Purpose: The incidence of pediatric herpes zoster has been increasing year by year. Pediatric herpes zoster is generally known to be less severe than adult cases, but may cause various complications such as secondary bacterial infections, encephalitis, meningitis, and Ramsay Hunt syndrome. In this study, we performed epidemiological and clinical investigations of children and adolescents diagnosed as herpes zoster. The incidence and clinical factors associated with complications of herpes zoster were studied. Methods: This study was retrospectively analyzed the medical records of 62 patients under 18 years who were diagnosed and treated with herpes zoster at Chosun University Hospital from 2007 to 2017. This patients were evaluated with regard to gender, age, dermatomal distributions, accompanying symptoms, underlying disease, treatment and complications. These patients were divided into two groups according to the presence or absence of complications. Results: Children under 18 years old account for 3.2% of all herpes zoster patients who were hospitalized at Chosun University Hospital from 2007 to 2017. The incidence of males was higher than that of females. The number of enrolled patients was increasing according to age. The number and the proportion of pediatric patients has been increasing year by year. Lesions of herpes zoster were most frequently found in the thoracic region, followed by the cervical, trigeminal, lumbar regions. The most common accompanying symptom was pain, followed by pruritus, fever, headache. Among the 62 cases, 27 cases (27.4%) were complicated by herpes zoster. Ramsay Hunt syndrome was the most common (16.1%), followed by meningitis and herpes ophthalmicus. Neither secondary bacterial infection nor postherpetic neuralgia were observed. Skin lesions in the trigeminal dermatomes was associated with complications (p=0.006). The mean of hospitalization period is longer in the group with complications (p=0.003). The patients accompanying symptoms such as headache was more likely to occur complications (p value＜0.05). There was no difference in age, sex, and underlying disease between the two groups. Conclusion: Patients with complications had longer duration of treatment and had more frequent with trigeminal and cervical region. The patients accompanying symptom such as headache were more likely to occur complications.

Increased total IgE and eosinophil count levels are thought to provoke the occurrence of urticaria. The purpose of this study is to measure serum total IgE levels, specific IgE sensitization rates, and blood eosinophil count and to investigate the relationship between those factors. Among children who visited the Department of Pediatrics at Chosun University Hospital from January 2011 to December 2013, we retrospectively analyzed 63 patients with acute urticaria. Positive rates of the total serum IgE level, specific IgE, and blood eosinophil count were analyzed in patients with acute urticaria. A total of 63 patients were included in the study and the rate of males to females was 1: 0.8. Mean age of patients was 6.41±4.97 years (range 0-17 years). Among the subjects, 42.9% of patients showed an elevated serum total IgE and 63.5% of patients showed at least more than one allergen-specific IgE by MAST (multiple allergosorbent test). The mean number of allergens detected in positive patients was 2.42±2.56/patient. The serum total IgE and allergen specific IgE showed significant positive correlation (OR = 0.290, p=0.02). This study is meaningful as it revealed a positive correlation between serum total IgE and allergen specific IgE in urticaria patients.

The aim of this study is to investigate the clinical significance of acanthosis nigricans scales and locations in order to validate the relation of hyperinsulinemia and insulin resistance in obese children. We conducted a retrospective analysis of clinical records of obese children who visited Chosun University Hospital between January 2013 and February 2014 due to their obesity. Five anatomical sites were examined for evaluation of acanthosis nigricans. Clinical characteristics were compared according to the presence and severity of acanthosis nigricans. Among 55 children, 37 children had acanthocis nigricans. A consensus score of acanthosis nigricans was calculated by summing the scores of five locations. The diagnostic categories were: No acanthosis nigricans group, mild group, moderate group, and severe group. Elevated acanthosis nigricans total score showed strong association with elevated BMI, triglyceride, and c-peptide in all groups. Elevated acanthosis nigricans total score also showed strong association with elevated fasting insulin and HOMA-IR. We also found that the neck was the most frequent location of acanthosis nigricans. However, acanthosis nigricans on axilla showed strong association with elevated fasting insulin and HOMA-IR. Estimation of scales and locations of acanthosis nigricans could be useful as a clinical alternative for determining hyperinsulinemia and insulin resistance in obese children.

Syncope is a common symptom, with 15% to 25% of children and adolescents experiencing at least one syncopal episode by young adulthood. In most cases, syncope is a symptom of benign diseases however may be a symptom of severe cardiac disease that results in sudden death. The purpose of this study is to analyze the etiologies and clinical characteristics of syncope in children and adolescents. We retroprospectively analyzed 51 patients with syncope. A total of 51 patients were included in the study and the ratio of males to female was 1: 1.04. The mean patient age was 12.7±3.1 years. Abrupt standing was the most common state of patients with syncopal attack. The etiologies of syncope were noncardiac syncope (60.7%), cardiac syncope (2%), neuropsychiatric syncope (25.5%), and unknown (11.8%). Abnormality of the head-up tilt test was more common in noncardiac syncope than the others [38.7% (12/31) vs 5% (1/20) (p=0.007)]. Further, EEG is a useful diagnostic test for neuropychiatric syncope [41.6% (5/12) vs 2.7% (1/36) (p=0.002)]. Therefore, detailed history taking and physical examinations were useful tools to diagnose the etiology of sycope. The head-up tilt test is an effective diagnostic test in noncardiac syncope and EEG is a valuable test in neuropychiatric syncope, especially in seizure.