Psoriasis is a common disease, with different age of onset, however it appears seldom under 10 years ofage. Among younger children the onset usually follows bacterial pharyngitis or any other upper respiratory tract infection. The genetic background of psoriasis determines lack of permanent healing. The only possibility of therapy is to diminish skin lesions. All the therapeutic methods available in adult’s treatment may be used in pediatric patients’ therapy, however with many limitations. The distant side effects of the therapy must be taken into account due to life-longlasting treatment.

Acne is the most common skin disease in adolescence being a consequence of hormonal alterations occurringin these years. Local hyperreactivity to and rogens within sebaceous follicles leads to increased sebum production, hypercornification of sebaceous ducts and comedo formation. Within microcomedons excessive proliferation of P. acnes takes place, which in consequence produces inflammation. Topical therapy of acneis directed against follicular keratinization (topical retinoids, benzoyl peroxide), and inflammation (erthromycin,clindamycin, and again benzoyl peroxide). In more severe cases of acne the treatment of choice are tetracyclines then erythromycin or azythromycin. In the most severe or resistant to antibiotics cases systemicis otretinoine is used.

Eruptions in the diaper area are the most common dermatologic problem in infancy. Such eruptions canbe divided into primary diaper dermatitis, an acute inflammation of the diaper area with multifactorial etiology, and secondary diaper dermatitis, a term which encompasses eruptions in the diaper area with defined etiology (pediatric and dermatological diseases). Primary diaper dermatitis is an irritant contact diaper dermatitis created by the combined influence of water/moisture, friction, urine/faces and secondary infection (Candida albicans). This article reviews the clinical manifestations and treatment options for primary diaper dermatitis.

Treatment of atopic dermatitis in children requires multidirectional action and one should take into consideration the age, present state of the skin and severity ofthe disease. In the course of treatment the elimination of allergens responsible for disease is necessary as wellas immunotherapy, symptomatical treatment and the proper skin care. The symptomatical treatment is basedon oral antihistamines of II generation. In some caseswith severe itch classical antihistamines are recommended (penetration of blood-brain barrier, anti-itchingactivity). Topical steroids, calcineurin inhibitors (tacrolimus, pimecrolimus) and emollients play the main rolein the treatment. The cases with the severe course of disease require cyklosporin A, oral steroids, mycophenolanmophetyle, phototherapy (UVA, UVB) and photochemiotherapy PUVA. In comparison to adults – theyare rarely used in children.

Skin plays an important role as a barrier against transepidermalwater lost, mechanical trauma, UV radiation,alergens, microorganisms and irritating substancespenetration. By regulating homeostasis it takes fundamentalpart in adaptation to life. In comparison to adults in neonates, infants and young children there are some essential differences of the skin anatomy andphysiology. Normal barrier function is disrupted, skin permeability is increased and the thermoregulation mechanisms reveal immaturity. It causes skin hypersensitivity and higher prevalence of irritations and allergic reactions. This review article presents anatomical and physiological differences in the infant’s skin. Carepractices of healthy and pathologically changed skin, as well as therapeutic management in scars were also discussed.

Some internal diseases, in children and adults present characteristic dermatological manifestations. In the article the clinical characteristics and diagnostic criteria of skin diseases related to internal pathology are discussed. The correct diagnosis of such cases is of great importance and may allow to start early appropriate therapy.

Long-chain polyunsaturated fatty acids (LC-PUFA) areessential dietary nutrients which can not be synthesized in human. Their main source is fish and seafood. LC-PUFAs have anti-inflammatory properties, reduce the risk of atherosclerosis and have been associated with infant neurodevelopment and visual function. LC-PUFA supplementation is recommended in prevention of cardiovascular diseases, metabolic syndromeand chronic inflammatory diseases. Fish oil consumption plays also a crucial role in pregnancy, lactationand infancy. In the Polish population LC-PUFA deficits are strongly linked with food habits. In case of low fish dietary intake the LC-PUFA supplements may be required.

Chronic inflammatory bowel disease (IBD) which include Crohn’s diseae (CD) and Ulcerative colitis (UC) are frequent diseases in children and young adults. Their therapy consists of following methods: nutritional support, pharmacotherapy (corticosteroids, 5-aminosalicylates and immunosuppressive agents) and surgery.At present, the bilogical therapies seem to be a very pomising alternative to these methods. It is designed to block or neutralize TNF-a, pro-inflammatory cytokine which plays a key role in the pathogenesis of IBD. Currently, there is one such medication registered in pediatrics. It is infliximab-chimeric monoclonal antibody against TNF-a.

In the years 2006–2008 Department of Cardiology in Children’s Memorial Health Institute realized for the second time (previously in the years 2003–2005) multitask, multicenter program entitled: “The improvement of cardiological care in a child with cardiac pathology with special emphasis on assessing the results of treatment and improvement of life quality of children with congenital heart disease” under the auspices of “National cardiovascular disease prevention and treatment program for the years 2006–2008, POLKARD”. The objectives of the program included transcutaneus estimation of hemoglobin saturation of oxygen in arterialblood (pulsoxymetry) in neonates in Masovian voivodeship ,training of neonatologists, family doctors and pediatricians in field of pediatric cardiology, program of qualification for interventional and cardiosurgical treatment in children with CHD in their place of living, the evaluation of needs and results of treatment of children with cardiac pathologies with the special consideration of children born in years 2004–2005, population of patients with Kawasaki disease and changesin cardiovascular system, the assessment of results of treatment of GUCH patients and developing psychological and information support methods for population of children with cardiac pathology.

Phosphorus and inorganic phosphate (Pi) play an importantrole in a variety of biological processes suchas cell signaling, nucleotide metabolism, energy metabolism, membrane function and bone mineralization. Chronic Pi insufficiency results in impaired bonemineralization, rickets or osteomalacia. Elevated Piconcentrations are observed in patients with chronicrenal failure. Parathyroid hormone (PTH) and vitamin D regulate Pi metabolism in the intestine, kidney and bone. Pi transport is also regulated by the variety oflocal factors. Phosphatonins are peptides which caninhibit Pi reabsorption in the proximal tubule. Several phosphatonins such as fibroblast growth factor 23(FGF-23), secreted frizzled-related protein-4 (sFRP-4), extracellular phosphoglycoprotein (MEPE) and fibroblast growth factor 7 (FGF-7) have been shown to playa pathogenic role in several hypophosphatemic disorderssuch as tumor-induced osteomalacia (TIO), autosomaldominant hypophosphatemic rickets (ADHR), X-linked hypophosphatemic rickets (XLH), autosomal recessive hypophosphatemia (ARHP) and McCune-Albright syndrome.

The knowledge of dysmorphic syndromes allows usto diagnose the complex genetic syndrome and then implement the correct treatment and correct genetic counseling concerning the etiology, natural course of the disease, prognosis and possible complications as soon as determining the recurrence risk of the disease in family. Mowat-Wilson syndrome was described by Mowat, Wilson and others in 1998. It is caused by different mutations or deletions ZEB2 gene. Syndrome is characterized by typical facial features, intellectual disability and multiple congenital abnormalities interalia Hirschsprung disease, heart diseases, agenesis ofcorpus callosum. The authors describe the clinical and genetic aspects of Mowat-Wilson syndrome with elements of genetic counseling.

The consequences of perinatal asphyxia are is chemia and hypoxia leading to gradual intestinal epitheliumne crosis and atrophy as well as loss of intestinal barrier integrity. Subsequently, the interruption in intestinalmucosal barrier and its permeability will occur. This will result in the permeability of substances, which innormal conditions would not be able to cross the barrier due to its tightness and allows the translocation of both endotoxin and whole microorganisms. These changes may lead to the development of multiple –organ failure. One of the most important decisions to be made is when to start the enteral feeding. There is a concernthat too early contact of milk with hypoxic and injured mucosa may result in inflammation, multiple organ failure or necrotising enterocolitis. From the other handlack of enteral stimulation may increase the risk of bacterial translocation, prolong the parenteral nutritionand its complications. Authors present current opinion of the experts working in the National Survey in Paediatric and Neonatal Intensive Care for enteral feeding in babies with perinatalasphyxia.

Non-accidental injuries (observed in battered childsyndrome), most frequently of the skeletal and central nervous system, are found usually in children below 3 years of age. Diagnostic imaging in these childrenis as follows: plain films of the skeleton (performed according to special protocol), CT of the CNS and insome cases MRI of the head. In children with abdominal traumas, leading to intestinal, pancreatic and hepatic injuries, plain abdominal films, US studies,CT of the abdomen, and in some cases contrast GIexaminations are performed. Semiology of the most frequent skeletal, CNS and abdominal lesions is presented. Author presents a diagnostic algorithm in non-accidental trauma patients.

Objectives:
Tea tree oil has a strong antibacterial, antifungal and antiviral properties. It is used in the therapy of various diseases but the most frequent in dermatologicaltreatment. The oil can be applied in therapyof furunculous, contagious impetigo, herpes zoster infections and tinea pedis. Tea tree oil has influence onse bum secretion. The purpose of the study was undertaken to evaluate the influence of tea tree oil products on decrease of facial sebum production.

Materials and methods:
The study was performed in20 patients, aged 18–40 years with moderate seborrheaon face. Lipid coat was measured twice using the sebumeter before and after trial.

Results:
The study showed decreased sebum level in 20 patients (mean 11,8%) after 4 weeks tea tree oil therapy.

Conclusions:
Results confirm previous observations and suggest that using products containing tea tree oilis helpful in seborrhea patients.

In the emergence of patient rights, the laws of young patients in the diagnostic and therapeutic medical procedures have been ignored for a long time. Currently, minor patients’ laws are standing to many regulations that distinguish laws of children in the broad process of treatment, depending on their age. Special attention is reposed on the rights of minors below sixteen years of age. Although the Act of Professions of Doctor and Dentist, as well as other acts of a similar rank for this age group provide a number of laws, it must be remembered that in most cases the process of medical approach relies solely on the decision of the statutory caregivers or guardians of minors. When analyzing the issues concerning the provision of health services to patients under 16 years of age, the major issue states for the agreement or disagreement for high risk medical procedures, fulfillment of the obligation of submitting the compulsory vaccinations of minors, as well as the right for reliable information concerning treatment.