Everything that is New and Exciting in Pediatric Dermatology

Lisa Swanson, MD, the only practicing pediatric dermatologist in the state of Idaho, shared pearls of wisdom gained with full audience of dermatology professionals at SDPA’s summer conference in Austin, Texas. Her humor was evident as she initiated the lecture with, “Are you guys ready to be slapped in the face with pediatric dermatology?” “Early baby life matters” in the development of atopic dermatitis (AD). Recent literature has found antibiotic exposure in the first month of life decreases risk of the development of AD.  When pregnant mothers take probiotics before and after the birth of their baby and breastfeed, their babies have a reduced risk of development of atopic dermatitis. Dr. Swanson reports food allergies in AD patients may be a result of AD causing an impaired barrier which allows food proteins to abnormally enter the body and stimulate allergy. Food avoidance is not recommended and kids with severe eczema, who have higher rates of food allergies, would benefit from referral to an allergist.

COVERAGE: SDPA Annual Summer Dermatology Conference, June 16-19, 2022, Austin, Texas

Parents often desire “natural” treatments for the management of eczema in their children and unfortunately, there are not many products which have been well studied and found helpful.  Olive oil should be avoided, while sunflower seed oil and coconut oil may be slightly helpful. Additionally, topical CBD has shown some positive results and Dr. Swanson recommends this in the form of the product CQuellTM.   Treatment options for the AD patient were discussed including the “oldie but goodie” Derma-smootheTM oil, which Dr. Swanson touts as a great option for babies with cradle cap. Those parents who are concerned about the ingredient of peanut oil should be reassured that it contains the non-allergy component of peanut oil.  The ARON regimen out of the UK is another topical treatment option which Dr. Swanson has found to be very successful in the treatment of AD in her pediatric patients. This can be applied 5 times a day for flares of eczema in these patients and tapered with improvement. Lastly, Dr. Swanson notes dupilumab as a “life changing” medication for patients, their families and their providers. It is now approved to the age of 6 months with no loading dose needed in children under the age of 6 years.

Psoriasis in the pediatric patient is increasing and Dr. Swanson reports the importance of identifying this condition to help prevent the “psoriatic march” toward increased rates of obesity, substance abuse and arthritis. She reviewed the 2017 JAMA DERM article for screening guidelines to use when evaluating the pediatric patient. Dr. Swanson reviewed use of ustekinumab for pediatric patients with severe psoriasis. As there is an increased risk of the development of IBD with this treatment, she recommended screening these patients including use of calprotectin levels in these patients. Next, Dr. Swanson discussed toddler acne which presents in babies 6-18 months and may scar and should be treated.  She reports she uses clindamycin wipes BID as first line for the treatment of these patients. Additional discussion included diaper rash, nevi and birthmarks.

Byline: Sarah B.W. Patton, PA-C