Pediatric Dermatology

Washington, D.C. - Elective dermatologic surgeries in children have been enhanced by new technologies, new clinical research, new anesthesia, and new therapies. A five-member panel discussion held at the annual meeting of the American Academy of Dermatology highlighted many of these advances and provided practical tips for treating children over the age of 7.

Washington -- New therapies continue to emerge in pediatric dermatology, and recent studies demonstrate the effectiveness of such therapies. Ilona J. Frieden, M.D., highlighted studies in some areas of common concern in a presentation at the annual meeting of the American Academy of Dermatology.

Wailea, Maui. - Age is an important variable in the diagnosis of contact dermatitis, said Suzanne M. Connolly, M.D., associate professor of dermatology, Mayo Clinic, Scottsdale, Ariz.

Washington D.C. - By remaining aware of female patients' non-dermatologic medical issues, dermatologists can offer a suitable acne medication that will address oral contraception, as well, according to Moneera Haque.

Washington - The optimum doses of biologic treatments for psoriasis may be higher than previously believed, according to Mark Lebwohl, M.D., professor and chairman, department of dermatology, Mt. Sinai School of Medicine.

About 15 years ago, while riding on a shuttle bus at the annual American Academy of Dermatology meeting, I overheard two elderly dermatologists discussing the state of dermatology, as they perceived it. One gentleman commented that he had not seen a single advance to rival the advent of tetracycline for acne, and that most of the new treatments did not work very well. At the time, I remember thinking that these practitioners were out of touch with all of the hot new therapies for skin disorders. Since that time, as I have been bombarded by myriad new and supposedly revolutionary "advances," I, too, am beginning to question whether we should equate the concept of "newness"

Wailea, Hawaii - Compliance with allergen avoidance may seem like quite a challenge, even to patients with limited allergies. The Contact Allergen Replacement Database (CARD) aims to level the playing field.

Welcome to a new department in Dermatology Times. Beginning with this month's Special Report, DT will present a monthly panel review of specific cases in pediatric dermatology, an effort coordinated by editorial adviser Lawrence Schachner, M.D. In this installment, a panel of pediatric masters discusses treatment options for the unusual case of a 12-year-old Hispanic girl who was brought in by her parents for treatment of a white spot that had developed after she was out playing in the sun.

Washington - Cutaneous lesions are common in infants with neonatal lupus erythematosus (NLE) and may have life-long sequelae. However, the most worrisome associations are its noncutaneous features and the increased risks for a mother to develop an autoimmune disorder herself, said Amy S. Paller, M.D., at the annual meeting of the American Academy of Dermatology.

Boca Raton, Fla. - Contact dermatitis from topical medications is the most common type of adverse drug reaction, and allergic contact dermatitis is the most common and most important form of contact dermatitis induced by topical drugs, according to James S. Taylor, M.D., head of the industrial dermatology section of the department of dermatology at the Cleveland Clinic Foundation in Cleveland. "Patients with medicament contact dermatitis usually have a good prognosis, but with a propensity for relapse," Dr. Taylor said.

Maui, Hawaii - For thousands of years, people have flocked to the Dead Sea searching for relief for their itchy skin. Now, Chicago-area psoriasis and atopic dermatitis sufferers are bathing in reconstituted Dead Sea water at a suburban clinic.

Tampa, Fla. -- Dermatologists can use hypnosis as an adjunctive or monotherapy for helping patients relax for in-office procedures, feel less pain, or even change habits such as skin picking. What dermatologists might not know about medical hypnosis is it usually takes only one to three minutes to induce hypnosis, using a brief hypnotic technique, according to Philip D. Shenefelt, M.D., associate professor of medicine, Division of Dermatology in the Department of Internal Medicine, University of South Florida, Tampa.

PARTICIPANTSMarcia Glynn, MD Assistant Professor, Dermatology Director, PediatricDermatology Martin Luther King/Charles R. Drew Medical Center Los Angeles,CaliforniaJudy Hunter, MD Pediatrician Principal Investigator HealthCare PartnersMedical Group Torrance, California

Moderator: What is ringworm, and do you find it to be seasonalin nature?

Q&A/ROSACEAAlbert Kligman, M.D., Ph.D., is a pioneer who continues to break new ground in dermatology. Dialogue with a Mentor is brought to you by an unrestricted educational grant from Galderma Laboratories, LP.

Washington, D.C. - A unique case report of necrobiosis lipoidica (NL) within coronary artery bypass graft scars presents the dermatologist with the ongoing challenge of managing an ever-present skin disorder that denies therapy, according to Shannon Heck, M.D.

Washington D.C. - Juvenile Xanthogranuloma (JXG) is a rare histiocytic proliferation of uncertain histogenesis usually found in the cephalic region and more common in males less than one year of age. So when an 11-day old female neonate presented to Wake Forest University Baptist Medical center with a firm, immobile, non-pulsatile, pink-red nodule and telangiectases localized to the right groin, JXG was not initially suspected. However, as part of the initial workup, a confirmatory biopsy revealed the diagnosis.

Washington - Topical application of tazarotene 0.05 percent was effective in reducing cutaneous roughness and scaling in a patient with a rare form of ichthyosis known as Rud's syndrome, according to Maria Concetta Fargnoli, M.D., a dermatologist at the University of L'Aquila, Italy.

The Smoothbeam diode laser was given expanded FDA clearance for treatment of facial acne.

A drug used to treat skin infections including athlete's foot, could help to slow the progression of Alzheimer's disease, scientists say.

Scottish researchers have discovered a breakthrough treatment they believe will allow thousands of skin-cancer sufferers to treat themselves at home.

National report -- In a study that could have implications for faster wound healing in the future, Australian researchers have dispelled the belief that only epidermal stem cells are capable of tissue regeneration; short term and long term. They report in the February 2004 issue of The Journal of Clinical Investigation that significant proliferative and tissue-regenerative capacity resides in the more mature progeny of keratinocyte stem cells - including early differentiating cells.

Miami, Fla. - The challenge in neonatal dermatology is that pediatricians who commonly see various skin conditions in infants often lack the training and knowledge to respond to the skin eruptions, according to the head of pediatric dermatology at the Phoenix Children's Hospital.

Washington -- A recent prospective study has shown that treatment of atopic dermatitis with tacrolimus ointment (Protopic, Fujisawa) produced clinical improvement and reduced healthcare resource use and improved patient and caregiver quality of life, said Mark Boguniewicz, M.D., professor, division of pediatric allergy-immunology, National Jewish Medical and Research Center, Denver, and University of Colorado School of Medicine.

Waikoloa, Hawaii - Controlled studies show water from thermal springs in Avene, France, reduces inflammation, pruritis, and erythema, according to a general practitioner whose employer markets the water. The water is effective in treating psoriasis, inflammation caused by laser treatments, and mild to moderate atopic dermatitis, said Fran?ois Verriere, M.D., at the Hawaii Dermatology Seminar.

Waikoloa, Hawaii - Bexarotene 1 percent gel (Targretin) is a useful alternative modality, offering advantages to other therapies, for the treatment of mycosis fungoides (MF), according to Joan Guitart, M.D., at the annual Hawaii Dermatology Seminar in January.

Waikoloa, Hawaii -- Pilot study results indicate that 0.12 percent betamethasone valerate foam is more effective than vehicle alone for short-term stasis dermatitis treatment. "This topical therapy can lead to improved health-related quality of life in these patients," said Alexa Boer Kimball, M.D., assistant professor and director, dermatology clinical trials, Stanford University School of Medicine.

Washington, D.C. - Because all the ramifications of new medications - and even some of the older ones - are not yet known, practitioners should give special consideration to possible side effects. In making treatment decisions, get as much information as possible, said Roselyn E. Epps, M.D.

Miami, Fla. - Dermatologists treating pediatric skin diseases should always look for related, underlying psycho-social issues and make referrals or offer solutions when problems are identified. The challenge is that sometimes the psycho-social issues from which children and teens suffer are not so obvious, according to Karen Mallin, Psy.D., instructor in the departments of psychiatry and behavioral sciences and dermatology and cutaneous surgery at University of Miami School of Medicine, Miami.

Miami - Atopic dermatitis (AD) can be challenging to diagnose even for the seasoned dermatologist because it mimics other common skin diseases in the pediatric population. It also can be challenging to treat, with the addition of new agents on the market. There are key points to consider when making the diagnosis and tried-and-true methods of treatment to keep in mind when recommending therapies to parents and their children, according to Bernice Krafchik, M.D., dermatologist, and professor emeritus at the University of Toronto.