PracticeUpdate Dermatology Best of 2018

EXPERT OPINION 24

Highlights From the Society for Pediatric Dermatology Summer Meeting By Sarah L. Chamlin MD Dr. Chamlin, Professor of Pediatrics and Dermatology

at Northwestern University Feinberg School of Medicine and member of the Advisory Board for PracticeUpdate Dermatology , offers highlights from the Society for Pediatric Dermatology meeting that was held 11–14 July 2018 in Lake Tahoe, California.

improved with therapy. Those who did not respond were escalated to isotretinoin therapy. Only 3 patients experienced side effects, which included lighthead- edness, headache, and fatigue, and 5 patients discontinued the medication for a variety of reasons. This treatment option should be considered for young females. Dermoscopy Dr. Elizabeth Seiverling of theMaineMedical Center dis- cussed dermoscopy for pediatric melanocytic lesions and emphasized the features of pediatric melanoma. Disorganized pseudopods should prompt practitioners to biopsy children for the possibility of atypical Spitz nevi and melanoma. Carrera C, et al studied this topic in a recent publication that is well worth reading. 2 Vascular lesions The newest ISSVA classification for vascular anom- alies is an invaluable resource for all providers who see children and adults with vascular lesions. This is accessible in PDF form at www.issva.org/UserFiles/ file/ISSVA-Classification-2018.pdf . This was updated in May of 2018, and it includes common and rare vascu- lar malformations and tumors with their known genetic mutations, when known. Dr. Lali Baselga from Hospital de la Santa Creui Sant Pau reviewed targeted thera- pies based on these genetic mutations Pediatric CTCL Pediatric cutaneous T-cell lymphoma (CTCL) most often presents in hypopigmented or patch form in children. This can mimic inflammatory skin conditions such as pityriasis alba and pityriasis lichenoides chronica. CTCL should be suspected in children with persistent

Music during pediatric laser treatment Dr. Cheryl Bayart of the Cleveland Clinic Foundation and colleagues at Seattle Children’s Hospital studied the effect of music intervention to decrease pain dur- ing laser procedures. The “music-free” children older than 66 months of age experienced significantly more pain than the intervention group. Of note, both patient and parent unsolicited feedback in the music group were very positive. Consider using a music app and let the children pick the songs. This low-cost simple inter- vention may decrease pain and stress for any pediatric procedure. Pediatric patch testing Allergic contact dermatitis (ACD) is a challenging diag- nostic problem in pediatric patients. Many fewer kids undergo epicutaneous patch testing as compared with adults, and a standardized patch testing series has not been produced for children, with the exception of T.R.U.E. TEST, which is approved for use in children but only contains 35 allergens. In November of 2017, the ACDS met to create a patch test panel for children, which included 38 allergens. Dr. JiaDe Yu of Massachu- setts General Hospital reported these findings of the Pediatric Contact Dermatitis Workgroup in poster and presentation form, with published results just available. This group of experts suggest using the 38 allergens, and expanding as necessary for personal products. Of note, approximately 60 allergens can be placed on the back of a 6-year-old. 1 Spironolactone for acne in adolescent females Dr. Erin Roberts of the Mayo Clinic in Rochester used spironolactone to treat 80 female patients with a median age of 19 (range, 14–20). Most patients, (80%,)

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