weekend in usa so holiday weekend
Sun May 30, 1999 02:14:05 PM siegfrec:3
months, 80+% success; we're doing another PCDB study now
Sun May 30, 1999 02:14:25 PM siegfrec:This
photo didn't digitalize well
Sun May 30, 1999 02:14:33 PM Edlavitch:i
would like you to mail me a reference and i will send it out in my announcement
Sun May 30, 1999 02:14:50 PM siegfrec:sisters--one
has atopic dermatitis
Sun May 30, 1999 02:15:01 PM siegfrec:the
other ichthyosis vulgaris
Sun May 30, 1999 02:15:03 PM Edlavitch:can
not tell this one where problem is
Sun May 30, 1999 02:15:16 PM jmymed:Look
at the elbows
Sun May 30, 1999 02:15:27 PM Edlavitch:ok
Sun May 30, 1999 02:15:27 PM siegfrec:most
obvious in the popliteal area
Sun May 30, 1999 02:15:59 PM Edlavitch:last
slide
Sun May 30, 1999 02:16:03 PM Andrei:athletic
foot
Sun May 30, 1999 02:16:08 PM siegfrec:another
form of ichthyosis, as a comparison
Sun May 30, 1999 02:16:23 PM siegfrec:epidermolytic
hyperkeratosis
Sun May 30, 1999 02:16:26 PM Edlavitch:lichen
planus
Sun May 30, 1999 02:16:43 PM Edlavitch:what
causes this?
Sun May 30, 1999 02:17:07 PM siegfrec:autosomal
dominant--I had to end with a fancy derm name
Sun May 30, 1999 02:17:32 PM jmymed:Thank
you. This was very informative
Sun May 30, 1999 02:17:33 PM siegfrec:babies
born with this
Sun May 30, 1999 02:17:44 PM siegfrec:are
all blistered
Sun May 30, 1999 02:17:51 PM Edlavitch:this
is definitely fancy and was one of the most fun ways to do the webtour,
save these slides we will repeat this
Sun May 30, 1999 02:18:09 PM Edlavitch:i
would like the reference in cimetidine
Sun May 30, 1999 02:18:13 PM kim:thank
you for a great chat- it will use a lot of the info you gave me
Sun May 30, 1999 02:18:27 PM kim:bye
everybody
Sun May 30, 1999 02:18:28 PM Andrei:Very
nice slides indeed. thank you Elaine. Nice chat
Sun May 30, 1999 02:18:38 PM Edlavitch:thank
you all for attrending we will repeat this one and maybe a few new slides
next year
Sun May 30, 1999 02:18:50 PM siegfrec:It
was fun, but my typing is too slow!
Sun May 30, 1999 02:18:54 PM len:Bye
everyone. Sunshine calls.
Sun May 30, 1999 02:18:55 PM jmymed:That's
a good idea Julius.
Sun May 30, 1999 02:19:02 PM Edlavitch:thanks
everyone, I am going for a nice bike ride
Sun May 30, 1999 02:19:07 PM siegfrec:bye!
Sun May 30, 1999 02:19:13 PM Edlavitch:good
night andrei
Sun May 30, 1999 02:19:20 PM Edlavitch:thank
you very much
Sun May 30, 1999 02:19:29 PM Edlavitch:sholom
bendr
Sun May 30, 1999 02:19:30 PM bendetmr:thank
u for the effort
Sun May 30, 1999 02:19:41 PM Andrei:Have
a nice day Julius
Sun May 30, 1999 02:19:50 PM len:Shalom,
Moshe.
Sun May 30, 1999 02:19:54 PM Edlavitch:next
season I hope you all continue to come
Sun May 30, 1999 02:20:19 PM Andrei:Of
course