Interesting Conversations March 2017 (Pedcast)

Voice Intro

Welcome to another edition of Portable Practical Pediatrics. I am your host, Dr. Paul Smolen, a board certified pediatrician. People call me Doc Smo. My patients bring up such interesting topics…so interesting that a few years ago, I started sharing some of them with my blog audience. I have to say that after 35 years of practicing pediatrics I have learned and lived this Doc Smo pearl, “The best doctors listen way more than they talk.” With that in mind, I am going to share with some of the interesting things my patients have told me recently. I think you will see that by listening intently, I learn a lot from my patients.   So let’s get into the next set of “Interesting Conversations” I’ve had recently with my patients and their families, shall we? Continue reading

The Chickenpox/ Shingles Story (Pedcast)

Voice introduction

I was having a discussion the other day with the mom of one of my patients. She was asking me why we vaccinate children against chickenpox; a disease that her mother told her was a benign mild childhood illness that doesn’t hurt kids.  Keep in mind that almost none of the parents of my current patients have ever seen or had any experience with the disease of chickenpox.  The disease is virtually gone in the United States so everything parents know today is based on what they have heard.  This particular mom had so many questions and a few misconceptions about chickenpox. Because of this I thought many of my blog listeners probably have many of the same questions, so today were going to talk about the disease known as chickenpox: the myths and facts and the rationale behind vaccinating today’s children. Why do we bother vaccinating for a harmless childhood illness? Continue reading

Interesting Conversations 2015 (Pedcast)

Welcome to another edition of, one of the most popular pediatric blogs out there. I feel really fortunate to have such a great job that allows me to have interesting conversations with so many intelligent fascinating people. As you can imagine, I get asked a lot of questions and many of these questions lead to interesting conversations so I thought once in a while, maybe I would share some of these questions and discussions with my blog audience. So here goes, my inaugural pedcast that I call “Interesting Conversations”. Continue reading

Wound Care Do’s and Don’ts for Kids (Pedcast)



Today we are going to talk about minor scrapes and cuts. By minor I mean only surface injuries without injury to underlying structures and wounds less than an inch in length.  A lot more kids get hurt than sick so parents and pediatricians spend a lot of their time caring for bruises and cuts.  Over time, parents need to become experts in minor wound care so today I thought it might be useful to talk about the important topic of broken skin care in children. Continue reading

The ABCDE of Moles with Dr. Sue Primmer (Pedcast)


Dr. Smolen

-Fortunate to have good friend and expert pediatric dermatologist, Dr Sue Primmer…returning

-For people who haven’t heard Dr. Primmer before, you are in for a treat.  She is both a pediatrician and a pediatric dermatologist.

-We are going to talk today, via Skype,  about a topic that parents have a lot of questions about…moles/ pigmented lesions of the skin.

-Disclaimer: No specific information for your child but rather general information. Also, wear re going to mention some products and Dr Primmer and I both want you to know that neither of us have any financial connections with any companies that make these products.

-So let’s get started by learning  about the biology of pigmented skin cells.

Question by Dr. Smolen:  Dr Primmer, what exactly is a mole…  and …how do they differ from other pigmented skin spots… or … for that matter, non pigmented areas of skin?

(Dr. Primmer)-Brief description of what a mole is.

Acquired vs congenital

-Describe what makes acquired moles change/evolve

, from infancy to old age.

Question by Dr. Smolen:  I am sure you have seen tens of thousands maybe, maybe hundreds of thousands of  children’s moles in your career.  Why do parents bring their children to see you about their moles?  What are they worried about?


(Dr. Primmer) –Worry about cancer in an unusual mole or they simply want them gone for cosmetic reasons.  In actuality, almost no children need to see dermatologist for moles since cancers so rare.

-Cancer risk discussion –brief

-Mention that melanoma is not only very rare in children but usually does not arise from normal skin, not inside an existing mole.

   Risks for melanoma:

     Freckling pigmentation

     Ugly duckling

     Blistering sunburns

     Family history

     More than 20 typical moles or more than 10 atypical moles

(Dr. Smolen) So what you are saying is that even though melanoma rare in childhood, parents need to be thinking about it.

(Dr. Primmer)  Avoiding sun damage which contributes to melanoma.   Let’s get back to that in a few moments.

Question  by (Dr. Smolen):  Sue, I have heard dermatologists refer to typical and atypical moles. Tell us more about atypical moles.  How does one distinguish typical versus atypical?

(Dr. Primmer) -ABCDE- elucidate

 (Dr. Smolen) Sounds like parents need to commit the ABCDE rules to memory.

(Dr. Primmer) Mention Atypical Mole Syndrome- Need Dermatologist for periodic exams

 (Dr. Smolen): Is this syndrome rare?

Dermatoscope-explain briefly

Question by Dr. Smolen:  So, what you are telling us is that parents don’t need to worry about melanoma, pigmented skin cancers in their kids…right?

(Dr. Primmer) -Actually, not true.  Children grow up to be adults and their skin “Holds a grudge”.  Sun damage carries into their adult years and this is what causes cancers of all sorts.


         Sun protection essential

                  Clothing and hats- talk about best type.  Mention about older people’s bottoms!

                  Sunscreens—Best types and reapplication

                  Avoid peak UV sun times if possible

                  Never go to tanning beds

 Summary by Dr. Smolen:  Dr Primmer, let me make sure  I properly heard all the important information you told us today.

Children usually develop moles after birth in response to natural sunlight.   Moles have a life cycle with light being their fertilizer.

Moles are divided into congenital, typical aquired and  atypical acquired.  Typical vs atypical moles are sorted out by the by the ABCDE rule.

Children rarely get melanoma, that deadly cancer that adults can get… but the skin damage that can lead to skin cancers like melanoma occurs in infancy and childhood and parents can take action to prevent these, especially in children who freckle and are lightly pigmented… Clothing, hats, proper application of sunscreens, and avoidance of sunburns are essential to avoiding skin cancers as they get older.

Parents with children in the following categories need to be especially cautious about their child’s skin:  Congenital mole over the midline of their body, a freckling fair skinned child, a child who develops more than >20 typical moles or more than >10 atypical moles, or any child who develops what you call an ugly duckling mole.

Finally, unless there is a very good reason, removing moles can be a bad idea.  Scars etc.

Did I miss anything Dr Primmer?

(Dr. Smolen) -As always, you are a fountain of information and wisdom.  Also a pleasure to talk to.  Talking to you always makes me smile.

-Thank you for making another pedcast about children’s skin issues.

-I hope we can make many, many more.

This is Dr Paul Smolen , hoping you now have a better understanding of you’re the spots on all your little tots.  Until next time.