Table of Content

15 May 2026 Volume 44 Issue 5

  

Standard · Protocol · Guideline

Expert consensus on non-pharmacological interventions for atopic dermatitis in children

Professional Committee of Child Allergology, China Maternal and Child Health Association, Dermatology and Venereology Group of Pediatric Branch Society, Chinese Medical Association: Editorial Board of the Journal of Clinical Pediatrics

Journal of Clinical Pediatrics. 2026, 44(5):  381-393.  doi:10.12372/jcp.2026.25e1596

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Atopic dermatitis (AD), a chronic and recurrent inflammatory skin disorder, has witnessed a sustained global and domestic upward trend in incidence since the 21st century, emerging as a critical public health concern. The comprehensive management framework for AD encompasses two core pillars: pharmacotherapy and non-pharmacological interventions. Despite the expanding armamentarium of AD pharmacotherapies in recent years, the intricate pathogenesis and marked clinical heterogeneity of AD render monotherapy insufficient for optimal disease control. Non-pharmacological interventions thus remain an indispensable cornerstone in AD prevention and management. However, existing domestic and international AD treatment consensus and guidelines are predominantly structured around pharmacotherapy, with a notable paucity of systematic attention and integration of non-pharmacological strategies. Against this backdrop, the Children’s Allergy Committee of the China Maternal and Child Health Association, the Dermatology and Venereology Group of Pediatric Branch Society, Chinese Mechical Association and Editorial Board of the Journal of Clinical Pediatrics convened 33 dermatology experts from 30 medical institutions to formulate this consensus, drawing on the latest domestic and international research advances and clinical practice experience. This consensus systematically delineates non-pharmacological management strategies for AD, with core recommendations including avoidance of triggering factors, standardized skin care to maintain skin barrier homeostasis, and implementation of health education and psychological support. It emphasizes the pivotal role of non-pharmacological interventions as foundational measures in AD management, aiming to reduce disease recurrence and enhance the quality of life of affected children. Additionally, it clarifies the applicable scenarios and key implementation points for each measure, providing systematic and practical guidance for clinicians, caregivers of affected children, and health managers.

Clinical practice essentials of Expert consensus on non-pharmacological interventions for atopic dermatitis in children

Limin Dou, Jianbo Wang, Yunqing REN, Ming LI

Journal of Clinical Pediatrics. 2026, 44(5):  394-398. 

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Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder that is highly prevalent in children. Because of its pathogenesis and clinical heterogeneity, exclusive use of pharmacological treatment cannot achieve the optimal control of AD. This consensus therefore endorses non-pharmacological interventions as essential components of comprehensive AD management. The recommendations emphasize the avoidance of environmental triggering factors, the maintenance and restoration of skin barrier homeostasis via structured skincare, and the implementation of patient/caregiver education and psychological support. These measures aim not only to reduce relapse frequency and extent clinical remissions, but also to improve the quality of life for patients and caregivers. The consensus offers four core recommendations: (1) Non-pharmacological interventions should be employed as primary management strategies across the spectrum of AD severity, from mild to severe disease. (2) Effectiveness of the interventions should be assessed through clinical and medical evaluation, with supplemental objective or laboratory measurements when feasible. (3) Primary interventions include systematic avoidance of environmental triggers, regular application of skin care, and structured programs for education and psychological support. (4) Non-pharmacological strategies are applicable at all stages of disease, from prevention to active flares and clinical remissions.

Expert Review

Molecular mechanisms, diagnosis, and treatment of skin disorders associated with CARD14 mutations

ZHAO Xinrong, XU Zigang

Journal of Clinical Pediatrics. 2026, 44(5):  399-404.  doi:10.12372/jcp.2026.25e1600

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In recent years, with advances in molecular biology and genetics, the CARD14 gene has been confirmed to be closely related to a variety of diseases. Patients typically develop symptoms shortly after birth, which severely impacts their health and quality of life. Due to the large clinical heterogeneity of this group of diseases and the difficulty in treatment, early identification and personalized intervention have significant clinical significance. This article systematically expounds the molecular mechanism, clinical phenotype spectrum and the latest progress of targeted therapy of CARD14-related skin diseases, aiming to provide theoretical basis and clinical reference for the precise diagnosis and treatment of such diseases.

Neutrophils and atopic dermatitis: from pathological mechanisms to research advances

TANG Qijun, LUO Xiaoyan

Journal of Clinical Pediatrics. 2026, 44(5):  405-411.  doi:10.12372/jcp.2026.25e1601

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Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder driven by multifactorial mechanisms, with dysregulated immune responses as its central pathogenesis. Innate immune cells serve as the core of early inflammatory reactions in AD skin and act as critical nodes for inflammatory signal transduction and amplification. Neutrophils (NEU), the pivotal cellular component of innate immunity, play essential roles in the initiation of inflammation and antibacterial immunity. This review provides an overview of the current understanding regarding the origin, classification, activation mechanisms, and physiological/pathological functions of NEU—including pro-inflammatory, immunosuppressive, and atypical properties. It further explores how NEU rapidly activate upon sensing cutaneous inflammatory or antigenic signals, and subsequently promote inflammatory progression through effector mechanisms such as chemotaxis, degranulation, phagocytosis, reactive oxygen species (ROS) production, and formation of neutrophil extracellular traps (NETs). Additionally, NEU recruit other immune cells to collectively contribute to the development of skin barrier impairment and pruritus. This review aims to comprehensively present cutting-edge insights into the involvement of NEU in the pathophysiological processes of AD, thereby facilitating readers' grasp of research advances in this field.

Original Article

Short-term efficacy and recurrence risk of dupilumab in the treatment of moderate to severe atopic dermatitis in children: a single-center retrospective study

HAO Yanzhao, LI Wanyue, LI Jianguo, DOU Jinfa, YU Huiqian, WANG Jianbo

Journal of Clinical Pediatrics. 2026, 44(5):  412-417.  doi:10.12372/jcp.2026.25e1604

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Objective To evaluate the short-term efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in children and the recurrence after drug withdrawal. Methods A retrospective study was conducted, including children with moderate to severe AD who visited the dermatology outpatient department from January 2024 to March 2025 and completed 16 weeks of dupilumab treatment. Dupilumab was administered according to the standard protocol based on age and weight. The Atopic Dermatitis Score (SCORAD), Eczema Area and Severity Index (EASI), ItchyQuant, and Patient-Oriented Eczema Measure (POEM) scores of the children were compared at baseline and at weeks 4, 8, 12, and 16 of treatment. Follow-up was conducted for 12 weeks after drug withdrawal in children who completed 16 weeks of treatment to assess recurrence. Results A total of 41 children with moderate-to-severe atopic dermatitis (AD) were enrolled, including 22 boys and 19 girls, with a median age of 8.00 (5.50-10.00) years. Statistically significant differences were observed in SCORAD, EASI, ItchyQuant, and POEM scores between baseline and weeks 4, 8, 12, and 16 of dupilumab treatment (all P<0.001). Pairwise comparisons revealed that, compared with baseline, SCORAD and EASI scores decreased significantly at weeks 8, 12, and 16 (all P<0.001); ItchyQuant and POEM scores decreased significantly at weeks 4, 8, 12, and 16 (all P<0.001). At week 16 of treatment, 35 (85.37%), 22 (53.66%), 10 (24.39%), and 1 (2.44%) children achieved EASI-50, EASI-75, EASI-90, and EASI-100, respectively. A total of 33 children were followed up for 12 weeks after treatment discontinuation. Overall comparisons of SCORAD, EASI, ItchyQuant, and POEM scores between the last treatment (week 16) and weeks 4, 8, and 12 after discontinuation showed statistically significant differences (all P<0.001). Pairwise comparisons indicated that at 12 weeks after discontinuation, SCORAD, EASI, ItchyQuant, and POEM scores were significantly increased compared with the last treatment (P<0.001). Despite significant rebound, SCORAD, EASI, ItchyQuant, and POEM scores at 12 weeks after discontinuation remained significantly lower than baseline levels (all P<0.001). According to different criteria for clinical deterioration, 8 children (24.24%) had an EASI increase ≥50% from the time of discontinuation with EASI≥7 points; 10 children (30.30%) had an ItchyQuant increase≥3 points from the time of discontinuation with ItchyQuant≥4 points; and 12 children (36.36%) had a POEM increase≥4 points from the time of discontinuation with POEM≥8 points. Conclusions Sixteen weeks of dupilumab treatment significantly improved skin lesions and pruritus symptoms in children with moderate-to-severe AD; however, a certain risk of relapse exists 12 weeks after treatment discontinuation.

Dermoscopic characteristics analysis of acral volar melanocytic nevi in children and adolescents

DONG Ying, CAO Tingting, WU Jianping, ZHANG li, GE Hongsong

Journal of Clinical Pediatrics. 2026, 44(5):  418-423.  doi:10.12372/jcp.2026.25e1605

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Objective To explore the dermoscopic characteristics of melanocytic nevi on the acral volar area in children and adolescents, and to analyze the distribution of different dermoscopic patterns in different anatomic localization. Methods The clinical data and dermoscopic images of patients with acral volar melanocytic nevi in Dermatology Department from June 2022 to June 2025 were analyzed retrospectively. Results A total of 138 melanocytic nevi in 129 pediatric patients were included, among which 120 cases were single acral volar melanocytic nevi and the remaining 9 cases were multiple acral volar melanocytic nevi. Among them, there were 57 girls (44.2%) and 72 boys (55.8%), with a median age of 5.00 (2.75-7.00) years. Among the 34 patients, 39 melanocytic nevi were located on the palms, and in 95 patients, 99 melanocytic nevi were located on the soles. The most common dermoscopic pattern was the parallel furrow pattern (43/138, 31.2%), followed by the the peas-in-a-pod pattern (32/138, 23.2%) and the fibrillar pattern (28/138, 20.3%). There is a statistically significant difference in the distribution of different anatomic localisation among different dermoscopic patterns (χ²=50.78, P<0.001). The chi-square partition test was used for pairwise comparisons, and it was found that the lattice-like pattern in the plantar arch area had a higher proportion compared to the parallel furrow pattern, the fibrillar pattern, and the peas-in-a-pod pattern. In the weight-bearing area of the sole (including the metatarsal area, the heel area, and the lateral midfoot area), the proportion of the fibrillar pattern was higher than that of the lattice-like pattern. In the volar surface of the fingers, the proportion of the peas-in-a-pod pattern was higher than that of the fibrillar pattern. All differences were statistically significant (P<0.005). Conclusions The dermoscopic patterns of acral volar melanocytic nevi in children and adolescents may be related to the anatomic localization. The lattice-like pattern is more common in the plantar arch area, the fibrillar pattern is more likely to occur in the weight-bearing area of the sole, and the peas-in-a-pod pattern is often seen on the volar surface of the fingers.

PSAT1 gene variant causes mild serine deficiency: clinical and genetic analysis of ichthyosis combined with peripheral neuropathy

HUANG Haisheng, ZHAO Anqi, ZENG Qin, WANG Yumeng, HE Wei, LI Ming

Journal of Clinical Pediatrics. 2026, 44(5):  424-430.  doi:10.12372/jcp.2026.25e1598

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Objective To investigate the clinical classification, genetic basis, and diagnostic and treatment strategies for serine deficiency caused by PSAT1 gene variants, in order to improve clinical recognition of this disorder. Methods Clinical data were retrospectively collected from a pediatric patient presenting with ichthyosis complicated by peripheral neuropathy. Family-based whole exome sequencing, Sanger validation, and protein structure prediction were performed. Following identification of the causative gene, treatment and follow-up were conducted. A systematic literature review was also carried out to summarize the clinical phenotypes, genetic variant characteristics, treatment responses, and prognostic features. Results The patient was a 12-year-old female who developed dry, scaly skin across the body at 2 years of age. Since the age of 7 years, she experienced progressive weakness in both lower limbs, foot drop, and horizontal nystagmus. Previous examinations revealed normal plasma serine levels (233.29 μmol/L and 319.19 μmol/L). Family-based whole exome sequencing identified a novel homozygous PSAT1 gene variant, c.697C>A (p.Q233K), which was classified as a variant of uncertain significance according to ACMG guidelines. Sanger sequencing confirmed that both parents were carriers. The patient received oral supplementation with L-serine （300 mg·kg^-1·d^-1） and glycine （200 mg·kg^-1·d^-1）. After one week of treatment, the dry skin and desquamation improved significantly. After 13 weeks, gait showed marked improvement, and the patient was able to squat and stand up independently. A literature review identified five additional cases of mild serine deficiency. Including the present case, a total of six cases were identified, all of which carried PSAT1 gene variants. Conclusion The phenotypic spectrum of serine deficiency is broad, with the mild form characterized by childhood-onset ichthyosis and adolescent-onset peripheral neuropathy as core manifestations. Affected individuals often have normal or only mildly reduced plasma serine levels, making this condition highly prone to being missed. Early diagnosis and timely supplementation with L-serine are critical for improving prognosis and can prevent irreversible neurological damage. For patients presenting with unexplained ichthyosis accompanied by peripheral neuropathy, genetic testing should be pursued as early as possible to establish a definitive diagnosis.

A genetic study of three families with epidermolysis bullosa simplex

QIN Sijia, CUI Mengxing, ZHANG Yue, ZHANG Guiyuan, LANG Pengxiang, CHEN Gang, LIANG Bo

Journal of Clinical Pediatrics. 2026, 44(5):  431-437.  doi:10.12372/jcp.2026.25e1603

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Objective To analyze the pathogenic gene mutation characteristics in three families with epidermolysis bullosa simplex (EBS) and explore the association between genotype and phenotype, providing evidence for molecular diagnosis and genetic counseling of EBS. Methods Three EBS families admitted between 2019 and 2023 were enrolled. Whole-exome sequencing (WES) was performed to screen candidate pathogenic mutations, followed by Sanger sequencing validation. For the novel KRT5 mutation, protein structure modeling and functional prediction were conducted using AlphaFold 3 and PDBePISA. Individualized intervention plans were formulated and followed up. Results All patients in the three families met the diagnostic criteria for localized EBS (EBS-loc), and there were differences in the extent, severity, and disease course. Genetic testing revealed that family 1 carried a novel missense mutation in the KRT5 gene (NM_000424.4): c.1291A>G (p.Lys431Glu), which was an autosomal dominant inheritance; family 2 carried a known missense mutation in the KRT14 gene (NM_000526.5): c.374G>A (p.Arg125His), which was co-segregated with the phenotype; family 3 carried a novel missense mutation in the KRT5 gene (NM_000424.4): c.428T>A (p.Val143Asp). Protein structure prediction showed that the p.Lys431Glu mutation would weaken the binding affinity and structural stability of the KRT5-KRT14 heterodimer. Conclusion This study identified a novel KRT5 (NM_000424.4): c.1291A>G (p.Lys431Glu) mutation that has not been reported before, enriching the EBS mutation spectrum. Protein structure prediction revealed the pathogenic mechanism of this mutation. Individualized comprehensive management can significantly improve the prognosis of EBS patients, and genetic testing provides an important basis for clear diagnosis, genetic counseling, and individualized management.

Clinical features of fructose-1,6-bisphosphatase deficiency in 4 children and literature review

HUANG Shuyue, CHENG Ming, WANG Xi′ou, SONG Yi, DU Mu, SONG Fuying, CAO Bingyan

Journal of Clinical Pediatrics. 2026, 44(5):  438-444.  doi:10.12372/jcp.2026.25e1355

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Objective To summarize the clinical features and genetic variation characteristics of children with fructose-1,6-bisphosphatase deficiency (FBP1D) caused by FBP1 gene variations. Methods Four pediatric patients with FBP1D admitted from January 2019 to June 2025 were enrolled as study subjects. Their clinical manifestations, laboratory findings, genetic testing results, treatment strategies, and prognosis were analyzed retrospectively. Additionally, a literature review was conducted to summarize data of previously reported Chinese FBP1D patients. Results The four patients were from four unrelated families, including 1 male and 3 females, with ages at diagnosis of 2 years and 3 months, 3 years and 5 months, 2 years and 11 months, and 4 years and 4 months, respectively. Core clinical presentations included fever, vomiting, anorexia, accompanied by drowsiness, fatigue, hyperhidrosis, and lethargy. Laboratory tests revealed hypoglycemia, metabolic acidosis, elevated lactate, and increased blood ketone bodies. All patients carried homozygous or compound heterozygous FBP1 gene variants, among which three novel variants were identified (c.242T>C, c.469G>C, c.115C>A). During a follow-up period of 6 months to 6 years, all patients achieved well-controlled disease under strict dietary management and close blood glucose monitoring, with essentially normal physical and mental development. As of December 20, 2025, a total of 38 FBP1D cases had been reported in China (23 males, 15 females), with the most common manifestations being hypoglycemia, metabolic acidosis, and convulsions. Approximately 81.6% of patients exhibited normal intellectual and motor development without neurological sequelae. The most frequent FBP1 gene variants were c.960dup, c.960del, c.490G>A, c.704del, and c.355G>A. Conclusion Ketotic hypoglycemia accompanied by metabolic acidosis and elevated lactate should raise suspicion of FBP1D, and genetic testing is recommended in such cases. Rational dietary management and blood glucose monitoring can effectively reduce the frequency of hypoglycemic episodes in FBP1D children. Hypoglycemic attacks tend to decrease with age, and most patients have a favorable prognosis.

Pediatric Grand Rounds

Urticaria as the initial manifestation of systemic juvenile idiopathic arthritis: a clinical perspective

ZHANG Qihao, REN Yunqing

Journal of Clinical Pediatrics. 2026, 44(5):  445-452.  doi:10.12372/jcp.2026.25e1599

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This article reports the case of an 8-year-and-6-month-old female who presented with recurrent generalized urticarial lesions and remittent high fever. Initially suspected as chronic urticaria, her condition showed poor response to conventional treatments including anti-infectives, antihistamines, and glucocorticoids. The disease progressed rapidly with multisystem involvement and a marked elevation in inflammatory markers. Through multidisciplinary collaboration and systematic evaluation, she was ultimately diagnosed with systemic juvenile idiopathic arthritis (SJIA) complicated by macrophage activation syndrome (MAS). Her condition was gradually controlled with multitarget immunosuppressive therapy, including high-dose glucocorticoid pulse therapy, cyclosporine, and ruxolitinib. Based on this case, this article focuses on the differential diagnosis, diagnostic approach, and early recognition strategies for diseases presenting initially with urticarial lesions, aiming to enhance pediatricians' ability in the diagnosis and management of such conditions, thereby enabling early screening, intervention, and improved prognosis for complex and critical cases.

Clinical Report

A case report of Chediak-Higashi syndrome

JI Zijing, HUANG Haisheng, ZHAO Anqi, HE Wei, LI Min, LI Ming

Journal of Clinical Pediatrics. 2026, 44(5):  453-455.  doi:10.12372/jcp.2026.25e1602

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Objective To explore the clinical characteristics and genetic features of Chediak-Higashi syndrome. Methods Trio whole-exome sequencing (trio-WES) was performed to identify the pathogenic gene variant. The clinical data of the child were summarized, and the clinical and genetic characteristics were analyzed. Results The patient, a 1-year and 7-month-old boy, presented to the dermatology department of the Children's Hospital of Fudan University with the chief complaints of pigmentation on the face and distal limbs, accompanied by gray hair for over one year. Trio-WES revealed compound heterozygous mutations in the LYST gene (c.2962C>T, c.10564+1dupG). The splicing site mutation (c.10564+1dupG) was a de novo variant. The inheritance pattern was consistent with autosomal recessive inheritance. A final diagnosis of Chediak-Higashi syndrome caused by LYST gene mutations was made. Conclusion Cases of Chediak-Higashi syndrome caused by LYST gene mutations are rarely reported. The variant combination identified in this case is previously unreported, which expands the genotype-phenotype spectrum of LYST gene defects and provides further data for understanding Chediak-Higashi syndrome. Precise diagnosis relies on molecular genetic testing. More cases need to be accumulated to further analyze the genotype-phenotype correlation and prognostic evaluation.

Rare epidermolytic nevus in children caused by mosaic variation of KRT10 gene: a case report

PAN Chaolan, CHENG Wenjie, ZHANG Jia

Journal of Clinical Pediatrics. 2026, 44(5):  456-459.  doi:10.12372/jcp.2026.25e1606

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Objective Epidermolytic nevus (EN) is a mosaic phenotype of epidermolytic ichthyosis (EI). This study reported a rare case of EN caused by mosaic mutation of KRT10 gene, and explored the genotype and phenotype of this disease. Methods Clinical data of a child with EN who was admitted to the Dermatology Diagnosis and Treatment Center in November 2024 were collected. Peripheral venous blood samples of the child and her parents were collected respectively, and skin tissue samples from the child's lesional site were obtained to extract whole-genome DNA. Next-generation sequencing was used to detect gene variations in the proband and her parents, which was verified by Sanger sequencing. Meanwhile, peripheral blood genomic DNA of 100 unrelated healthy individuals was extracted as control samples. Results The child, a 1-year-and-7-month-old female, was admitted to the Dermatology Diagnosis and Treatment Center due to "striate erythema on the trunk and limbs for more than 1 year". Genetic testing results showed that the child had a heterozygous variation of KRT10 gene c.466C>T: p.Arg156Cys in the lesional tissue (variation ratio 10.18%), while the child and her parents had no such variation in the blood, suggesting it was a de novo mosaic mutation; the guidelines of the American College of Medical Genetics and Genomics (ACMG) indicated that this locus mutation was pathogenic. No identical variation was found in 100 healthy controls. Conclusions This study confirms that KRT10 gene c.466C>T (p.Arg156Cys) is the pathogenic mutation of this case of EN, which causes the disease by affecting protein conformation and disrupting the assembly and stability of keratin intermediate filaments; the low proportion of heterozygous mutation in the child's lesional tissue and wild type in the peripheral blood suggest that the mutation is a somatic mosaic variation occurring in the late stage of embryonic development, with a low risk of multi-system involvement, but the possibility of germline mosaicismshould be vigilant.

A case report of a newborn neuroblastoma presenting with a single light blue nodule on the top of the head as the initial manifestation

DOU Limin, ZHAO Piaoping, TANG Weitao, MA Yangyang, DONG Kuiran, WANG Liuhui, YE Ying, LI Ming

Journal of Clinical Pediatrics. 2026, 44(5):  460-464.  doi:10.12372/jcp.2026.25e1607

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The patient was a G1P1 neonate born at 38 weeks of gestation with a birth weight of 3.1 kg and an Apgar score of 10. A pale blue nodule was noted on the vertex of the infant’s head immediately after birth, which was misdiagnosed as a hemangioma at a local hospital. Subsequently, similar cutaneous nodules gradually appeared on skin, and the infant was admitted to the Department of Dermatology of our hospital at the age of 2.5 months. Physical examination showed that no raccoon eyes sign was observed. Multiple pale blue nodules, the size of broad beans, were scattered on the skin firm in texture, smooth in surface, with poor mobility and no tenderness. Skin lesion ultrasound and hepatosplenic ultrasound revealed multiple lesions in the liver, and the infant was then referred to the Department of Oncology. Neuroblastoma was finally confirmed by pathological examination. The infant received chemotherapy combined with surgical treatment, and has been well who was followed up for 10 years after diagnosis. For single pale blue cutaneous nodule in the neonatal period, palpation to evaluate the texture of the nodule is necessary. Firm nodule may indicate the need for timely referral to surgical oncology for screening of neuroblastoma.

Literature Review

Clinical application of birch triterpenes extract in epidermolysis bullosa

CHEN Fuying, LU Wenmin, LI Ming

Journal of Clinical Pediatrics. 2026, 44(5):  465-470.  doi:10.12372/jcp.2026.25e1597

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Epidermolysis bullosa (EB) is a group of inherited skin disorders caused by genetic defects that lead to increased mechanical fragility of the skin and mucous membranes. It can be accompanied by systemic complications such as malnutrition, chronic inflammation, infection, and squamous cell carcinoma. There is no curative treatment available. Birch triterpenes gel is an innovative botanical gel formulation primarily composed of betulin as the active ingredient. It accelerates wound healing by modulating the inflammatory response at the wound site, promoting keratinocyte migration, and stabilizing dermal-epidermal adhesion. Furthermore, it has demonstrated multiple positive outcomes in reducing procedural pain, decreasing the burden of dressing changes, and alleviating overall wound burden, including wound pain and itching, with an overall favorable safety profile. This article provides a review of the mechanism of action, clinical efficacy, safety, and clinical application of birch triterpenes gel, aiming to offer evidence-based guidance for the clinical management of EB patients in China.

Application of motivational interviewing in the management of pediatric and adolescent diseases

GU Siyi, XU Mingyu, LI Fei

Journal of Clinical Pediatrics. 2026, 44(5):  471-477.  doi:10.12372/jcp.2026.25e1121

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Motivational interviewing (MI) is a person-centered, goal-oriented communication method that enhances individuals' intrinsic motivation for behavior change by exploring and resolving ambivalence. In recent years, MI has been gradually applied in pediatrics, demonstrating significant clinical potential in areas such as pediatric mental and psychological disorders and chronic disease health management. Additionally, the parent-involved MI intervention model demonstrates multidimensional effects in improving treatment adherence, enhancing parental mental health, and optimizing clinical outcomes for children with illnesses. Since there are significant differences between children and adults in physical and psychological development, the application of MI in pediatrics has unique characteristics and challenges distinct from those in adults. This article systematically summarizes the current application models, status and effects of MI in pediatrics, and discusses future research directions.

Clinical challenges and research progress in nutritional support for children with anorexia nervosa

WANG Lihui, MA Ming

Journal of Clinical Pediatrics. 2026, 44(5):  478-484.  doi:10.12372/jcp.2026.25e1559

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Anorexia nervosa(AN) is an eating disorder characterized by the deliberate maintenance of low body weight,with both low diagnosis rate and low standardized treatment rate. Patients with long-term malnutrition are prone to severe multisystem complications, and nutritional support is the core component of their treatment. Currently, two regimens are predominantly applied in clinical nutritional support: the traditional low-calorie refeeding and high-calorie refeeding. Among them, the high-calorie refeeding regimen not only shortens the length of hospital stay and reduces medical costs, but also does not increase the risk of refeeding syndrome. However, the applicability of this regimen in children with severe malnutrition and its long-term effects require further exploration. Regarding the nutritional support regimens for children with AN, particularly the initial calorie intake regimen, there is still no unified consensus internationally. In view of this, this paper systematically reviews the nutritional assessment tools, nutritional support strategies, and key points for the prevention of refeeding syndrome in children with AN. Studies have shown that the adoption of multidimensional integrated assessment can effectively improve the accuracy of nutritional evaluation.