Publications by authors named "Kimberly D Morel"
Background: Recessive dystrophic epidermolysis bullosa (RDEB) is a genetic disorder caused by pathogenic variants in COL7A1.
Objectives: To determine the association between different COL7A1 variants and clinical disease severity in 236 North American patients with RDEB.
Methods: Published reports or in silico predictions were used to assess the impact of pathogenic variants in COL7A1 on type VII collagen (C7) protein function.
Central line dressings (CLDs) may be associated with adverse skin reactions in hospitalized children. Currently, standardized protocols to guide the management of cutaneous CLD reactions are unavailable at our children's hospital and in the pediatric literature. We surveyed dermatologists at multiple institutions who routinely perform pediatric consults to assess their management practices and/or the use of standardized protocols for addressing adverse cutaneous reactions to CLDs.
View Article and Find Full Text PDFTransition of care in adolescents with epidermolysis bullosa: The provider perspective.
Pediatr Dermatol
November 2024
Article Synopsis
- The study focused on the challenges of transitioning patients with epidermolysis bullosa (EB) from pediatric to adult care, revealing that provider support is crucial during this process.
- A survey conducted with members of the Epidermolysis Bullosa Clinical Research Consortium found that 88% of providers were concerned about this transition, while only 38% had formal transition of care (TOC) programs.
- The results highlighted the importance of establishing formal TOC programs and a team-based approach, emphasizing the need to identify adult care providers to facilitate better transitions for patients.
Approach to Mycosis Fungoides in children: Consensus-based recommendations.
J Am Acad Dermatol
December 2024
Article Synopsis
- This project gathered experts to create guidelines for treating a skin condition called pediatric Mycosis fungoides (MF), which is different from how adults are treated.
- They talked about important factors that go beyond just measuring the size of the disease, like itching, how it affects daily life, and feelings of worry or embarrassment.
- The team made 10 recommendations for managing both early and advanced stages of pediatric MF, but they still need more information on how to treat the later stages properly.
Article Synopsis
- Linear IgA Dermatosis (LAD) is a rare autoimmune skin disease characterized by IgA deposits at the skin's basement membrane, affecting both children and adults with diverse clinical features.
- The European Academy of Dermatology and Venereology (EADV) developed consensus guidelines by collaborating with 29 experts across multiple countries to ensure a comprehensive approach to diagnosis and treatment.
- The resulting guidelines provide a combination of evidence-based and expert-based recommendations to aid dermatologists in effectively diagnosing and managing LAD.
An analysis of information about infantile hemangiomas on TikTok: A cross-sectional study.
Pediatr Dermatol
March 2024
The video app TikTok, a controversial platform, has increasingly been utilized for the dissemination of health-related topics. In this study, the quality of information on the top 50 most viewed TikTok videos on infantile hemangiomas (IHs) labeled #hemangioma was analyzed. The results showed that the videos were skewed toward more severe subtypes of IH, and most were directed at raising awareness about IH or combating stigmatizing attitudes toward birthmarks.
View Article and Find Full Text PDFAn investigation of vascular anomalies centers' transition of care practices.
Pediatr Dermatol
November 2023
Article Synopsis
- This study investigates the transition of care practices in multidisciplinary vascular anomalies centers (VACs).
- Out of 71 VAC leaders surveyed, 37 responded, revealing that only 16% of centers have established TOC programs.
- Key challenges identified include limited resources and the struggle to locate expert adult providers.
Characterization of wound microbes in epidermolysis bullosa: A focus on Pseudomonas aeruginosa.
Pediatr Dermatol
November 2023
Article Synopsis
- The most frequently found bacteria in wound cultures of Epidermolysis Bullosa patients are Staphylococcus aureus and Pseudomonas aeruginosa.
- Researchers focused on analyzing patients with wound cultures that tested positive for Pseudomonas aeruginosa due to its prevalence and potential link to cancer development.
- The study aims to provide insights for future research and improvement in wound care strategies for those with Epidermolysis Bullosa.
Background/objectives: The primary objective was to assess pain catastrophizing and functional disability in pediatric patients with epidermolysis bullosa (EB) and their parents/guardians. Secondary objectives included examining relationships between pain catastrophizing, functional disability, and correlations with other factors (e.g.
View Article and Find Full Text PDFParaneoplastic pemphigus associated with Castleman disease: A multicenter case series.
Pediatr Dermatol
January 2023
Introduction: Paraneoplastic pemphigus (PNP) is a rare, often fatal, autoimmune blistering disease of the skin and mucous membranes. In children, PNP is frequently associated with Castleman disease (CD). This series describes five cases of PNP associated with CD.
View Article and Find Full Text PDFMulticenter retrospective review of pulsed dye laser in nonulcerated infantile hemangioma.
Pediatr Dermatol
January 2023
Article Synopsis
- The study looked at how effective pulsed dye laser (PDL) treatment is for a type of birthmark called infantile hemangioma in kids, both before and after using a certain medicine called beta-blockers.
- Out of 117 kids treated with PDL, a small group got the treatment early, while most received it later, with those getting beta-blockers needing fewer laser sessions.
- The results showed a big improvement in skin appearance after the treatment with low chances of side effects, making PDL a helpful option for these patients.
Article Synopsis
- Evaluating pediatric patients with subcutaneous nodules is challenging due to the nonspecific nature of many lumps and bumps, which could range from benign to potentially harmful.
- Pediatric dermatologists play a crucial role in detecting serious conditions, emphasizing the importance of recognizing certain nodular lesions to avoid misdiagnosis or treatment delays.
- The review includes clinical indicators for identifying aggressive lesions, suggestions for evaluation strategies, and practical tips for dealing with difficult cases.
Article Synopsis
- The study evaluated hemangioma specialists' experiences with telemedicine during the COVID-19 pandemic to manage infantile hemangiomas (IH) and identified perceived effectiveness and barriers.* -
- A total of 281 patients from 15 international medical centers were involved, with an average referral-to-evaluation time of 17 days and high physician confidence (95%) in telemedicine assessments.* -
- Findings indicate that telemedicine is effective for IH management, favoring hybrid approaches with photographs, potentially reducing wait times and expanding access to specialists in underserved regions.*
Analysis of existing "how to" manuals for the care of inpatients with epidermolysis bullosa.
Pediatr Dermatol
September 2022
"How to" skin care manuals assist health care professionals caring for hospitalized patients with epidermolysis bullosa and other disorders. Manuals created by Epidermolysis Bullosa Clinical Research Consortium sites were collected and analyzed. Analysis of manuals revealed variable content.
View Article and Find Full Text PDFThis article reviews the clinical findings of epidermal nevi and their associated syndromes and provides an update on their pathogenic genetic changes as well as targeted therapies detailed to date.
View Article and Find Full Text PDFArticle Synopsis
- Accurate diagnosis of epidermolysis bullosa (EB) is crucial for effective treatment and counseling, as different types require different management strategies.
- The study analyzed testing patterns among 771 patients, comparing results from transmission electron microscopy (TEM), immunofluorescence mapping (IFM), and genetic analysis to determine how often they produced consistent diagnoses.
- Findings showed a preference for genetic analysis over traditional methods, but both TEM and IFM often yielded unclear or inconsistent results, indicating the need for a more definitive diagnostic approach.
A dermatologic perspective on multisystem inflammatory syndrome in children.
Clin Dermatol
August 2021
As of May 2020, an emerging immune-mediated syndrome primarily affecting children has been detected primarily in Europe and the United States. The incidence of this syndrome appears to mirror the initial infectious assault with a delay of several weeks. This syndrome has been termed "multisystem inflammatory syndrome in children" (MIS-C) and is observed in association with the coronavirus disease 2019.
View Article and Find Full Text PDFArticle Synopsis
- - A study analyzed 238 infants with facial infantile hemangiomas (IHs) to determine the incidence and risk factors for PHACE syndrome, finding that 44.5% were diagnosed with the syndrome.
- - Significant risk factors for PHACE included IH surface area of 25 cm² or greater and involvement of three or more locations on the body, with specific locations like the parotid gland associated with a reduced risk.
- - The research was conducted at 13 pediatric dermatology centers in North America between 2009 and 2014, emphasizing the need for further understanding of IH characteristics and their link to PHACE syndrome.
As of May 2020, an emerging immune-mediated syndrome mainly affecting children has been detected primarily in Europe and the United States. The incidence of this syndrome appears to mirror the initial infectious assault, with a delay of several weeks. This syndrome has been termed "multisystem inflammatory syndrome in children" (MIS-C) and is observed in association with the coronavirus disease 2019 (COVID-19).
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to analyze the link between enteroviral skin infections and nasal swab tests for respiratory pathogens, particularly focusing on enterovirus/rhinovirus.
- Researchers reviewed medical records of 543 children who underwent enterovirus skin testing, with a subset of 170 also receiving a nasopharyngeal swab for further pathogen analysis.
- Results indicated that the nasal swab test is quite sensitive (90%) in detecting skin infections but had a lower positive predictive value (43%), suggesting it can effectively rule out infections if negative, although its ability to confirm infections is limited.
Article Synopsis
- Patients with epidermolysis bullosa (EB) have a risk of bacterial infections in their wounds and a subset are at risk for squamous cell carcinoma (SCC), leading to the need for careful wound management and analysis of bacterial cultures.
- A retrospective analysis of 739 wound cultures from 158 EB patients showed that Staphylococcus aureus and Pseudomonas aeruginosa were the most commonly found bacteria, with significant rates of antibiotic resistance observed.
- The findings emphasize the importance of monitoring bacterial resistance, as 47% of patients had methicillin-resistant S. aureus, reinforcing the need for effective antimicrobial strategies to prevent complications.
Multisystem Inflammatory Syndrome in Children Associated With Coronavirus Disease 2019 in a Children's Hospital in New York City: Patient Characteristics and an Institutional Protocol for Evaluation, Management, and Follow-Up.
Pediatr Crit Care Med
March 2021
Article Synopsis
- * A multidisciplinary team created the protocol based on extensive literature and hands-on experience, aiming to enhance case identification, risk stratification, and treatment approaches for children with MIS-C.
- * The implemented protocol successfully treated 54 patients over two months, with all patients surviving without requiring invasive support, demonstrating improved early treatment outcomes and effective follow-up care.
Characterization of vascular stains associated with high flow.
J Am Acad Dermatol
March 2021
Article Synopsis
- High-flow vascular stains (HFVS) are distinct from typical port wine stains due to their increased arterial flow and specific clinical features such as warmth and rapid capillary refill.
- A multicenter study analyzed 70 HFVS patients, identifying key characteristics like flat appearance, red or pink-red colors, and common occurrences of soft tissue swelling, particularly in the head and neck.
- Distinguishing HFVS from slow-flow stains is crucial, as their changing appearance over time may indicate the need for further evaluation of potential complications beyond the skin.
Article Synopsis
- Transitioning from pediatric to adult care is crucial for children with long-term health needs, especially conditions like epidermolysis bullosa (EB), which require additional support from healthcare providers.
- * Various effective transition models emphasize the importance of a structured program, early engagement, teamwork among specialists, and support for mental health to improve outcomes for these patients.
- * Patients with EB face unique challenges during this transition, and collaboration among healthcare providers is essential to create programs that address their specific needs and ensure successful care continuity.