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Choosing Wisely®

American Academy of Pediatrics – Section on Dermatology

Although combination topical antifungal/corticosteroids have been approved for the treatment of tinea corporis, candidiasis, and diaper dermatitis, we recommend against use of these agents. Many providers are unaware that the combination products contain a relatively high-potency topical steroid. For treatment of tinea corporis, the application of a topical antifungal agent alone is recommended. If symptoms such as severe pruritus require concomitant application of a topical steroid, a ...

Choosing Wisely®

American Academy of Pediatrics – Section on Neurological Surgery

Consideration should be given to avoid unnecessary radiation exposure when appropriate. For instance, CDM tools incorporate 3 or more variables from history, physical examination, or simple clinical tests to guide patient management. Results from the National Emergency X-Radiography Utilization Study (NEXUS) and the Pediatric Emergency Care Applied Research Network (PECARN) provide a high negative predictive value for significant cervical spine injuries in pediatric patients. Low-risk criteria ...

Choosing Wisely®

American Academy of Pediatrics – Section on Neurological Surgery

Low-risk asymptomatic lesions such as small rubbery scalp masses representing dermoid cysts or shallow midline sacral dimples do not routinely require intervention as a young infant. Routine magnetic resonance imaging requiring anesthesia is typically not recommended. Given the US Food and Drug Administration’s Drug Safety Communication on pediatric anesthesia (www.fda.gov/Drugs/DrugSafety/ucm532356.htm) warning that general anesthesia and sedation drugs used in children younger than 3 years ...

Choosing Wisely®

American Academy of Pediatrics – Section on Dermatology

Tinea capitis, a dermatophyte infection of the hair shafts of the scalp, is treated with antifungal agents. Topical treatments cannot penetrate the hair shaft itself, which is where the infection lies; thus, monotherapy with topical medications is insufficient to effectively treat the infection. This insufficient treatment can lead to increased health care costs resulting from multiple visits and the prescribing of ineffective medications. For this reason, when tinea capitis is suspected or is ...

Choosing Wisely®

American Academy of Pediatrics – Section on Neurological Surgery

Routine imaging to evaluate ventricle size in an asymptomatic patient with hydrocephalus is not necessary. When imaging is needed, performing a rapid brain MRI is a recommended option to prevent radiation exposure to the child. Surveillance imaging, if needed, should only be ordered by specialists who treat hydrocephalus.