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  • Presentation

What's New in Pediatric Dermatology?

Description

In the presentation, Dr. Lisa Swanson, a pediatric dermatologist, shares significant advancements in pediatric dermatology, particularly focusing on the treatment of conditions like hemangiomas and atopic dermatitis. Dr. Swanson highlights the effectiveness of Propranolol and introduces nadolol as a promising alternative for treating hemangiomas, emphasizing the importance of early intervention. She discusses the rise in steroid phobia and presents the Erin regimen for managing atopic dermatitis in infants, and the success of new non-steroidal treatments such as Tapineroff and Ruxolitinib. Dr. Swanson notes the systemic impact of conditions like atopic dermatitis on growth and mental health, pointing out that better skin management can lead to improved overall well-being. The use of biologics for treating psoriasis and alopecia areata is also a major theme, with Dr. Swanson sharing poignant patient stories that illustrate the transformative effects of these treatments. She underscores the importance of compassionate care in dermatology, stating that the goal is not only to treat conditions but to improve the quality of life for patients, reflecting a deep commitment to their well-being.

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Conclusions

  • Propranolol effectively treats infantile hemangiomas, with early initiation leading to better outcomes.
  • Nadolol shows superior efficacy compared to Propranolol for treating problematic infantile hemangiomas.
  • Counseling on Propranolol treatment should emphasize the importance of food to prevent hypoglycemia.
  • Topical Timolol is only effective for superficial hemangiomas and should not be used for ulcerating types.
  • The Aron regimen is a successful compounded treatment for atopic dermatitis and should not be replaced with DIY mixes.
  • Dupilumab has demonstrated the ability to improve sleep and growth in children with atopic dermatitis.
  • Dupilumab treatment correlates with reduced ADHD medication usage in children with atopic dermatitis.
  • Vaccination in children receiving Dupilumab should be carefully timed, particularly with live vaccines.
  • New topical and injectable biologics are advancing treatment options for severe atopic dermatitis and pediatric psoriasis.
  • Children with severe atopic dermatitis are at risk for psychiatric comorbidities, potentially linked to elevated IL-4 levels.
  • Leaute-Labreze C et al. "Early initiation of treatment with oral propranolol for infantile hemangioma improves success rate." Ped Derm. 2023; 40: 261-264.
  • Munoz-Garza F et al. "Efficacy and safety of topical timolol for the treatment of infantile hemangioma in the early proliferative stage: A randomized clinical trial." JAMA Derm. 2021; 157(5): 583-587.
  • Fatima Lakhani, et al. "Case Series Study of the Efficacy of Compounded Antibacterial, Steroid, and Moisturizer in Atopic Dermatitis." Ped Derm. Vol 34 No 3 322-325, 2017.
  • Yildirim et al. "Dupilumab treatment for atopic dermatitis is associated with decreased utilization of psychostimulants for ADHD: A retrospective cohort study." JAAD April 2023.
  • Sun H et al. "Biologics for pediatric psoriasis: A systematic review and meta-analysis." Ped Derm Vol 39 No 1 42-48, Dec 2021.
  • King B and Craiglow B. "Janus kinase inhibitors for alopecia areata." JAAD Vol 89 No 25 s29-s32, Aug 2023.
  • Rosmarin et al. "Two phase 3, randomized, controlled trials of ruxolitinib cream for vitiligo." N Engl J Med 2022; 387: 1445-1455.
  • Nestor et al. "Polypodium leucotomos as an adjunct treatment of pigmentary disorders." J Clin Aesthet Dermatol. 2014 Mar; 7(3): 13-17.