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. He joined the brand in March of 2023 as an editor before being promoted to senior editor in January 2024. Fitch graduated from Youngstown State University in Youngstown, Ohio in 2020 with a degree in telecommunications and journalism. He started his career as a news and sports videographer before becoming an on-air sports anchor at the NBC-affiliated news station in Youngstown. Fitch briefly worked as a national content writer for a Chicago-based national television station before joining the 

team. He can be reached at: jfitch@mjhlifesciences.com.

Articles

 and joined the MJH Life Sciences team in December 2019. She graduated from Youngstown State University in 2019 with a bachelor's degree in journalism and a minor in political science. Prior to graduating, Morgan worked as the editor-in-chief of her college newspaper. She went on to work as an assignment editor at a broadcast news station in Youngstown, Ohio before joining 

 You can reach her at mpetronelli@mjhlifesciences.com.

RFK Jr. stated he "couldn't be more pleased" to announce that COVID-19 vaccination among healthy children and pregnant women has been removed from CDC's immunization schedule. 

CDC pulls COVID-19 vaccine recommendation for healthy children, pregnant individuals

The approved indication now includes children down to 6 weeks of age to protect against invasive meningococcal disease via serogroups A, C, W, and Y.

FDA approves MenQuadfi meningococcal vaccine for children 6 weeks or older

Get caught up with Contemporary Pediatrics! This list helps you navigate our top stories from the week, all in one place.

Weeky review: COVID-19 vaccine approved, framework laid out, and more

A recently published study found sharp increase in the use of nicotine pouches among US high school students, with usage nearly doubling from 2023 to 2024.

Nicotine pouch use nearly doubles among US high school students

Contemporary Pediatrics connects pediatricians with peer-reviewed articles, guideline updates, and practice strategies for real-world clinical application.

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The mother of a 12-year-old girl brings her daughter to the office for evaluation of recurrent, itchy red bumps and blisters on her legs. The mother gets the same rash recurrently as well.

Itchy blisters bother a 12-year-old girl

**Editor's Note** Please note that starting January 1, 2025, we will be switching to an online-exclusive publication process. This will allow us to publish case submissions quicker without having to deal with the variables that come along with print publication. All cases will still be eligible for print publication consideration, but publication in our print magazine is not guaranteed and will be up to the editor's discretion. 

Do you have a puzzling pediatric case that you’d like to share with the readers of 

We are looking for intriguing diagnoses that have stumped the experts—a diagnostic “Puzzler”—to help our physicians enhance their day-to-day practices. If you have such a story to tell, tell us.

Here’s what to do: Before you begin, we suggest that first you review the Puzzler 

https://www.contemporarypediatrics.com/case-studies

. Please note the specific style required for writing Puzzler manuscripts.

Next, prepare a draft of your case, including a summary of the presenting symptoms, a case overview, a 

table of the differential diagnosis (MANDATORY)

, and the special aspects of your case that qualify it as a Puzzler, and send it to us. Please note that the differential diagnosis table should also be discussed in the body text. We’ll review your draft and let you know what you need to add or revise before we send the manuscript to peer review for evaluation.

Puzzlers vary in length, and we suggest a minimum of 1,200 words up to a maximum of 2,000 words, but that is because of the complexity of some cases and whether some patients returned for many assessments before their diagnoses were determined. Also, some authors describe the pathophysiology of the differentials in great detail. Please also note no more than 3 authors are allowed per article.

What's most important is to show us the process that you used to analyze the case, including:

Why you decided to order certain tests and why you did not order others.

Peer consultations or why you elected to contact other specialists.

Lab values including vital signs or blood tests.

Labs and values if your patient was attended to in the emergency department or other hospital departments such as radiology or neurology.

Discussion related to the possible diagnoses.

Final diagnosis, treatment, prognosis, and follow-up.

Remember to indicate numbered citations within the body of the text and include a complete list of corresponding literature/references at the end of the manuscript. (Do not use any citation management programs or unlink them.) 

Limit references to 25. No references (unless it is a seminal study) can be older than 10 years.

We prefer primary research as references, but some cases are so obscure that authors will need to pull from a variety of sources. However, 

. Be advised that peer reviewers are adamant that the disease/disorder you describe was actually diagnosed and not determined by index of suspicion on the basis of ruling out various differentials. We use AMA11 as our publication style, which uses superscript citation numbers and a corresponding numbered reference list. Please create your citations and references in this style.  Check this recent article posted online at 

https://www.contemporarypediatrics.com/view/the-rx-of-adhd

 for examples of reference style. IMPORTANT NOTE WITH AMA 11TH EDITION: PLEASE PUT DOI OR WEBSITES/URLS AT THE END OF THE REFERENCE LINE.

When you send your draft manuscript, also 

. These image files must be high-resolution jpg or tiff files (minimum of 300 dpi) and as large in size as possible. We suggest a minimum of 7 horizontal inches. The images must be original photos with clear permissions to use, not images from copyrighted sources. Send as separate attachments with your e-mail submission; do not embed images into your manuscript document.

After we receive your manuscript, our editors and peer reviewers will review your draft and let you know if we accept your submission for publication. 

Puzzler is one of the departments for which we receive the most submissions, so it may be several months after submission before you receive feedback from us.

If we do accept your submission for publication, we will contact you with further instructions.

Send your submissions in Microsoft Word format to 

, via e-mail to mpetronelli@mjhlifesciences.com

Guidelines for PUZZLER, Contemporary Pediatrics

Roflumilast foam 0.3% trial investigator Jennifer Soung, MD joined us to discuss the importance of this newly FDA-approved topical treatment for scalp and body psoriasis patients aged 12 years and older. 

Jennifer Soung, MD reacts to FDA approval of roflumilast foam 0.3%

FDA approved roflumilast (Zoryve; Arcutis Biotherapeutics) foam 0.3%

 to treat plaque psoriasis of the scalp and body in individuals aged 12 and older. Jennifer Soung, MD, director of clinical research at Southern California Dermatology and a clinical trial investigator, joined us to break down the approval and the impact it can have in the psoriasis treatment landscape.

"I'm super excited," said Soung. "Parents have been asking for many years, 'Is there anything else besides the topical steroid?' Prior to the approval of roflumilast, we really haven't had a highly effective nonsteroidal option.”

The foam formulation was approved based on findings from the phase 3 ARRECTOR trial and phase 2 Trial 204. In the ARRECTOR trial, 66.4% of participants using roflumilast foam achieved a Scalp-Investigator Global Assessment (S-IGA) Success compared to 27.8% using vehicle (

 < 0.0001), while Body-Investigator Global Assessment (B-IGA success) was achieved in 45.5% compared to 20.1% with vehicle (

Soung emphasized the psychosocial burden that visible skin disease places on younger patients, stating, "They’re much more susceptible to the psychosocial impacts of plaque psoriasis because it’s such a visible disease,” she said. “They tend to not want to do sports, or they don’t participate in social activities, so they’re much more withdrawn." 

The studies also measured improvement in itch, one of the most bothersome symptoms for patients. In ARRECTOR, 65.3% of patients treated with roflumilast experienced significant itch reduction compared to vehicle, with some scalp itch relief evident within 24 hours of the first dose (

 = 0.0164). Roflumilast foam 0.3% was well tolerated, with adverse events such as headache, diarrhea, and nausea occurring in fewer than 4% of patients. 

“One thing I love about Arcutis and the way they designed their clinical trials is they did their trials in adults and adolescents concurrently,” Soung noted. “That makes it easier for that pediatric patient and their families.”

Click here for full approval details regarding roflumilast foam 0.3% for scalp and body psoriasis.

Editors’ note: Jennifer Soung, MD has relevant disclosures with AbbVie, Alumis, Aslan, Amgen, Arcutis, Bristol Myers Squibb, Boehringer Ingelheim, Biopharma, Dermavant, Eli Lilly, Galderma, Incyte, Johnson & Johnson, KoBio Labs, LEO, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi, and UCB. 

Fitch, J. FDA approves roflumilast foam 0.3% for scalp, body psoriasis. Contemporary Pediatrics. May 22, 2025. Accessed May 22, 2025. https://www.contemporarypediatrics.com/view/fda-approves-roflumilast-foam-0-3-for-scalp-body-psoriasis 

Roflumilast foam 0.3% trial investigator Jennifer Soung, MD, joined us to discuss the importance of this newly FDA-approved topical treatment for patients aged 12 years or older with scalp and body psoriasis.

News

Jennifer Soung, MD, reacts to the FDA approval of roflumilast foam 0.3%

Victor Carrion, MD, emphasizes how pediatricians can monitor and support mental health in youth while navigating limited access to specialized care.

Supporting mental health in pediatric primary care with Victor Carrion, MD

Victor Carrion, MD, director of the Stanford Early Life Stress Research Program and professor of child and adolescent psychiatry at Stanford University, emphasized that pediatric providers are central to recognizing and responding to early mental health concerns in children and adolescents. 

“Fifty percent of individuals that develop mental illness would have developed these signs and symptoms by age 14,” Carrion explained. “Seventy-five percent of them would develop signs and symptoms by age 24. Access continues to be the main mental health problem in our discipline. It is difficult to find therapists, and sometimes the wait can be prolonged.”

In the meantime, pediatricians can play a proactive role by monitoring severity and safety while patients wait for specialized care. Carrion suggests anchoring evaluations in day-to-day function, rather than focusing solely on diagnosis. 

“How is the individual doing at school or at work? How is the individual doing in their personal relationships, with family, with friends, with others? And are these symptoms causing any distress?” If a child is maintaining their function and relationships without distress, it may not indicate a mental health disorder, noted Carrion.

For those who are struggling, Carrion recommends that clinicians assess whether symptoms are worsening and be prepared to escalate care if safety becomes a concern. “If it seems that the condition is getting to a degree where the individual may injure themselves or others, it is very important to refer to emergency services.” 

In the absence of immediate access to therapy, pediatricians can also direct families to existing support tools. Carrion points to free online resources hosted by the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry’s “Facts for Families Guide” page.

 His own program at Stanford also offers a variety of self-guided materials

: “We have a number of exercises in our pages that are based on mindfulness and breathing that really help the individual cope.” 

Symptom presentation varies widely by age group, Carrion noted. Preschoolers may show regressive behaviors like thumb-sucking or bedwetting while school-aged children often present with somatic complaints such as headaches or stomachaches, and adolescents may withdraw socially. Regardless of presentation, it is vital for caregivers to reinforce open communication. 

“They may not want to talk at that moment,” Carrion said, “but at least they know that if they want to talk, they can actually go and talk to someone.” 

Editor's note: Victor Carrion, MD, has disclosures with Oxford Press, APA Press, and Ellipsis Health

1. Facts for families guide. American Academy of Child & Adolescent Psychiatry. Accessed May 21, 2025. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Layout/FFF_Guide-01.aspx

2. Early Life Stress and Resilience Program. Stanford Medicine. Accessed May 21, 2025. https://med.stanford.edu/elspap/Resources.html

Colleen Sloan, PA-C, RDN, highlights what she is seeing in practice related to screen time, devices, and social media and impacts on nutrition. 

Discussing social media and potential nutrition impacts with Colleen Sloan, PA-C, RDN

Colleen Sloan, PA-C, RDN, registered dietitian in pediatrics; host of 

, explored how social media and screen use intersect with pediatric nutrition, weight, and mental health.

Sloan emphasized that for today’s youth, screen time has become a part of their lifestyle. While adults may be tempted to dismiss social media as harmful, she noted that for younger generations, it is integrated into daily life. Social media can offer access to useful information and tools, but it also presents risks when it promotes unrealistic expectations. “It can really be a time trap and sets inappropriate expectations for body image and for… the foods that we’re eating,” she said.

From July 2021 to December 2023, half of teenagers aged 12 to 17 years reportedly spent 4 hours or more a day on screens, according to the CDC.

Sloan observed that in clinical practice, the numbers are often higher. “When I’ve asked my patients to check their screen time, it’s anywhere between 2 and 3 to 10 hours, and I even had one case where a girl was up to 18 hours in a day.” 

She also connected increased screen time with rising obesity rates among children and adolescents. With nearly 1 in 5 young people classified as obese, Sloan said excessive screen use has long been known to displace physical activity and affect eating behaviors. One concern is mindless eating. “One study actually showed that one-third of daily energy intake and half of a child’s meals were consumed in front of the screen,” she noted, referencing research published in 

Beyond nutrition and activity, Sloan pointed to emotional and psychological concerns. Exposure to heavily filtered, idealized images online can contribute to body dissatisfaction, anxiety, and disordered eating. “Kids, especially young females are constantly bombarded with filtered, unrealistic images of beauty and fitness. So that's leading a lot to anxiety, depression, disordered eating habits, and even leading into full blown eating disorders.,” she said.

For pediatricians, Sloan recommended initiating gentle conversations about how children view their bodies and the role of media in shaping those perceptions. “That’s a really good way to explore if social media is impacting their mental health and their body image.”

1. Zablotsky B, Arockiaraj B, Haile G, Ng A. Daily Screen Time Among Teenagers: United States, July 2021–December 2023. CDC. October 2024. Accessed May 16, 2025. https://www.cdc.gov/nchs/products/databriefs/db513.htm

2. Robinson TN, Banda JA, Hale L, et al. Screen Media Exposure and Obesity in Children and Adolescents. 

. 2017 Nov;140(Suppl 2):S97-S101. doi: 10.1542/peds.2016-1758K. PMID: 29093041; PMCID: PMC5769928.

Music therapist Jenna Marcovitz discusses the role of pediatricians in making timely referrals to music therapy to support whole-child health.

  Connecting families to music therapy, with Jenna Marcovitz, MA

Music therapy can support pediatric patients across physical, emotional, and developmental domains—but first, families need to know the service exists. In a follow-up conversation to her 

on music therapy’s wide-ranging benefits for children, Jenna Marcovitz, MA, MT-BC, CCLS, RMT, director of music therapy at UCLA Health, emphasized the role of pediatricians in connecting families with these valuable services. Sharing even basic outcomes, such as support for speech and language development, can serve as an entry point into care.

“The first step, I think a great resource could be suggesting music therapy to patients and families—maybe they haven't even heard of it,” Marcovitz said. For families in the United States, she recommends the American Music Therapy Association’s online directory to locate board-certified professionals. 

“It’s a great starting point,” she said. “You can find organizations that provide music therapy or private practice professionals who can provide, even in-home music therapy services or telehealth music therapy services.” Globally, the World Federation of Music Therapy offers similar access to regional directories.

In an earlier conversation, Marcovitz outlined how music therapy is tailored to clinical goals and delivered through evidence-based interventions in a therapeutic relationship. “Although music entertainment can have therapeutic benefit, it isn’t always necessarily targeting a physical goal,” she explained previously. “In music therapy, that is what we do. In situations where you are working with patients and families that are under immense amounts of stress and existential and emotional distress, music therapy can provide a space for them to really process their emotions,” Marcovitz said. “We know emotions are connected to our whole body health.”

By collaborating with multidisciplinary healthcare teams and centering individualized goals, Marcovitz and her colleagues aim to integrate music therapy not just as a creative complement to care, but as a foundational component of holistic pediatric treatment.

Powell Perng, BSE, BA, MS4

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