Pediatric Dermatology Research Articles

Enhancing Spanish Patient Education Materials: Comparing the Readability of Artificial Intelligence-Generated Spanish Patient Education Materials to the Society of Pediatric Dermatology Spanish Patient Brochures.

Patient education materials (PEMs) are crucial for improving patient adherence and outcomes; however, they may not beaccessibledue to high reading levels. Our study used seven readability measures to compare the readability of SpanishPEMsfromthe Society of Pediatric Dermatology (SPD) with those generated by Open-AI's ChatGPT 4.0 and Google Gemini. Our results showed that when prompted to produce material at a 6th grade level, both AI ChatBots generated significantly improved readability scores when compared to the SPD handouts. These findings suggest that AI-generated PEMs couldbetter meet readability standards and potentially improve patient outcomes, although further studies are needed to confirm this.

Impact of the Society for Pediatric Dermatology Mentorship Award Program on Careers in Pediatric Dermatology: Workforce Implications.

Extended essays or commentaries providing an opportunity to express personal views and opinions that are meant to enlighten, entertain, and educate readers, and can include articles about medical history, ethics, literature or the arts related to pediatric dermatology. Patient perspectives are also encouraged. Questions on whether a potential submission is appropriate for this section can be addressed to the Editors-in-Chief, or the Section Editors, Lucinda Kohn, MD, MHS (lucinda.kohn@cuanschutz.edu) or Neil Prose, MD (prose001@mc.duke.edu).

"Vulva," Not "Private Part": The Importance of Accurate Genital Terminology.

Effective communication in pediatric dermatology is critical for accurate diagnosis and treatment, particularly in sensitive areas such as the anogenital region. Unfortunately, children and their families often use euphemisms or incorrect terms when referring to this area, and many adults lack knowledge of anogenital terminology. Pediatric dermatologists can play a unique role in educating children and their families on correct anatomical language, which enhances body awareness, empowers young patients, improves safety, and contributes to accurate medical assessments and treatment adherence. By promoting the use of correct anatomical terms, pediatric dermatologists can improve patient outcomes and foster a healthier understanding of body anatomy and health.

Food Allergy Test-Guided Dietary Advice for Children With Atopic Dermatitis: A Consensus Study.

The use of blood specific IgE or skin prick tests (SPT) to guide dietary exclusions for disease control in children with atopic dermatitis (AD) is controversial. We undertook a consensus exercise on how to interpret SPT results and dietary history for cow's milk, hen's egg, wheat, and soy in children < 2 years old with AD. Fourteen clinicians from general practice, pediatrics, pediatric dermatology, pediatric allergy, and pediatric dietetics from UK and Ireland took part in an online modified Delphi study. Over three rounds, participants gave their anonymous opinions and received individualized and group feedback, based on the premise that all children had SPTs. The findings were discussed in an online workshop. Of 18 symptoms, 12 were identified as relevant to immediate and 7 to delayed allergy. Regarding SPTs, there was consensus over which allergens to use for wheat and soy but not cow's milk or hen's egg; for all study foods, wheal size was determined as 0-1 mm negative, ≥ 5 mm sensitized, but between 2 and 4 mm, categorization varied by food. During the final workshop, consensus was reached on dietary advice for nine combinations of SPT results and dietary history. We attained consensus on how SPTs and dietary history for four common food allergens should be interpreted in young children under 2 years of age with AD. These pragmatic recommendations may support clinician education, consistency of decision-making, and future research.

Inflammatory Diseases in Paediatric Dermatology

Inflammatory Diseases in Paediatric Dermatology

Dupilumab Efficacy in Children with Palmoplantar Eczema

Background. Atopic dermatitis (AD) is a chronic inflammatory skin disease with such clinical manifestations as eczematous lesions and itching. One of its clinical forms is palmoplantar eczema. It is urgent and unresolved issue in pediatric dermatology as this disease significantly affect the patients’ quality of life due to involvement of functionally significant areas, symptoms severity, difficult induction of remission. Clinical case description. This article presents case series of patients with AD involving palms and soles who have shown positive results to the treatment with genetically engineered biologic drug — dupilumab. Conclusion. Palmoplantar eczema, as one of the forms of AD, hardly responds to topical therapy in clinical practice of dermatologist. Moreover, systemic treatment is not only limited in pediatrics, but also is not effective enough. Prescription of the genetically engineered biologic drug, dupilumab, seems to be one of the effective methods for management of this disease in these patients.

Telehealth in a Pediatric Patient with Nevoid Basal Cell Carcinoma Syndrome

During COVID19, telemedicine was adapted by many practices to serve patients with a variety of health conditions including those affected by cancer. Here we report an 11-year-old patient who went to her dentist where a routine panorama x-ray showed multiple jaw keratocysts. Because jaw keratocysts can be identified with a hereditary predisposition to basal cell cancer and other tumors, she was referred for genetics. She was seen in 2021 where telehealth was the primary modality for visits. The hospital’s secure video platform was used to gather medical history and counsel the mother on genetic testing for nevoid basal cell carcinoma syndrome(NBCCS). While in the past genetic testing was often thousands of dollars, the genetic testing company offered a patient pay option of $250. Two days later, the patient presented to the cancer center to have her blood drawn and a fifteen-minute physical exam was performed which identified macrocephaly, and palmar pits. Of note the mother asked about numerous pinpoint lesions around the patient’s ocular region. Genetic testing was positive for a pathogenic variant in PTCH1 c.454_455del. The patient was referred to pediatric dermatology where over fifty basal cells were diagnosed and started treatment with imiquimod and efudex. She also was referred to cardiology and gynecology given reports of individuals with cardiac fibromas and gynecologic ovarian tumors. The patient is now 14 going into her freshman year of high school and is doing well. This case highlights how telehealth offers a holistic approach to patient care.

Emergency consultations to pediatric dermatology at a large children’s hospital in Saudi Arabia

Dermatology is commonly considered a non-urgent and outpatient-centered specialty. Limited studies have evaluated skin diseases presenting to the pediatric emergency department. This study aims to characterize the most common pediatric dermatological conditions prompting an emergency department visit between August 2018 and August 2023 in a large children’s hospital in Riyadh, Saudi Arabia. A total of 183 patients were included. The majority of patients were 2 years old and younger [87 (47.5%)]. Gender was almost equally distributed, with 51.4% of the population being females. Infectious and inflammatory disorders were the most commonly encountered conditions, accounting for 35.5% and 33.9%, respectively. The top three diagnoses were atopic dermatitis (12.02%), impetigo (6.56%), and infantile hemangioma (6.01%). Understanding the variety of skin disorders presented to pediatric emergency departments can positively enhance patient care in dermatology clinics and promote preventative public health initiatives, thus minimizing emergency department visits.

Combined Pediatric Rheumatology/Dermatology Clinics: Benefits and Challenges.

Integrated care models, like combined rheumatology/dermatology clinics (RDCs), facilitate efficient coordination between specialists and provide comprehensive care. Given the limited literature on pediatric RDC logistics, outcomes, benefits and, challenges, we comprehensively characterized our patient cohort at the UCSF Benioff Children's Hospital RDC and surveyed pediatric dermatologists participating in RDCs. We retrospectively reviewed 71 patients new to the UCSF Pediatric RDC between September 2017 and September 2023. A survey was distributed in 2024 to 17 dermatologists in North America, each representing a unique pediatric RDC. 69% of patients (49/71) were female. Seventeen (24%) presented without a known diagnosis; the first RDC visit established a diagnosis for 7 of them (41%). Of patients with a previously established diagnosis, initial RDC evaluation confirmed it in 52 (96%) and revised it for 2 (4%). The most encountered diagnoses were linear morphea (33%), lupus (23%), and psoriasis (13%). New systemic therapy was prescribed for 23% of patients, and additional work-up was recommended via skin biopsy (8%) and imaging (28%). Survey results revealed all pediatric RDCs include trainees, but only 59% (10/17) receive administrative support. All agreed that RDCs are valuable for patient care and most (15/17, 88%) felt that the RDC was a valuable use of their time. Pediatric RDCs are valuable for consensus diagnosis, streamlined evaluation, and management of complex patients. Though clinical and administrative support for RDCs is generally poor, RDCs are valuable to patients, a good use of time for clinicians, and offer educational opportunities for team members.

Pediatric Dermatology eConsultation in Academic Centers: A Collaborative Model for Optimized Outpatient Care.

The demand for pediatric dermatology services in the U.S. is high, especially at large academic healthcare centers. eConsultation programs provide a solution to poor in-person access by offering diagnostic and management support to primary care providers (PCPs). To determine the real-world utility of eConsultation in pediatric dermatology within a closed system at a major academic center, we assessed the outcomes, diagnostic and management concordance, and predictors of eConsult completion of an asynchronous provider-to-provider pediatric dermatology eConsult program. Retrospective cohort study of 900 consecutive outpatient pediatric dermatology eConsult referrals from PCPs at a tertiary academic center from 2017 to 2021. Of 900 eConsult referrals, 621 (69%) were completed without the need for in-person dermatology follow-up. 46 (5%) were completed but required follow-up. 233 eConsult referrals (26%) were declined, primarily due to medical complexity. Thirty referrals (3%) were declined because of inadequate clinical photos. The PCP communicated eConsult recommendations to the patient/family on an average of 1.6 days (SD 3) after receiving the completed eConsult. eConsults for adolescents were less likely to be completed compared to infants (p = 0.03). Diagnostic and management concordance between PCP and dermatologist was 78% and 67%, respectively. Provider-to-provider eConsultation provides rapid speciality guidance to PCPs managing low-complexity skin conditions in pediatric outpatients. The lower rate of management plan concordance compared to diagnostic concordance suggests that eConsultation improves outpatient skin management by PCPs.

Mental health among parents and their children with eczema in Hong Kong.

This cross-sectional survey research investigated mental health symptoms and quality of life among Chinese parents and their children with eczema at a paediatric dermatology clinic in Hong Kong from November 2018 to October 2020. Health-related quality of life, eczema severity, and mental health among children with eczema, as well as their parents' mental health, were studied using the Children's Dermatology Life Quality Index (CDLQI), Infants' Dermatitis Quality of Life Index (IDQOL), Nottingham Eczema Severity Score (NESS), Patient-Oriented Eczema Measure (POEM), and the Chinese version of the 21-item Depression, Anxiety, and Stress Scales (DASS-21). In total, 432 children and 380 parents were recruited. Eczema severity (NESS and POEM) and health-related quality of life (CDLQI) were significantly positively associated with parental and child depression, anxiety, and stress levels according to the DASS-21, regardless of sex (children: r=0.28- 0.72, P<0.001 to 0.007; parents: r=0.20-0.52, P<0.001 to 0.034). Maternal depression was marginally positively associated with increased anxiety in boys with eczema (r=0.311; P=0.045). Younger parents had higher risk of developing more anxiety and stress compared with the older parents (adjusted odds ratio [aOR]=-0.342, P=0.014 and aOR=-0.395, P=0.019, respectively). Depression level of parents with primary to secondary education was 58% higher than their counterparts with post-secondary education or above (aOR=-1.579; P=0.007). Depression, anxiety, and stress among children with eczema and their parents were associated with eczema severity and impaired quality of life in those children. These findings regarding impaired mental health in children with eczema and their parents highlight the need to include mental well-being and psychosocial outcomes in future studies and clinical practice.

Updates and Pearls from the Society of Pediatric Dermatology Meeting

The 49th annual Society of Pediatric Dermatology (SPD) meeting was a tremendous success, attracting over 650 attendees, the highest number ever recorded. The 3-day conference featured a wide range of new developments and tips and tricks from experts in the field.

A Consensus on Staphylococcus aureus Exacerbated Atopic Dermatitis and the Need for a Novel Treatment.

The skin microbiome is essential for skin barrier function because it inhibits pathogen colonization, and decreased microbiome diversity correlates with increased Staphylococcus aureus (S. aureus) burden and atopic dermatitis (AD) severity. Managing S. aureuss-driven AD in clinical practice remains problematic due to complications such as AD exacerbation, impetigo, abscesses, and invasive infections. This project used a modified Delphi process comprising face-to-face discussions followed by a blinded vote to define 5 final consensus statements. A panel of 6 pediatric dermatologists developed a consensus on S. aureus-driven AD exacerbation, challenges in current treatments for AD with secondary bacterial infections, and new developments to improve patient care and outcomes. The panel's 5 consensus statements provide recommendations for dermatologists, pediatricians, and healthcare providers treating patients with secondary infected AD. These recommendations underscore the importance of recognizing and managing S. aureus skin infection in AD clinical practice and promoting antibiotic stewardship to mitigate resistance. The panel defined a significant unmet need for a single topical AD therapy effective against all symptoms, including pruritus, S. aureus-driven AD exacerbation, infection, and inflammation, across AD severity levels. J Drugs Dermatol. 2024;23(10):825-832. doi:10.36849/JDD.8240.

50671 Adverse Events of JAK-Inhibitors in Pediatric Dermatology: A Preliminary Analysis

50671 Adverse Events of JAK-Inhibitors in Pediatric Dermatology: A Preliminary Analysis

49940 Racial differences in wRVU compensation for pediatric dermatology visits may be driven by laser procedures

49940 Racial differences in wRVU compensation for pediatric dermatology visits may be driven by laser procedures

Society for Pediatric Dermatology 49th Annual Meeting Poster Abstracts Presented in Toronto, Canada, July 11–14, 2024

Society for Pediatric Dermatology 49th Annual Meeting Poster Abstracts Presented in Toronto, Canada, July 11–14, 2024

53983 Pediatric Dermatology Made Simple: Physician Assessment of Informative Guides on Common Dermatologic Conditions for Spanish-Speaking Patients

53983 Pediatric Dermatology Made Simple: Physician Assessment of Informative Guides on Common Dermatologic Conditions for Spanish-Speaking Patients

50253 Pediatric Dermatology e-Consultations: Process, Scope, and Effectiveness

50253 Pediatric Dermatology e-Consultations: Process, Scope, and Effectiveness

Skin health of Aboriginal children living in urban communities.

Skin concerns are frequent among urban-living Aboriginal children, yet specialist dermatology consultations are limited with studies highlighting the need for improved cultural security. Through newly established paediatric dermatology clinics at two urban Aboriginal Community Controlled Health Organisations (ACCHOs), we aimed to describe clinic and patient data, including disease frequencies and associations, to inform dermatology service provision and advocacy. A prospective cohort study of Aboriginal children and young people (CYP, 0-18 years) attending Aboriginal Health Practitioner (AHP) co-ordinated paediatric dermatology clinics at two urban ACCHOs. Data were collected from 32 clinics over 19 months, with 335 episodes of care and a mean attendance rate of 74%. From 78 new patients, 72 (92%) were recruited into the study, only one of whom had previously received dermatologist assessment. Eczema, tinea or acne accounted for 47% (34/72) of referrals, and 60% of patients received their first appointment within 4 weeks of referral. In 47/72 (65%) consultations, the GP referral and dermatologist diagnosis concurred. The most frequent diagnoses (primary or secondary) at first consultation were atopic dermatitis (26%, 19/72), dermatophyte infections (25%, 18/72), acne (21%, 15/72), bacterial skin infections (18%, 13/72) and post-inflammatory dyspigmentation (18%, 13/72). Three categories of the 2022 Australasian College of Dermatologists curriculum (infections, eczema/dermatitis, pigmentary disorders) accounted for 59% of all diagnoses. This study highlights the specialist dermatology needs of urban-living Aboriginal CYP. ACCHO-embedded dermatology clinics co-ordinated by AHPs demonstrated benefits for Aboriginal CYP in accessing care. Opportunities to embed dermatology practice within ACCHOs should be prioritised.

The reporting of social determinants of health in pediatric dermatology clinical trials: a systematic review.

Despite the acknowledgment of the importance of social determinants of health (SDOH) on clinical outcomes, few clinical trials provide information about SDOH. Including these markers in pediatric dermatologic clinical trials may lead to improved care and novel observations about the disease. Using a systematic review, assess the use of SDOH in pediatric dermatology clinical trials. CINAHL Plus, Cochrane: CENTRAL, Embase, PubMed, and Scopus were searched. English language randomized controlled trials about pediatric dermatology diseases published from January 2011 to May 2022 were included. Two authors independently screened all records using Covidence at 2 levels. Two authors independently collected data using Covidence and Microsoft Excel and assessed study quality. A protocol was registered at Open Science Framework: https://doi.org/10.17605/OSF.IO/B93VY. A total of 6463 records were retrieved and 4298 were screened at title/abstract. Next, 1738 records were screened at full text and 1085 were included. Of these, 119 reported an SDOH factor for a pediatric dermatology disease. Income or socioeconomic status was the factor most reported followed by social support, location, and health insurance. Most of the studies were conducted outside of the United States. There are a limited number of dermatology clinical trials that include a pediatric population. Despite including over 1000 pediatric dermatology clinical trials, only 119 used SDOH. Pediatric dermatology researchers must prioritize including and reporting additional SDOH in clinical trials if the goal is to impact and improve clinical care and innovate for diverse populations of patients.