About

Dr. Sarah Stein is an Associate Professor of Medicine and Pediatrics at the University of Chicago Medicine, where she serves as the Director of Pediatric Dermatology. She has served as the Dermatology Residency Program Director from 2012 to 2019. Dr. Stein received her BA from Haverford College and her MD from the Albert Einstein College of Medicine. She completed her Pediatrics Residency at the New England Medical Center/Tufts University and her Dermatology Residency at Northwestern University Feinberg School of Medicine. Her expertise lies in the diagnosis and management of childhood skin diseases, including dermatitis, pigmentary disorders, birthmarks, hair and nail disorders, infectious skin conditions, and cutaneous manifestations of internal diseases. She has a particular interest in skin disease presentation in children of color and emphasizes family education and support as fundamental components of pediatric patient care. Dr. Stein is an educator and lecturer, teaching dermatologists, pediatricians, and primary care physicians about childhood skin diseases. Recognized for her contributions to education and clinical care, she received the Department of Medicine's Excellence in Education and Clinical Care Award in 2006 and the Postgraduate Teaching Award in 2015. She is a Senior Faculty Scholar in the Bucksbaum Institute for Clinical Excellence and a fellow in the Academy of Distinguished Medical Educators at the University of Chicago. Dr. Stein is actively involved in scholarly publishing, serving as an Associate Editor of Pediatric Dermatology and a section editor of Clinics in Dermatology, and she frequently peer reviews for various dermatology journals.

Research topics

• Medicine
• Pathology
• Internal medicine
• Surgery
• Dermatology
• Pediatrics
• Radiology
• Immunology

Selected publications

• Topics in Adolescent Dermatology

  Pediatric Annals · 2025-06-01

  editorialOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Not Your “tick"-pyical Headache

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01 · 1 citations

  article

  Abstract Introduction:Subarachnoid hemorrhage is a medical emergency in which blood develops between the arachnoid and pia mater requiring prompt head imaging and potential neurosurgical intervention. It can be caused by trauma or aneurysm rupture and is associated with significant mortality and morbidity. We present a case of a patient developing non-traumatic subarachnoid hemorrhage in the setting of a tick-borne illness.Case: A 60-year-old female with past medical history significant for immunosuppression secondary to polycystic kidney disease status post living donor kidney transplant in 2020 presented with flu-like symptoms and required admission for new pancytopenia. Lab findings included elevated ferritin and transaminases with concern for hemophagocytic lymphohistiocytosis (HLH) as well as positive parvovirus, ehrlichiosis, CMV, EBV, and BK. Initially, the patient was mentating appropriately with negative CT head imaging. Despite steroids, transfusions, IVIg, antibiotics, and antivirals, she had persistent fevers with progressive pancytopenia and subsequent encephalopathy requiring intubation. Follow-up CT head showed new bifrontal subarachnoid hemorrhages (SAH) and repeat imaging in the following days demonstrated progression of the SAH's and a new intraparenchymal hemorrhage Lumbar puncture was delayed due to severe thrombocytopenia but ultimately showed minimal pleocytosis without infection. The patient initially had a period of clinical improvement with Ehrlichia resolution and some viremic suppression. However, she then decompensated again in the setting of new GNR bacteremia and aspergillosis with inability to wean immunosuppression and eventual transition to comfort care.Discussion. This was a challenging case given difficulty managing the underlying hyper-inflammatory disorder with subsequent co-infection from multiple pathogens. Ehrlichia, a small gram negative bacteria initially specific to canines, was found to have human transmission as recently as 1986. Common non-specific symptoms include fever, fatigue, leukopenia, thrombocytopenia, transaminitis, and rarely encephalopathy, Cytomegalovirus (CMV) PCR was also positive later in the course but the hemorrhages were stable at that point. We hypothesize that the Ehrlichia induced thrombocytopenia and adjunctive HLH predisposed our patient to the SAH. After restarting doxycycline, the patient showed clinical improvement. However, she continued to require immunosuppression in an attempt to mitigate the persistent maladaptive immune response. This led to an augmentation of her already profound immunosuppression with unremitting pancytopenia predisposing her to the emergence of multiple other infectious processes including CMV, GNR bacteremia, and aspergillosis. We present this case to highlight a rare presentation of Ehrlichia induced subarachnoid and intraparenchymal hemorrhages in the setting of pancytopenia.

  PublisherDOI

• Cosmeceuticals in the Pediatric Population Part I: A Review of Risks and Available Evidence

  Pediatric Dermatology · 2025-02-09 · 2 citations

  reviewOpen accessSenior authorCorresponding

  The rise in the use of cosmeceuticals among children and adolescents has created a new challenge for dermatologists, who are confronted with the task of advising young patients on the risks that these products can carry and the often questionable efficacy of these products. While some cosmeceuticals can be beneficial for this population when used correctly, such as broad-spectrum sunscreen or specific anti-acne agents, other products may not carry benefits for young skin and could even cause complications, particularly in young consumers who have skin conditions such as acne or atopic dermatitis. Many of the common ingredients in cosmeceutical products have had very limited (if any) studies conducted in pediatric populations, and much of the data regarding the efficacy claims and risks of these products must be inferred from studies in adult patients.

  PublisherOA PDFDOI

• Cosmeceuticals in the Pediatric Population Part <scp>II</scp> : Ethical Dilemmas and Patient Talking Points

  Pediatric Dermatology · 2025-02-20 · 2 citations

  reviewOpen accessSenior authorCorresponding

  The rise in the use of cosmeceutical products amongst the pediatric population raises several ethical dilemmas, as well as new situations and questions that dermatologists must navigate with patients. Ethical concerns discussed in this review include the marketing of cosmeceutical products directly to children, the influence of social media and trends related to skincare, the use of anti-aging ingredients by children (who have not yet manifested any aging signs), and the misuse of cosmeceutical products to lighten one's complexion in childhood. We also discuss several related patient talking points for dermatologists to employ with young patients interested in cosmeceutical products.

  PublisherDOI

• 89: Neonatal Miliaria Pustulosa: A Case Series

  Journal of Investigative Dermatology · 2025-03-01

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Hermansky-Pudlak Syndrome Complicated by Crohn's Disease and Hidradenitis Suppurativa: A Case of Multisystem Immune Dysregulation

  ACG Case Reports Journal · 2025-03-29 · 1 citations

  articleOpen access

  Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder marked by defects in lysosomal function that can manifest with a granulomatous enterocolitis resembling Crohn's disease (CD). We present a 16-year-old adolescent boy with HPS-associated CD and hidradenitis suppurativa (HS), representing one of a few cases of HPS with concurrent CD and HS described in the literature to date. Disease stabilization on combined infliximab and methotrexate highlights potentially shared inflammatory pathways involved in the pathogenesis of HPS-associated CD and HS. Given the rarity and refractory nature of this disease constellation, our case may provide a beneficial treatment strategy for other patients.

  PublisherDOI

• Neonatal Miliaria Pustulosa—A Case Series

  Pediatric Dermatology · 2024-11-10 · 2 citations

  articleOpen access

  BACKGROUND/OBJECTIVES: Miliaria pustulosa is a noninfectious, transient skin eruption of pustules overlying erythematous plaques secondary to obstruction of eccrine glands. There are very few case reports in the literature detailing miliaria pustulosa in neonates. When presenting in neonates, its similarity to life-threatening infections may cause diagnostic confusion. By differentiating this condition from similar presentations, unnecessary treatments and tests in this population may be avoided. METHODS: Retrospective review of the medical records of nine neonates presenting with a pustular eruption diagnosed as miliaria pustulosa. Patients were seen at a children's hospital in Chicago, IL, USA; cases were selected by investigator recall. RESULTS: In this case series, miliaria pustulosa presents in nine neonates as clusters of eruptive pustules with resolution or significant improvement noted after an average of 2.6 days (range 1-5 days). The average age was 4.6 days (range 1-10 days old) and the average gestational age was 34.7 weeks (range 26.3-40.1 weeks). All patients had pustular outbreaks in areas occluded by swaddling, clothes, or adhesive. Seven patients had geometric lesions that were underlying sites of intravenous (IV) site adhesive or electrocardiogram (EKG) leads. CONCLUSIONS: The consistent morphological features of this pustular eruption at sites of skin occlusion and the transient course in the setting of an otherwise well-appearing infant are strongly suggestive of the diagnosis of miliaria pustulosa. It is important for clinicians to be familiar with this benign presentation and to differentiate it from other neonatal pustular eruptions to minimize invasive tests and treatments in this vulnerable population.

  PublisherOA PDFDOI

• Stigmatization and Mental Health Impact of Chronic Pediatric Skin Disorders

  JAMA Dermatology · 2024-04-24 · 57 citations

  articleOpen access

  Importance: Chronic skin disorders in children frequently are visible and can cause stigmatization. However, the extent of stigmatization from chronic skin disease and association with mental health needs further study. Objective: To examine the extent of stigma, dependence on disease visibility and severity, and association with mental health and quality of life (QOL) in chronic pediatric skin disease. Design, Setting, and Participants: A cross-sectional, single-visit study was conducted at 32 pediatric dermatology centers in the US and Canada from November 14, 2018, to November 17, 2021. Participants included patients aged 8 to 17 years with chronic skin disease and 1 parent. Main Outcomes and Measures: Using the Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) Stigma-Skin, the extent of stigma with child-, caregiver-, and physician-assessed disease visibility (primary outcome) and severity was compared, as well as reduced QOL (assessed by Skindex-Teen), depression, anxiety, and poor peer relationships (PROMIS child and proxy tools) (secondary outcomes). Results: The study included 1671 children (57.9% female; mean [SD] age, 13.7 [2.7] years). A total of 56.4% participants had self-reported high disease visibility and 50.5% had moderate disease severity. Stigma scores significantly differed by level of physician-assessed and child/proxy-assessed disease visibility and severity. Among children with chronic skin disorders, predominantly acne, atopic dermatitis, alopecia areata, and vitiligo, only 27.0% had T scores less than 40 (minimal or no stigma) and 43.8% had at least moderate stigma (T score ≥45) compared with children with a range of chronic diseases. Stigma scores correlated strongly with reduced QOL (Spearman ρ = 0.73), depression (ρ = 0.61), anxiety (ρ = 0.54), and poor peer relationships (ρ = -0.49). Overall, 29.4% of parents were aware of bullying of their child, which was strongly associated with stigma (Cohen d = -0.79, with children who were not bullied experiencing lower levels of stigma). Girls reported more stigma than boys (Cohen d = 0.26). Children with hyperhidrosis and hidradenitis suppurativa were most likely to have increased depression and anxiety. Conclusions and Relevance: The findings of this study suggest that physician assessment of disease severity and visibility is insufficient to evaluate the disease impact in the patient/caregiver. Identifying stigmatization, including bullying, and tracking improvement through medical and psychosocial interventions may be a key role for practitioners.

  PublisherOA PDFDOI

• <i>Malassezia</i>‐associated skin diseases in the pediatric population

  Pediatric Dermatology · 2024-05-22 · 10 citations

  reviewOpen accessSenior authorCorresponding

  Malassezia are yeast species that commonly colonize healthy skin. However, they have been associated with or implicated in the pathogenesis of numerous skin disorders, particularly in the setting of pediatric populations. In this review, we will focus on several Malassezia-associated skin conditions manifesting in infants, children, and adolescents: pityriasis versicolor, Malassezia folliculitis, infantile and adolescent seborrheic dermatitis, head and neck dermatitis, and neonatal cephalic pustulosis. We examine the literature and provide an overview of these conditions, including clinical presentation in diverse skin colors, diagnosis, risk factors, and treatment and management. Additionally, we summarize and highlight some of the proposed theories on the role of Malassezia spp. in the pathogenesis of these skin conditions.

  PublisherDOI

• Racial and ethnic disparities in early mortality among patients with inborn errors of immunity

  Journal of Allergy and Clinical Immunology · 2023-10-05 · 18 citations

  articleOpen access
  PublisherOA PDFDOI

Frequent coauthors

• Elena Pope

  Oregon Dermatology & Research Center

  72 shared

• Colette Lieber

  Bergen Community College

  64 shared

• Arline Tsuchiya

  University of California, Irvine

  64 shared

• Bo Ngan

  Hospital for Sick Children

  64 shared

• Kirsten Turchan

  64 shared

• María C. Garzon

  64 shared

• Orli Wargon

  Sydney Children's Hospital

  64 shared

• Scott Walsh

  64 shared

Education

• B.A., Biology

  Haverford College

  1989

• M.D.

  Albert Einstein College of Medicine

  1994

• M.D., Pediatrics

  New England Medical Center/Tufts University

  1997

• M.D., Dermatology

  Northwestern University Feinberg School of Medicine

  2000

Awards & honors

• Senior Faculty Scholar Bucksbaum Institute for Clinical Exce…
• Postgraduate teaching award U of Chicago, Dept of Medicine (…
• Fellow in the Academy of Distinguished Medical Educators U o…
• Excellence in Education and Clinical Care Award U of Chicago…