PracticeUpdate: Dermatology & Rheumatology

42ND ANNUAL MEETING OF THE SOCIETY FOR PEDIATRIC DERMATOLOGY 14

Dr Sarah Chamlin’s top 5 poster pearls fromSPD 2016 Sarah Chamlin MD, is Associate Professor of Pediatrics and Dermatology at Northwestern University Feinberg School of Medicine, Attending Physician at Children’s Memorial Hospital specialising in paediatric dermatology, and Advisory Board member of PracticeUpdate Dermatology .

SPD 2016 14-17 JULY 2016 • MINNEAPOLIS,

MINNESOTA, USA PracticeUpdate Dermatology Advisory Board member Dr Sarah Chamlin shares her top sessions and take-aways from the American Society for Pediatric Dermatology 2016 annual meeting.

1. Tofacitinib is a promising future therapy for severe adolescent alopecia areata. In total, 13 patients with a median age of 15 years were treated with tofacitinib, with 68% experiencing clinically significant growth. Adverse events were mild and included headaches, upper respiratory infections, and mild transaminitis. 2. The common misperception that food plays a role in childhood atopic dermatitis persists for most parents (82%). In addition, most parents of children with AD (58%) are unaware that infection can be a complicating factor. These data were reported as part of a survey performed at a state fair of 392 parents. Most parents get information about AD from their primary care provider and the Internet. 3. Allergic contact dermatitis is increasingly common in children. Reports of adverse reactions, most commonly nickel-related dermatitis, to common household toys or electronics such as iPads, laptops, and video game controllers are on the rise. Consider these exposures when evaluating and treating children with contact dermatitis. 4. Evidence supports certain behavioural techniques to alleviate pre- procedural anxiety and procedural pain perception for children undergoing in-office procedures. The ideal timeframe to review the details of the procedure with the child is 5 to 7 days beforehand. Counselling within this timeframe may lessen anxiety. Children prepared for a painful procedure by being told they would have “medium” pain experienced significantly less pain than those not prepared. 5. Clinical findings in AD patients vary among ethnicities , and these differing presentations can guide management. Hyperpigmentation, neck lichenification, and lichen spinulosus are more common in black patients. Follicular prominence is more common on the extensor surfaces of Asian children and least common in non-Hispanic white children. Facial erythema is more common in Asian and non-Hispanic white children. Infraorbital fold involvement is less common in Asian children. Orbital darkening was seen across all ethnicities, and white dermatographism was only observed in white children. Of note, some of these findings that vary by races are listed as Hanifin and Rajka minor criteria for AD.

K evin Boyd MD from the University of Alabama in Birmingham reviewed articles published over the past year relevant to paediatric dermatologists (Boyd K. The Year in Review: Pediatrics. Paper pre- sented at: 42nd Annual Society for Pediatric Dermatology Meeting; July 14–17, 2016; Minneapolis, MN).

Paediatric dermatology literature year

Consensus communication on early peanut introduction and the prevention of peanut allergy in high-risk infants. Fleischer DM, Sicherer S, Greenhawt M, et al. Pediatrics 2015;136:600-604. • Early introduction of peanut to infants at high risk for peanut allergy (ie, those with a history of egg allergy or severe eczema) is recommended to reduce this risk. The study reported an 11% to 25% absolute reduction in risk of developing peanut allergy in high- risk infants. While dermatologists should be aware of the LEAP trial ( N Engl J Med

in review By Sarah Chamlin MD

PRACTICEUPDATE RHEUMATOLOGY & DERMATOLOGY