Ask the expert: Can kids get melanoma?

Carlos Rodriguez-Galindo
Carlos Rodriguez-Galindo, MD

My 16-year-old daughter loves to tan. Should we be worried about skin cancer? – Sunseeker’s dad

Although melanoma is very rare in children, the incidence of childhood and adolescent melanoma has increased on average 2 percent per year since 1973. Thankfully, however, the incidence rate has started to decrease again in the last few years. The biggest increase has been in girls ages 15-19, possibly because girls are more likely than boys to sunbathe and use tanning beds.

While melanoma is the least common type of skin cancer in adults, skin cancer in children is almost always melanoma. Because melanoma often appears differently in children than in adults, doctors and parents sometimes overlook it or misdiagnose it as a different skin problem.

We spoke with Dr. Carlos Rodriguez-Galindo, clinical director of the Solid Tumor Center at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, to learn what parents should know about melanoma in children.

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Solving Addison’s puzzle: Uncovering a congenital heart defect

Addison-on-bike-trail1Addison is a smart, sweet and caring child who brings a smile to everyone she meets. She is known for her hugs and frequently doles them out to anyone and everyone. She loves elephants—and her heart is elephant-sized! However, until last fall, Addison’s heart was causing mysterious and persistent medical issues that prevented her from doing all the things she loves. Unbeknownst to my husband and me, Addison was born with a congenital heart defect.

As a baby, Addison thrived but always seemed to have something going on. She had issues with reflux and did not enjoy tummy time or sleeping on her back. Waking several times during the night is not uncommon for a baby, but Addison seemed to be waking in pain every hour or two. When she was 9 months old, a GI specialist diagnosed her with reflux, and as she grew into a toddler, Addison developed significant respiratory issues, including a croupy cough. Now when she woke up during the night, it was with severe coughing fits.

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Ask the expert: How to prevent dog bites

Rogers_Carolynjpg
Carolyn R. Rogers-Vizena, MD

Our 5-year-old neighbor was recently bitten by a dog. How can I keep my kids safe?

-Fearing Fido

Unfortunately, dog bites happen every day, and for the most part, they are avoidable. At Boston Children’s Hospital, we see everything from small lacerations that can be repaired in the Emergency Department to bone-crushing facial injuries that require multiple reconstructive operations. Most of the patients with bad dog bites that I see in our Department of Plastic & Oral Surgery are in the 4-6-year-old range – an age when children are usually mature enough to avoid a completely unfamiliar dog, but still young enough to unintentionally provoke a dog they feel comfortable with.

Sometimes bites are caused by a pet that the child lives with. More often, they seem to come from dogs that children are familiar with but don’t know as well, such as a friend or family member’s dog. Although I can’t necessarily say that one breed of dog is more likely to bite than another, certain breeds have incredible power and can cause a lot of damage with just one bite. The most serious bites I have cared for are from Pit Bulls, Rottweilers and Akitas.

A patient treated by our team was attacked by a dog that smashed the child’s jaw and cheekbone, and badly injured the tissue around the eye. We repaired the patient’s bones with plates and screws and used bone from the skull to reconstruct areas where bone was missing. The child looks much better but still has a long way to go and will undoubtedly have some permanent injury. Fortunately, severe bite injuries like this are much less common than skin injuries!

As a dog lover and owner as well as someone who treats many kids with dog bites, these are are my tips for keeping your kids safe:

No1

Always supervise your children around dogs.

Dog petNever leave a dog alone with kids, particularly young children. I don’t think you can be too safe.

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Never say never: Gymnast with brachial plexus soars

Photo credit: Robert Marra
Photo credit: Robert Marra

Shortly after Julia Duplin was born, doctors diagnosed her with brachial plexus birth palsy; some of the nerves running from her upper spinal cord to her left arm had been damaged during birth. The early prognosis was that she would have some level of disability in her left arm.

Seventeen years later, she’s captain of Winthrop High School’s gymnastic team. She whips around the uneven bars with apparent ease and effortlessly flips across the sprung floor. How did Julia journey from an awkward toddler who crawled using only her right arm to a gymnastics powerhouse?

From the beginning, Julia’s parents Dianne and Joseph committed themselves to her recovery, encouraging her to do as much as possible and not letting her brachial plexus injury hold her back.

“Many brachial plexus patients go on to excel in sports despite the limits of the affected arm,” says Peter Waters, MD, chief of Boston Children’s Hospital Orthopedic Center. “If a child has the drive, talent and passion for sports, a brachial plexus injury won’t hold her back.”

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