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    Pediatricians' Knowledge, Attitudes, and Therapeutic Approaches Regarding Diaper Dermatitis: A Common Condition with Many Different Practices [Response to Letter]
    (Dove Medical Press Ltd, 2023) Yildiz, Ismail; Kizilca, Ozgur; Haksayar, Aysen; Demirkale, Zeynep Hizli
    [Abstract Not Available]
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    Pediatricians? Knowledge, Attitudes, and Therapeutic Approaches Regarding Diaper Dermatitis: A Common Condition with Many Different Practices
    (Dove Medical Press Ltd, 2023) Yildiz, Ismail; Kizilca, Ozgur; Haksayar, Aysen; Demirkale, Zeynep Hizli
    Background: Diaper dermatitis is one of the most common skin diseases in early childhood. The prevalence of diaper dermatitis varies between 7% and 35% depending on population and age groups. There may be some differences among the pediatricians about treatment approaches to this common skin condition.Aim: The purpose of this study is to evaluate the management strategies of pediatricians for diaper dermatitis.Methods: The questionnaire-based cross-sectional study was conducted between September and December 2021. The questionnaire which contained 21 items aimed to investigate the approaches of pediatricians to diaper dermatitis treatment, follow-up and prevention strategies.Results: A total of 217 pediatricians (59.4% female, median age 40.0 years) practicing in 32 different provinces of Turkey completed the questionnaire. The most preferred medical treatments in the first visit of children with diaper dermatitis, in respect of frequency, were zinc oxide, panthenol/dexpanthenol, and hamamelis virginiana extract (70.9%, 36.9%, 33.6% respectively). If there was no response to the first-line treatment in the control examination, the treatment was rearranged by adding an antifungal creams, topical low-potency corticosteroids, and/or high concentration zinc oxide creams (67.7%, 57.6%, 28.6%, respectively). Most cases were referred to a dermatologist if these treatments were not effective in the control visits of patients.Conclusion: Although pediatricians often prefer topical barrier creams for the treatment of diaper dermatitis, options may change depending on the severity of the lesions or the treatment response to the first-line topical treatments.
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    Proven Food-Induced Acute Urticaria and Predictive Factors for Definitive Diagnosis in Childhood
    (Karger, 2021) Aydogan, Metin; Topal, Erdem; Uysal, Pınar; Acar, Hazal Cansu; Cavkaytar, Özlem; Demirkale, Zeynep Hizli; Özdemir, Cevdet; Günaydın, Nursen Ciğerci
    Background: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy. Objective: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood. Methods: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study. Results: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow's milk, hen's eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow's milk-induced acute urticaria was 92% (95% CI: 81-96%). A history of cow's milk-induced and/or hen's egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen's kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002). Conclusion: Cow's milk, hen's eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria.