Pediatric Dermatology

Pediatric patients are threatened by infestations such as bedbugs, head lice and scabies, so parents need to be vigilant of these risks, according to the chief of the division of pediatric dermatology at the Children’s Hospital of Pittsburgh.

Children who have more severe atopic dermatitis, or eczema, are less likely to outgrow allergies to milk or eggs, Medical News Today reports.

Academic pediatric dermatologists can burn out for the same reasons as do their general dermatology colleagues, but they also face unique challenges, those in the field say.

Evidence-based treatment options for moderate-to-severe pediatric atopic dermatitis and psoriasis are severely limited, according to specialists in the field, leading to the creation of a national collaborative by several pediatric dermatologists.

Although most oral lesions observed in children pose little health risk, some of these lesions may be severe and followed by permanent sequelae, an expert says. And some pediatric oral lesions can provide clues to the presence of a systemic disease, she adds.

The pulsed dye laser (PDL) can treat capillary malformations in children and, in exceptional circumstances, infantile hemangiomas, according to a professor of dermatology and pediatrics at the Medical College of Wisconsin, Milwaukee.

Pediatric onychomycosis is relatively uncommon, with an overall prevalence among all patients with onychomycosis of about 2.5 percent. The condition occurs more often in adolescents than in young children, says Amy Paller, M.D., Walter J. Hamlin Professor, chairwoman of dermatology, professor of pediatrics, Northwestern University Feinberg School of Medicine, Chicago.

If congenital nevi are small, there is insufficient evidence to suggest they should be removed, for they are not likely to transform into melanoma, according to the chief dermatologist at Phoenix Children's Hospital, Phoenix. However, giant nevi present a much higher risk, says Ron Hansen, M.D., F.A.A.D., a board-certified dermatologist and board-certified pediatrician.

Vascular birthmarks are very ccommon in newborns, and some varieties affect up to 50 percent of babies. But the challenge for dermatologists can be the early diagnosis and the ability to distinguish the subtle differences between a banal birthmark and one that calls for quick action.

Milwaukee - Results of a small prospective study demonstrate that corticosteroid treatment of infantile hemangiomas can lead to profound, but largely reversible, immune suppression in infants, MedPage Today reports.

National report - Little did dermatologist Luette Semmes, M.D., know that her successful treatment of a young patient with bullous pemphigoid would land her a spot on national television a few years later.

Wailea, Hawaii - The level of concern for neonatal dermatoses ranges depending on the type of condition, according to Julie V. Schaffer, M.D., director of pediatric dermatology, director of resident education, assistant professor of pediatrics and dermatology, NYU Langone Medical Center, New York.

With interest in the new subspecialty of pediatric dermatology still less than robust, leaders in the field are looking at training requirements to see how they might be impacting recruiting. Meanwhile, the window is closing for a small but well-qualified group of physicians to be "grandfathered" into board certification.

Pediatric patients seek many of the same cosmetic procedures that their parents desire. The question, according to one expert, becomes whether dermatologists and others should perform cosmetic procedures on patients who are still growing - physically and mentally.

Pediatric dermatology has achieved important milestones in recent years, including board certification. However, the small dermatology subspecialty stands at a crossroads in 2010. Faced with a significant shortage of physicians choosing a career in pediatric dermatology, those committed to the subspecialty's survival are searching for solutions.

Psoriasis in adults is among the most-researched inflammatory skin diseases. Yet treatment options for moderate-to-severe atopic dermatitis and psoriasis in children represents a largely unmet medical need, according to an expert.

Pediatric dermatologists are taking a very slow - but hopeful - approach to using propranolol to treat hemangiomas in children. In doing so, they are also carefully monitoring children for possible unwanted reactions such as hypotension, bradycardia and hypoglycemia.

Key advances in pediatric dermatology include a deeper understanding of the role of propranolol in treating hemangiomas and of the link between attention deficit hyperactivity disorder (ADHD) and atopic dermatitis (AD), according to an expert. Meanwhile, research into other pediatric issues, including diet and acne, continues.

Dr. Ondo, clinical assistant professor of dermatology, University of New Mexico, Albuquerque, traveled 30 hours each way on a two-week journey to Hyderabad, near India's southeastern coast. He described the experience as interesting, memorable, and at times overwhelming.

In September 2009, Amgen decided to withdraw application for expanded use of its biologic tumor necrosis factor (TNF) blocking agent etanercept (Enbrel) in pediatric patients with moderate-to-severe psoriasis.

The certification of pediatric dermatology as a subspecialty is a relatively recent milestone in the field of dermatology.

Neonatal pigmentary conditions are common; however, some serious conditions should be evaluated and followed by a pediatric dermatologist throughout the child's life, an expert says.

Biologic therapy is proven to increase the quality of life in adult patients suffering from moderate-to-severe psoriasis. A recent study shows that etanercept (Enbrel, Immunex) can achieve similar positive results in children and adolescents, offering hope to this patient population.

Recent study results indicate that there is a relationship between the severity of psoriasis and CRP levels, as well as BMI in pediatric patients. These patients are also at a higher cardiovascular risk, begging the need for treatment strategies in terms of lipid-lowering therapies.

San Francisco - Children with skin diseases such as severe psoriasis, eczema and hemangiomas are benefiting from new treatments and new knowledge about existing treatments, experts say.

San Francisco - Most patients with atopic dermatitis (AD) will respond to conventional therapies, such as basic skincare and avoidance of prevocational factors; topical corticosteroids and calcineurin inhibitors; antibiotics for infection and oral antihistamines.

San Francisco - As researchers learn more about the origin of infantile hemangiomas, a particularly promising new treatment is emerging in the form of propranolol, an expert says.

Post-transplant lymphoproliferative disorder is lymphocyte proliferation in patients following post-transplant immunosuppression and is the most common neoplasm in pediatric organ transplant recipients. Due to the increased frequency of organ transplantation, dermatologists should be aware of the cutaneous presentation, as a timely diagnosis and treatment is crucial for a favorable prognosis.

Results of a recent study suggest that while upper airway infections, such as rhinosinusitis and adenotonsillitis, may exacerbate atopic dermatitis in children, surgical treatment for those infections may improve the severity of AD.

Kohala Coast, HI - In children with severe atopic dermatitis, dermatologists should feel empowered to match the aggressiveness of their treatment to the aggressiveness of the disease, said Elaine C. Siegfried, M.D., at the Winter Clinical Dermatology Conference.