I would not operate on this. I, I would do a CBC and a chest X-ray, and the main reason for doing those is because they're virtually always normal and it helps to reassure the family.
I would not operate on this. I, I would do a CBC and a chest X-ray, and the main reason for doing those is because they're virtually always normal and it helps to reassure the family.
clinicalRetinoid medications for acne are significantly associated with development of pyogenic granulomas; removal of medication often resolves the lesion↗
▶Ep 2 · 4:14
clinicalRetinoid medications for acne are significantly associated with development of pyogenic granulomas; removal of medication often resolves the lesion↗
▶Ep 2 · 4:47
clinicalPyogenic granuloma surgical resection has approximately 3% recurrence rate with gross negative margins↗
▶Ep 2 · 4:47
clinicalPyogenic granuloma surgical resection has approximately 3% recurrence rate with gross negative margins↗
▶Ep 2 · 4:54
quoteYou do not need to take, um, a wider margin, so about a 3% recurrence rate with that.↗
▶Ep 2 · 4:54
quoteYou do not need to take, um, a wider margin, so about a 3% recurrence rate with that.↗
▶Ep 2 · 5:04
clinicalShave excision with curettage of pyogenic granuloma has 9.5% recurrence rate↗
▶Ep 2 · 5:04
clinicalShave excision with curettage of pyogenic granuloma has 9.5% recurrence rate↗
▶Ep 2 · 5:20
quoteSilver nitrate actually has the lowest success rate, 15% recurrence rate with it.↗
▶Ep 2 · 5:20
clinicalSilver nitrate treatment for pyogenic granuloma has 15% recurrence rate, the highest among treatment options↗
▶Ep 2 · 5:20
clinicalSilver nitrate treatment for pyogenic granuloma has 15% recurrence rate, the highest among treatment options↗
▶Ep 2 · 5:20
quoteSilver nitrate actually has the lowest success rate, 15% recurrence rate with it.↗
▶Ep 2 · 5:33
quoteYou're not gonna get a path specimen, and it may require multiple treatments.↗
▶Ep 2 · 5:33
quoteYou're not gonna get a path specimen, and it may require multiple treatments.↗
▶Ep 2 · 8:28
epidemiologicalIn a large study, 80% of characteristic Spitz nevi involuted spontaneously↗
▶Ep 2 · 8:28
epidemiologicalIn a large study, 80% of characteristic Spitz nevi involuted spontaneously↗
▶Ep 2 · 8:44
clinicalHalf of pediatric dermatologists would observe classic Spitz nevi without excision, waiting for spontaneous resolution↗
▶Ep 2 · 8:44
clinicalHalf of pediatric dermatologists would observe classic Spitz nevi without excision, waiting for spontaneous resolution↗
▶Ep 2 · 9:43
clinicalIn a series of 30 patients with incompletely removed Spitz nevi, 24 were observed and none recurred; 6 were re-excised and only 1 had residual disease↗
▶Ep 2 · 9:43
clinicalIn a series of 30 patients with incompletely removed Spitz nevi, 24 were observed and none recurred; 6 were re-excised and only 1 had residual disease↗
▶Ep 2 · 10:23
clinicalIn a retrospective study with 1-3mm margins for Spitz nevi, 20% had positive margins on re-excision↗
▶Ep 2 · 10:23
clinicalIn a retrospective study with 1-3mm margins for Spitz nevi, 20% had positive margins on re-excision↗
▶Ep 2 · 10:45
guidelineBarnhill recommends 3-5mm margins for classic Spitz nevi, 1cm for atypical, and melanoma-protocol margins for severely atypical based on depth↗
▶Ep 2 · 10:45
guidelineBarnhill recommends 3-5mm margins for classic Spitz nevi, 1cm for atypical, and melanoma-protocol margins for severely atypical based on depth↗
▶Ep 2 · 11:56
epidemiologicalAbout one-third of Spitz nevi cases had nodal micrometastases on sentinel lymph node biopsy in combined adult and pediatric series↗
▶Ep 2 · 11:56
epidemiologicalAbout one-third of Spitz nevi cases had nodal micrometastases on sentinel lymph node biopsy in combined adult and pediatric series↗
▶Ep 2 · 12:18
clinicalIn 8 series, 39% of Spitz nevi with sentinel lymph node biopsy were positive, but all patients remained disease-free at 3-year follow-up without further intervention↗
▶Ep 2 · 12:18
clinicalIn 8 series, 39% of Spitz nevi with sentinel lymph node biopsy were positive, but all patients remained disease-free at 3-year follow-up without further intervention↗
▶Ep 2 · 14:12
quote24 patients. Uh, well, small studies. We got not a lot of these in kids, all right, but we see them. We see it. We've, I, I suspect all of us have seen at least a few.↗
▶Ep 2 · 14:12
quote24 patients. Uh, well, small studies. We got not a lot of these in kids, all right, but we see them. We see it. We've, I, I suspect all of us have seen at least a few.↗
▶Ep 2 · 18:28
epidemiologicalPediatric melanoma ABCDE criteria capture only 40% of cases in children under 10 and 60% in children over 11↗
▶Ep 2 · 18:28
epidemiologicalPediatric melanoma ABCDE criteria capture only 40% of cases in children under 10 and 60% in children over 11↗
▶Ep 2 · 19:35
guidelineMelanoma margin recommendations: 5mm for in situ, 1cm for ≤1mm thick, 1-2cm for 1-2mm thick, 2cm for >2mm thick↗
▶Ep 2 · 19:35
guidelineMelanoma margin recommendations: 5mm for in situ, 1cm for ≤1mm thick, 1-2cm for 1-2mm thick, 2cm for >2mm thick↗
▶Ep 2 · 19:50
clinicalCochrane review suggests 2cm margins are adequate for thick melanomas; no benefit demonstrated for 4cm margins↗
▶Ep 2 · 19:50
clinicalCochrane review suggests 2cm margins are adequate for thick melanomas; no benefit demonstrated for 4cm margins↗
▶Ep 2 · 20:12
epidemiologicalGiant congenital nevi (>20cm) have 8% melanoma risk, higher if hairy; 60% of melanomas occur in first decade, reported as young as 3 years↗
▶Ep 2 · 20:12
epidemiologicalGiant congenital nevi (>20cm) have 8% melanoma risk, higher if hairy; 60% of melanomas occur in first decade, reported as young as 3 years↗
▶Ep 2 · 20:35
epidemiologicalPediatric melanoma has higher metastatic rate to lymph nodes (about 25%) than adults, especially in children younger than 10 and with thicker lesions↗
▶Ep 2 · 20:35
epidemiologicalPediatric melanoma has higher metastatic rate to lymph nodes (about 25%) than adults, especially in children younger than 10 and with thicker lesions↗
▶Ep 2 · 21:02
clinicalIf sentinel node is negative in melanoma, probability of subsequent recurrence is only about 5%↗
▶Ep 2 · 21:02
clinicalIf sentinel node is negative in melanoma, probability of subsequent recurrence is only about 5%↗
▶Ep 2 · 21:08
clinicalIf sentinel node is negative in melanoma, probability of non-sentinel node being positive is low but not zero↗
▶Ep 2 · 21:08
clinicalIf sentinel node is negative in melanoma, probability of non-sentinel node being positive is low but not zero↗
▶Ep 2 · 27:50
quoteI would not operate on this. I, I would do a CBC and a chest X-ray, and the main reason for doing those is because they're virtually always normal and it helps to reassure the family.↗
▶Ep 2 · 27:50
quoteI would not operate on this. I, I would do a CBC and a chest X-ray, and the main reason for doing those is because they're virtually always normal and it helps to reassure the family.↗
▶Ep 2 · 28:02
quoteI think a 6 year old with a single node in the neck that's not growing, I think the chance of lymphoma is almost zero.↗
▶Ep 2 · 28:02
quoteI think a 6 year old with a single node in the neck that's not growing, I think the chance of lymphoma is almost zero.↗
▶Ep 2 · 30:57
clinicalAcute unilateral cervical lymphadenopathy is mostly bacterial (strep and staph); acute bilateral is usually viral↗
▶Ep 2 · 30:57
clinicalAcute unilateral cervical lymphadenopathy is mostly bacterial (strep and staph); acute bilateral is usually viral↗
▶Ep 2 · 31:30
clinicalChronic/subacute unilateral lymphadenopathy suggests atypical mycobacteria, Bartonella, tuberculosis, or toxoplasmosis↗
▶Ep 2 · 31:30
clinicalChronic/subacute unilateral lymphadenopathy suggests atypical mycobacteria, Bartonella, tuberculosis, or toxoplasmosis↗
▶Ep 2 · 31:45
clinicalChronic/subacute bilateral lymphadenopathy suggests EBV, CMV, or HIV↗
▶Ep 2 · 31:45
clinicalChronic/subacute bilateral lymphadenopathy suggests EBV, CMV, or HIV↗
▶Ep 2 · 32:43
clinicalLymphadenopathy may persist 6-8 weeks after antibiotic treatment↗
▶Ep 2 · 32:43
clinicalLymphadenopathy may persist 6-8 weeks after antibiotic treatment↗
▶Ep 2 · 34:22
clinicalBiopsy indications for cervical lymphadenopathy include: >3cm, hard/fixed, supraclavicular or epitrochlear location, multiple nodal groups, systemic symptoms, hepatosplenomegaly, significantly abnormal labs, or abnormal imaging↗
▶Ep 2 · 34:22
clinicalBiopsy indications for cervical lymphadenopathy include: >3cm, hard/fixed, supraclavicular or epitrochlear location, multiple nodal groups, systemic symptoms, hepatosplenomegaly, significantly abnormal labs, or abnormal imaging↗
▶Ep 2 · 34:58
clinicalFNA for lymph nodes has 90% sensitivity and specificity but 10% false rate, with higher false-negative rate in Hodgkin lymphoma↗
▶Ep 2 · 34:58
clinicalFNA for lymph nodes has 90% sensitivity and specificity but 10% false rate, with higher false-negative rate in Hodgkin lymphoma↗
▶Ep 2 · 35:39
epidemiologicalMalignancy rate in cervical lymph node biopsies varies 10-25% overall but ranges 12-80% depending on referral patterns and specialty↗
▶Ep 2 · 35:39
epidemiologicalMalignancy rate in cervical lymph node biopsies varies 10-25% overall but ranges 12-80% depending on referral patterns and specialty↗
▶Ep 2 · 38:00
clinicalAtypical mycobacterial lymphadenitis is a local problem in immunocompetent children, usually age 1-5 years, enters through oropharynx, and is not considered contagious↗
▶Ep 2 · 38:00
clinicalAtypical mycobacterial lymphadenitis is a local problem in immunocompetent children, usually age 1-5 years, enters through oropharynx, and is not considered contagious↗
▶Ep 2 · 38:31
clinicalIn a randomized multicenter trial for atypical mycobacterial lymphadenitis, surgery had 96% cure rate versus 66% cure rate with antibiotics alone↗
▶Ep 2 · 38:31
clinicalIn a randomized multicenter trial for atypical mycobacterial lymphadenitis, surgery had 96% cure rate versus 66% cure rate with antibiotics alone↗
▶Ep 2 · 38:56
clinicalIn a series of 55 patients with confirmed atypical mycobacteria, 45 started on antibiotics and 30 (67%) resolved without surgery↗
▶Ep 2 · 38:56
clinicalIn a series of 55 patients with confirmed atypical mycobacteria, 45 started on antibiotics and 30 (67%) resolved without surgery↗
▶Ep 2 · 50:31
clinicalNeonatal breast mastitis occurs mostly in term or near-term infants due to estrogen exposure; very uncommon in preemies because estrogen levels don't rise↗
▶Ep 2 · 50:31
clinicalNeonatal breast mastitis occurs mostly in term or near-term infants due to estrogen exposure; very uncommon in preemies because estrogen levels don't rise↗
▶Ep 2 · 50:44
epidemiologicalPeak age for neonatal mastitis is 2-4 weeks; majority are staph but gram negatives reported↗
▶Ep 2 · 50:44
epidemiologicalPeak age for neonatal mastitis is 2-4 weeks; majority are staph but gram negatives reported↗
▶Ep 2 · 51:26
clinicalParenteral antibiotics for 7-14 days may be needed for neonatal mastitis because infants have delayed absorption and delayed antibiotic efficacy↗
▶Ep 2 · 51:26
clinicalParenteral antibiotics for 7-14 days may be needed for neonatal mastitis because infants have delayed absorption and delayed antibiotic efficacy↗
▶Ep 2 · 52:39
clinicalIn two small series of neonatal mastitis with I&D, breast deformity occurred in 2 of 5 patients (40%) in one study and 2 of 7 patients (29%) in another↗
▶Ep 2 · 52:39
clinicalIn two small series of neonatal mastitis with I&D, breast deformity occurred in 2 of 5 patients (40%) in one study and 2 of 7 patients (29%) in another↗
▶Ep 2 · 1:03:11
clinicalFibroadenomas are the most common breast lesion in the under-20 age group, representing an exaggerated response to estrogen↗
▶Ep 2 · 1:03:11
clinicalFibroadenomas are the most common breast lesion in the under-20 age group, representing an exaggerated response to estrogen↗
▶Ep 2 · 1:03:20
epidemiologicalAbout 10-15% of fibroadenomas are multiple and 10% are bilateral↗
▶Ep 2 · 1:03:20
epidemiologicalAbout 10-15% of fibroadenomas are multiple and 10% are bilateral↗
▶Ep 2 · 1:03:27
clinicalFibroadenomas typically increase in size over 6-12 months, then stabilize and can regress completely↗
▶Ep 2 · 1:03:27
clinicalFibroadenomas typically increase in size over 6-12 months, then stabilize and can regress completely↗
▶Ep 2 · 1:04:17
clinicalExcisional biopsy for fibroadenoma is recommended if continuing to grow, changing, over 5cm, symptomatic, complex on ultrasound, unreliable follow-up, or severe family anxiety↗
▶Ep 2 · 1:04:17
clinicalExcisional biopsy for fibroadenoma is recommended if continuing to grow, changing, over 5cm, symptomatic, complex on ultrasound, unreliable follow-up, or severe family anxiety↗
▶Ep 2 · 1:05:00
clinicalJuvenile fibroadenomas are larger lesions with rapid growth, greater than 5cm, but only 10% reach that size↗
▶Ep 2 · 1:05:00
clinicalJuvenile fibroadenomas are larger lesions with rapid growth, greater than 5cm, but only 10% reach that size↗
▶Ep 2 · 1:05:14
clinicalJuvenile fibroadenomas larger than 5cm are difficult to distinguish from cystosarcoma phyllodes, even on percutaneous biopsy↗
▶Ep 2 · 1:05:14
clinicalJuvenile fibroadenomas larger than 5cm are difficult to distinguish from cystosarcoma phyllodes, even on percutaneous biopsy↗
▶Ep 2 · 1:05:57
clinicalSimple fibroadenomas (isolated, well-demarcated, solid) have no increased cancer risk if no family history and no adjacent breast tissue abnormality↗
▶Ep 2 · 1:05:57
clinicalSimple fibroadenomas (isolated, well-demarcated, solid) have no increased cancer risk if no family history and no adjacent breast tissue abnormality↗
▶Ep 2 · 1:06:14
clinicalComplex fibroadenomas (with cysts, calcifications, or abnormal surrounding tissue) carry a slight increased risk of future breast cancer up to 20 years after diagnosis↗
▶Ep 2 · 1:06:14
clinicalComplex fibroadenomas (with cysts, calcifications, or abnormal surrounding tissue) carry a slight increased risk of future breast cancer up to 20 years after diagnosis↗
▶Ep 2 · 1:06:42
epidemiologicalMalignant breast disease in pediatric patients is rare and more commonly metastatic from other sites than primary breast tumors↗
▶Ep 2 · 1:06:42
epidemiologicalMalignant breast disease in pediatric patients is rare and more commonly metastatic from other sites than primary breast tumors↗
▶Ep 2 · 1:06:53
epidemiologicalLymphoma patients treated with chest radiation at young ages have up to 25% higher incidence of malignant breast disease↗
▶Ep 2 · 1:06:53
epidemiologicalLymphoma patients treated with chest radiation at young ages have up to 25% higher incidence of malignant breast disease↗
▶Ep 2 · 1:07:05
guidelineAmerican Society of Clinical Oncology discourages BRCA genetic testing before age 20 due to lack of timely medical benefit and psychosocial risks↗
▶Ep 2 · 1:07:05
guidelineAmerican Society of Clinical Oncology discourages BRCA genetic testing before age 20 due to lack of timely medical benefit and psychosocial risks↗
