whom this diagnosis applies.

The use of this term, and a new way of thinking about these infants, represent an innovative approach that can only improve the care we deliver to these patients. Article page 585<

Observational study of hospitalized and non-hospitalized children with eczema herpeticum

Sarah S. Long, MD

he observational study by Luca et al of clinical features and course of children with eczema herpeticum is useful because of the relatively large number of cases (n=79) accrued over 9 years and the ability to access records and capture patients in the Canadian system of those managed as inpatients and outpatients. The ndings at presentation (76% with generalized eruption, 56% with fever, 37% with systemic symptoms, and 10% with keratoconjunctivitis) provide a modern assessment of clinical manifestations of eczema herpeticum. Fifty-seven percent of patients were hospitalized. Although signicant predictors of hospitalization were <1 year of age, male sex, fever, and systemic symptoms, study methodology does not permit conclusions about which factors were or should be considered in decision to hospitalize. Only two children managed initially as outpatients were hospitalized. No serious complication was reported in any study patient. A novel nding was that severe (hospitalized) eczema herpeticum predicted repeated episodes. The authors appropriately acknowledge limitations of the study. Their work provides a useful cross-sectional picture of eczema herpeticum and its management. Article page 671< n this issue of The Journal, Chi et al have provided a concise and clear laboratory investigation of the timing from leuprolide stimulation to maximal luteinizing hormone (LH) response in girls being investigated for precocious puberty. The ndings are both important and simple. The diagnostic LH response in girls with central precocious puberty is near maximum at 30 minutes after administration of leuprolide, obviating the need for more numerous or prolonged sampling when this is the singular clinical question. Article page 757<

Leuprolide stimulation testing for central precocious puberty

Sarah S. Long, MD

Figure. Mean serum LH concentration at designated times after aqueous leuprolide acetate injection (20 mg/kg2) in subjects with central precocious puberty (solid diamond), central precocious puberty-Rx (open diamond), nonprogressive puberty, premature thelarche form (solid circle), and nonprogressive puberty-variant (open circle). SDs are omitted because of the small numbers in each group. Rx, receiving therapy; PT, premature thelarche form; Var, variant. October 2012
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