Dr. Anna L Bruckner This is Me

Education

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1. 1. Tips for a Safe and Healthy Summer ‘08 - Lucile Packard Children's Hospital

   www.lpch.org/newsEvents/NewsRe - [Cached]

   Published on: 6/2/2008   Last Visited: 6/23/2008

   "Parents ask us a lot of questions about using sunscreens on children," said Anna Bruckner, MD, chief of dermatology at Packard Children's."We recommend sun avoidance and protective clothing as the first line of sun defense.If sunscreen is used, we advise parents to use it liberally, starting about 30 minutes prior to exposure, even on cloudy days, and to reapply it every one to two hours.A sun protection factor of 30 or higher is best."Dr. Bruckner can also recommend tips for parents seeking a safe and effective insect repellent.
   
   Use the right sunscreen"Parents frequently ask questions about using sunscreens for children," said Anna Bruckner, MD, chief of dermatology at Packard Children's.

2. 2. ABD Approved Dermatology Fellowship Programs

   www.pedsderm.net/ABDapprovedpr - [Cached]

   Published on: 6/25/2008   Last Visited: 6/25/2008

   Anna Bruckner, MDDirector, Pediatric Dermatology269 Campus Drive, #2155Palo Alto, CA 94305650/725-7022650/736-0736(Fax)

3. 3. Pediatric emergencies demand diagnostic skill - DermatologyTimes

   www.dermatologytimes.com/derma - [Cached]

   Published on: 1/1/2006   Last Visited: 2/22/2006

   So it's important for physicians to recognize signs that are worrisome," says Anna L. Bruckner, M.D., assistant professor of dermatology and pediatrics at the Stanford University School of Medicine, Stanford, Calif.
   
   Erythema multiforme
   
   One condition she says physicians should be wary of is erythema multiforme (EM), a condition wherein patients develop small red spots on the skin that progress to blisters with epidermal necrosis at their centers over the course of several days.These changes give fully formed lesions a targetoid appearance.
   
   "EM is a benign, limited condition that's usually associated with a preceding herpes simplex virus infection.True EM is very rare in children," Dr. Bruckner says.Skin lesions with dusky centers do not always indicate EM, she adds."What can be confusing is that many other skin lesions have this targetoid appearance.So there are many conditions in children that can be misdiagnosed as EM," she says.
   
   Giant urticaria
   
   Giant urticaria are common in children and are often misdiagnosed as EM, according to Dr. Bruckner.
   
   "Giant urticaria are large hives, which sometimes can appear quite dramatic.In addition to being red and swollen, there can be duskiness or clearing in the center, which gives the lesions a targetoid appearance," she says.
   
   However, skin necrosis, a finding in EM, is not present in urticaria.
   
   Such hives themselves are rarely worrisome, especially if the child's symptoms do not include breathing difficulty, Dr. Bruckner says.In most cases, she says hives clear up readily with antihistamines.
   
   Drug reactions, EM fears
   
   Similarly, she tells Dermatolgoy Times that a serum sickness-like reaction is common with the use of antibiotics such as the cephalosporin Ceclor (Ranbaxy Pharmaceuticals) and is characterized by swollen, edematous plaques that also can be mistaken for EM.
   
   She adds that pediatricians often worry about EM because there's a very common misconception in the medical community that this condition progresses to Stevens-Johnson syndrome.
   
   "This is not true," Dr. Bruckner says.
   ...
   In many cases, Stevens-Johnson syndrome in children and adolescents is triggered by a Mycoplasma pneumoniae infection, Dr. Bruckner emphasizes.Clinical hallmarks of this condition include the acute onset of necrotic spots of skin, as well as severe conjunctivitis and mucositis.
   
   "When children have Stevens-Johnson syndrome, it looks very dramatic , their eyes are red, and their lips and mucous membranes are blistered and sloughing," she says.
   
   However, Stevens-Johnson syndrome also can be caused by medications, as can a related condition called toxic epidermal necrolysis (TEN), according to Dr. Bruckner.
   
   "TEN is a similar condition that's caused exclusively by medications," she says."In this condition, the skin suddenly appears very painful and red, then sheets of skin simply slough off," thereby compromising the skin's barrier function.Problems that can ensue include sepsis and dehydration.
   
   "This carries a very high mortality," Dr. Bruckner says.