Pediatric Dermatology

As the Vioxx/Celebrex scandal lays waste to the American healthcare landscape as we know it, the U.S. Food and Drug Administration (FDA) finds itself under relentless pressure to get things right. Congress is demanding more stringent safety standards and even threatening to create a new federal agency to take safety approvals and monitoring out of the FDA's hands.

The act of taxing a single group of patients who are seeking cosmetic surgery simply because they are easy targets is unfair, injudicious, potentially sexist and wrong.

An investigational topical antifungal product containing miconazole nitrate 0.25 percent in a petrolatum/zinc oxide barrier ointment base (Zimycan, Barrier Therapeutics) has demonstrated positive efficacy and safety results in a phase 3 study of the treatment of Candida diaper dermatitis.

Miami — Bacitracin has been labeled a top cause of allergic contact dermatitis (ACD) in children. Notably, it is an ingredient in Neosporin (Pfizer) and a staple in first aid kits in schools, summer camps and just about every other child-centered environment. Yet private practitioners do not routinely test for this allergen.

Loma Linda, Calif. — Dermatologists don't discuss mastocytosis much because it is rare and confusing, but, in large metropolitan areas, the incidence rate can add up to many patients, says Linda Golkar, M.D., assistant professor of dermatology, Loma Linda University, Loma Linda, Calif. Learning when to consider the disease, what diagnostic tests to perform and how to exclude involvement of other organs are required skills for front-line treatment.

New Orleans - In today's global, transient and sometimes overcrowded society, the spread of superficial cutaneous infections and infestations in children appears to be even more common than previously thought. International travel, immigration and foreign adoption have altered the typical distribution of some pediatric infections and infestations.

Miami — The bad news about pediatric atopic dermatitis (AD) is that it rarely reverses course completely. The good news is, doctors can largely control it through a variety of interventions.

There have been a number of important advances in pediatric dermatology, ranging from finding the optimal use for tissue adhesives to gaining a better understanding of general and local anesthetic use in the pediatric population and a greater appreciation for dermatologic surgeons' roles in treating vascular lesions and birthmarks.

New Orleans — Rare, life-threatening dermatoses are presenting in pediatric patients across the country, and some dermatologists are missing these critical diagnoses, according to Patricia Treadwell, M.D., professor of pediatrics, Riley Hospital for Children, Indianapolis.

New Orleans — Being a respected authority doesn't guarantee that one's presentations will stand out. Achieving this goal requires speakers to select subjects they love while knowing themselves and their audience, says Steven K. Shama, M.D., M.P.H., inprivate practice in Brookline, Mass.

Current concepts on sunscreen use still support recommendations for choosing a broad-spectrum sunscreen that has an SPF of 15 and contains titanium dioxide, zinc oxide, avobenzone or oxybenzone for UVA protection.

New Orleans — Modern medical acupuncture can be used in conjunction with current Western treatments in dermatology to optimize patient outcome, according to Donald J. Baker, M.D., clinical professor and director of integrative dermatology at the University of Medicine and Dentistry, New Jersey, Robert Wood Johnson Medical School, Camden, N.J.

Boston — According to Hugh A.Sampson, knowing there is a higher incidence of asthma among children who develop atopic dermatitis (AD) and food allergy early in life makes it possible to identify those who are likely to develop the respiratory disorder.

New Orleans — Undergraduates are accustomed to paying for their education. Why not dermatology residents?

Dear Editor,

I just ended one of the best years of my life! And one of its best aspects was experiencing the value of smaller organizations within our larger dermatology community. In particular, I want to share my perceptions of the Women's Dermatologic Society (WDS), of which I am the immediate past president, and show how it continues to add significantly to the greater whole.

If we stand in front of children, we are virtually intimidating giants looming over them.

Washington — Scorched by controversy over how it approves prescription drugs for the marketplace, the U.S. Food and Drug Administration (FDA) is preparing to establish an independent Drug Safety Oversight Board (DSB) to monitor FDA-approved pharmaceuticals and update physicians and patients when new information becomes available.

Las Vegas — With recent modifications to the rosacea classification system and a greater understanding of the use of antibiotics as inflammatory mediators in rosacea treatment, Joseph Bikowski, M.D. of the Bikowski Skin Care Center, Sewickley, Pa., outlined a tiered approach to rosacea treatment at the Winter Dermatology Conference here.

New Orleans — When dermatologist Steven K. Shama, M.D., talks about achieving the unforgettably positive office visit, he refers to "being in the moment" with each patient.

Another use for Google is to protect the content on my Web site from plagiarism.

Miami — Filler options are getting closer to what David J. Goldberg, M.D., considers ideal.

There are several infectious agents using both direct and indirect mechanisms that may play a role in skin cancers.

New Orleans — For a variety of reasons, cutaneous T-cell lymphoma (CTCL) — a low-grade lymphoma that typically presents in or on the skin — can be difficult to diagnose.

Aruba — Though its impact can be socially and financially crippling, chronic allergic contact dermatitis (ACD) of the hand responds to aggressive drug therapies combined with on-the-job precautions, according to Donald V. Belsito, M.D., M.B.A., professor and director of dermatology, University of Kansas Medical Center.

New Orleans — Hand eczema is one of the most common work-related illnesses or diseases. But diagnosis is complicated because hand eczema is almost always a group of concurrent reactions (to irritants, allergens and friction) that is exacerbated by the use of water, according to Frances J. Storrs, M.D., professor emerita of dermatology, Oregon Health and Science University in Portland.

According to Polly Matzinger, Ph.D., the immune system operates in a sleeping mode until injured tissues or cells waken it with alarm signals.

Aruba — Along with improved safety over topical steroids, calcineurin inhibitors appear to offer relief for a variety of skin conditions including pruritus and psoriasis, especially in sensitive areas, according to Joseph F. Fowler, Jr., M.D., clinical professor, University of Louisville"s Division of Dermatology.

New Orleans — Recent headlines underscore the life-threatening dangers of topical medications — information that may shock the lay community. Dermatologists should take into account the well-known risks to internal organ systems that these drugs present, according to Peter J. Aronson, M.D.

Classification of rosacea patients by subtype guides physicians toward the most appropriate treatment for each patient, says Frank Powell, M.D.