Key Insights From the SPD Pre-AAD Meeting: Advances, Challenges, and the Future of Pediatric Dermatology

Mercedes E. Gonzalez, MD

Following the 37th Annual Society for Pediatric Dermatology (SPD) Pre-Meeting in Orlando, Florida, Dermatology Times spoke with Mercedes E. Gonzalez, MD, co-chair of the meeting, to reflect on the key takeaways from the conference. This year’s pre-meeting covered a range of critical topics, from emerging treatments to evolving best practices in pediatric dermatology. In this Q&A, Gonzalez discusses the most impactful sessions, new insights that could shape clinical care, and the importance of collaboration within the pediatric dermatology community.

Dermatology Times: The SPD pre-AAD meeting has become an important tradition and part of the bigger conference. For those who missed it, what were the highlights and important takeaways?

Mercedes E. Gonzalez, MD: Our Laser panel with Deepti Gupta, MD, Lisa Arkin, MD, , and Andrew Krakowski, MD, was outstanding. The speakers reviewed how lasers work, what disease processes are most suitable for laser treatment and discussed practical pearls with the audience. All speakers shared great before and after pictures demonstrating dramatic improvements in vascular anomalies and scars with the right laser settings. In addition, the role of hair removal in hidradenitis suppurativa and gender affirming care was presented.

Speaking of hidradenitis suppurativa, Colleen Cotton, MD, gave an outstanding presentation. She discussed 3 case examples and discussed different treatment approaches based on severity of the clinical presentation. She also showed an amazing video of a deroofing procedure that had the audience entranced.

The Esterly lecture on classification of congenital hemangioma, capillary malformations and CMTC was an excellent updated review on genetics of these vascular birthmarks and how we may have to rethink our classification.

Dermatology Times: Your introduction for Maria Garzon, MD, who gave this year’s Esterly Lecture “Classification Conundrums in Vascular Anomalies: ‘The Three Cs’,” about her support as your mentor was inspirational. Why is it so important to have–and be–a mentor, especially in the pediatric dermatology space?

Mercedes E. Gonzalez, MD: Dr Garzon has been a mentor to many in the specialty, and she was my first mentor in pediatric dermatology. I wanted to share her mentees’ gratitude with the audience through a thoughtful introduction.

Many trainees first become enticed by pediatric dermatology after working with a mentor in the field. It is the experience of watching a patient interaction that often attracts students and residents to the specialty. Working closely with a fun-loving, kind-hearted, generous pediatric dermatologist (like Dr. Garzon) is often the key that brings people into the specialty.

Experienced mentors provide invaluable career advice, clinical knowledge, and research guidance, helping mentees navigate the complexities of specialized dermatologic care for children.

The SPD plays a vital role in supporting mentorship through structured programs such as the Facilitated Peer Mentoring Groups for Junior Pediatric Dermatologists, networking events at the AAD and annual SPD meetings, and educational initiatives. SPD connects trainees with experienced pediatric dermatologists, offers guidance on career development, and provides resources for research and clinical training. By fostering mentorship relationships, SPD ensures continued growth in the field and enhances access to expert care for children with dermatologic conditions.

Dermatology Times: The Sam Weinberg’s Cases of the Year are always a highlight. How do you choose which cases to include?

Mercedes E. Gonzalez, MD: We start a few months before the meeting with a call for submissions for interesting cases. It is a competitive review process in which a committee chooses the top 10 cases to present at the meeting. One is chosen as the winner of the travel grant.

This year there was a great case of severe Darier disease that was effectively treated with topical sirolimus. Another interesting case was of generalized pustular psoriasis with an underlying diagnosis of autosomal recessive deficiency of interleukin-36 receptor antagonist (DITRA) that was treated with spesolimab, a monoclonal antibody of the IL-36 receptor. This led to clearance of her eruption cleared after two loading doses.

Another case highlighted a pediatric dermatologist’s detective work in finding the cause of a persistent contact dermatitis in an unusual distribution. The culprit was a laundry sanitizing product containing quaternary ammonium compounds. The localized severe and brisk nature of her reaction was critical in deducing an irritant cause.

We were also reminded of the important role we play in the diagnosis of inflammatory bowel disease (IBD) with a case that highlighted the cutaneous findings of IBD.

Dermatology Times: There are so many exciting advances and opportunities in pediatric dermatology. What are you most excited about?

Mercedes E. Gonzalez, MD: I’m most excited about the expanding use of targeted biologic therapies for pediatric patients with severe inflammatory skin diseases. The approval of biologics for younger age groups—such as those for atopic dermatitis and psoriasis—as well as the introduction of JAK inhibitors for conditions like alopecia areata and vitiligo represent a significant advancement in treatment options.

Additionally, the growing number of effective topical treatments for atopic dermatitis is particularly exciting. These newer therapies not only improve disease control but also help minimize long-term side effects, ultimately providing substantial relief for patients and improving their quality of life. The ability to offer treatments that can induce prolonged remission and long-term skin clearance—similar to what has been seen in adults—has the potential to be life-changing for pediatric patients who are severely affected by chronic skin disease.

Dermatology Times: On the other hand, what issues remain challenging and need additional research?

Mercedes E. Gonzalez, MD: In terms of diseases that require greater research and attention, conditions such as congenital melanocytic nevi, genetic skin diseases like epidermolysis bullosa and ichthyosis, and vascular anomalies associated with genetic syndromes remain areas of critical need. These rare disorders currently have no definitive cure, and increased research efforts could lead to improved treatments and better outcomes for affected children.

Dermatology Times: There are a number of treatments for pediatric indications in clinical trials. Which ones are you most excited about and why?

Mercedes E. Gonzalez, MD: Currently I am most excited about the potential use of oral JAK inhibitors in children younger than 12 years of age who have severe alopecia areata. These are currently in clinical trials. Severe alopecia areata is a devastating disease for young children—it has a profound impact on their psychosocial development. There is a large unmet need for safe and effective treatments in this population. JAK inhibitors could be truly life changing in this age group. In addition, topical JAK inhibitors will be a welcome addition to our armamentarium for pediatric vitiligo, a disease state where there are currently very limited effective treatment options. I am also looking forward to the approval of other non-steroidal topical treatments for atopic dermatitis in young children.

Dermatology Times: Anything else you would like to share with readers?

Mercedes E. Gonzalez, MD: This is an exciting time for pediatric dermatology—finally clinical trials are expanding enrollment to younger patients and we are reaping the benefits of an expanded armamentarium of safe and effective treatment options for severe skin disease in children.

This is going to be a very exciting field for many years to come. I would like to encourage any trainee, medical student, or resident to consider pediatric dermatology. It is such a fulfilling career! There is so much you can do as a pediatric dermatologist, including academic medicine, research, clinical research, private practice, hospital-based practice in a children’s hospital or a larger institution—or a mix of all of the above.

There are many opportunities to get involved in research and you can do it (pretty easily) by joining the Pediatric Dermatology Research Alliance (PEDRA) and joining one of their interest groups there is always a project you can jump on.

Dr Gonzalez is a board certified pediatric dermatologist, a clinical assistant professor at the FIU Herbert Wertheim School of Medicine and the Phillip Frost Department of Dermatology at the Miller School of Medicine, and serves as Medical Director at Pediatric Skin Research in Miami, FL. She is also the co-editor of Goodheart's Photoguide to Common Pediatric and Adult Skin Disorders, Fourth Edition.