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Background/Objectives Methods Results Conclusion Atopic dermatitis (AD) is a common chronic skin disease in the pediatric population; however, rates of admissions for flares in patients established with dermatology compared to those that are not established have not been fully assessed in prior studies.We reviewed electronic medical records of patients hospitalized (billing codes 99221–99223, 99217) with diagnoses encompassing AD, eczema, and dermatitis (ICD‐10 codes L20.8‐L20.9, L30.8‐L30.9) between January 1, 2011, and December 31, 2021, at University Hospitals (UH) in Cleveland, Ohio. Patients were considered established with dermatology if they had been seen by a dermatology provider within 6 months prior to admission. Statistical analysis was performed using chi‐square goodness of fit.A total of 95 patient encounters met criteria for inclusion. Fifteen (15.8%) patients were established with dermatology at the time of admission and 80 (84.2%) were not. The chi‐square value (x2 = 44.74) was greater than the critical value of 10.828 at one degree of freedom (p < .001). There were 8 patients who had more than one admission for atopic dermatitis flares; 2 of these patients were established with dermatology prior to their first admission, and 4 were established at the time of the second admission.The majority of patients admitted with AD flare were not established with dermatology. Many of these patients lived in a low socioeconomic area and missed follow‐up appointments. Increasing access to dermatologic care for patients with atopic dermatitis, especially in lower‐income areas, could aid in decreasing atopic dermatitis‐related hospitalizations. [ABSTRACT FROM AUTHOR]

Our study aims to synthesize existing evidence of dupilumab for alopecia areata (AA) in pediatric patients with atopic dermatitis (AD). We searched MEDLINE and Embase on March 1, 2024, using keywords related to AD, AA, dupilumab, and pediatric patient populations per PRISMA‐ScR guidelines. A mean SALT score reduction of 42.6 following dupilumab treatment (p < .01) over an average of 3.21 months, and a mean reduction of Investigator Global Assessment (IGA) levels of 2.14 units (p < .01) demonstrates the efficacy of dupilumab in pediatric AA when there is concurrent AD. Our findings in combination with dupilumab's favorable safety profile in pediatric AD makes it an appealing option for AA treatment, however, a greater understanding of the underlying mechanisms, optimal pediatric patient selection criteria, long‐term efficacy, and safety profile of dupilumab in this context is warranted. [ABSTRACT FROM AUTHOR]

Objective: Controlling molluscum contagiosum (MC) infections is critical in atopic dermatitis (AD) management. This post hoc analysis assessed the efficacy and safety of berdazimer gel, 10.3% (topical, antiviral, nitric oxide–releasing medication) versus vehicle in MC patients with or without AD. Methods: Three Phase 3, multicenter, randomized, double‐blind, vehicle‐controlled, parallel‐group trials (B‐SIMPLE[berdazimer sodium in molluscum patients with lesions]1, −2, −4) enrolled patients 6 months and older with 3–70 mollusca. Berdazimer or vehicle was applied once daily to all MC lesions for 12 weeks. Data from three Phase 3 studies were integrated for subgroup efficacy and safety assessments using several weighted meta‐analysis approaches. Patients with concurrent AD or a history of AD/eczema were categorized as AD+ subgroup (AD− when absent). Primary efficacy endpoint: complete lesion clearance at Week 12. Safety endpoints included adverse events (AEs) through Week 24 and local skin reactions through Week 12. Results: Of 1598 enrolled patients, 209 (13.1%) were AD+. Baseline mean lesion counts were greater in AD+ (26.4) than AD− (19.3). Complete clearance rates were higher at Week 12 for berdazimer compared with vehicle in AD+ (n = 209; 35.0% vs. 27.4%; odds ratio [OR], 1.3; 95% CI, 0.7–2.5) and AD− (n = 1389; 29.1% vs. 18.9%; OR 1.8; 95% CI 1.4–2.4) subgroups. AEs in AD+ were application‐site pain (21.6% with berdazimer vs. 11.9% with vehicle), dermatitis (12.8% vs. 2.4%), and erythema (9.6% vs. 7.1%). Conclusions: Berdazimer gel showed favorable efficacy regardless of AD status. Berdazimer‐induced erythema may be indistinguishable from AD symptoms or with inflammatory response upon resolution of molluscum. [ABSTRACT FROM AUTHOR]

Many baby cleansers are promoted as hypoallergic products; however, these claims are not typically validated. This study assessed the 50 best‐selling baby cleansers from online retailer Amazon for potential allergens. We found that the presence of most marketing claims, including "hypoallergenic" or "allergy‐tested," did not correlate with the number of potential allergens in a cleanser. Furthermore, the total number of marketing claims of a cleanser was positively correlated with the number of allergens, highlighting the discordance between marketing claims and allergen content in baby cleansers. [ABSTRACT FROM AUTHOR]

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disorder that affects children worldwide, with potential associations to metabolic syndrome (MetS) and non‐alcoholic fatty liver disease (NAFLD). Limited research exists on the interplay between AD, MetS, and NAFLD in the pediatric population. This study aimed to investigate the prevalence and potential relationships among AD, MetS, and NAFLD in children. Methods: A case–control study design was employed, recruiting 50 children with AD (median age: 9.5 years) and 50 age‐ and sex‐matched healthy controls (median age: 11.5 years, p =.051). Data on demographic characteristics, clinical features, disease severity, treatment history, anthropometric measurements, and laboratory evaluations were collected. MetS and NAFLD were diagnosed based on established criteria. Results: The prevalence of MetS was significantly higher in children with AD compared with controls (24% vs. 2%, p =.002). Significant differences for systolic blood pressure (p <.001), diastolic blood pressure (p =.012), and waist circumference (p =.040) were observed between AD patients and controls. Children with AD had higher triglyceride levels (p =.005). NAFLD was exclusively seen in moderate to severe AD cases (6% vs. 0%, p =.242). AD severity showed associations with increased body mass index (p =.020). Conclusion: This study highlights the increased prevalence of MetS and the potential association with NAFLD in children with AD. The findings suggest that AD may contribute to the development of metabolic abnormalities at an early age. Further research is needed to elucidate the underlying mechanisms and explore preventive strategies for these interconnected conditions. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions At a single‐center pediatric hospital, the neurokinin‐1 receptor antagonist aprepitant was used to treat refractory pruritus in epidermolysis bullosa (EB) and atopic dermatitis (AD).Thirty‐seven patients were included (24 EB patients, 13 AD patients), ages 10 months to 37 years.58% (14/24) of patients with EB and 85% (11/13) of patients with AD reported aprepitant was effective in decreasing their pruritus, with age‐related differences in efficacy observed in EB patients, and access to the medication by insurance denial or availability of the drug as a barrier to use.Aprepitant shows promise in controlling refractory pruritus in pediatric EB and AD patients and deserves further study. [ABSTRACT FROM AUTHOR]

Background: Considering consumer trends toward the use of "clean" personal care products and increasing recognition of childhood allergic contact dermatitis, we sought to characterize the allergen profile of such children's products. Methods: Ingredients of baby washes/shampoos, bubble baths, and moisturizers identified using the "Clean Baby" filter on Target®'s online marketplace were analyzed for relevant pediatric contact allergens. Results: Product compositions declared fragrance in 82% of products, Compositae in 46%, cocamidopropyl betaine in 45%, glucosides in 37%, propylene glycol in 12%, lanolin in 1%, and no allergens in 9%—methylisothiazolinone and formaldehyde were not found. Conclusion: Children are greatly impacted by atopic dermatitis and skin barrier dysfunction, which underscores a need for greater public awareness of sensitizing and irritating ingredients, particularly regarding pediatric personal care products. [ABSTRACT FROM AUTHOR]

Background/Objectives: Pediatric dermatitis and nonaccidental trauma (NAT) may have overlapping cutaneous presentations, posing a risk of misdiagnosis and subsequent emotional distress and further harm. Through a systematic literature review, we reviewed pediatric (<18 years old) patients investigated for both dermatitis and NAT. Methods: EMBASE and MEDLINE databases were searched. English publications with original data involving pediatric patients investigated for both dermatitis and NAT were included. Nonhuman studies and incomplete articles/conference abstracts were excluded. Data extracted included the first author, year of publication, study design, participant count, sex of the population, age of the population, cutaneous presentation, timing of presentation, Child Protective Services involvement, and case relation to dermatitis and NAT. Results: This review included 21 case reports or series encompassing 29 patients. Among 26 patients initially investigated as NAT (26.9% involving Child Protective Services), final diagnoses included irritant contact dermatitis (53.8%), phytophotodermatitis (30.8%), allergic contact dermatitis (7.7%), perianal infectious dermatitis (3.8%), and atopic dermatitis (3.8%). Three patients initially diagnosed with nontraumatic dermatitis were later found to be victims of physical (2/3; 66.7%) or sexual abuse (1/3; 33.3%). Conclusions: Effective history‐taking and physical examinations should encompass a history of laxative use, contact with furocoumarin‐containing plants/fruit, parallel family/peer cutaneous presentations, caregiver involvement, financial burden, patient discomfort, birthmark assessment, and lesions aligning with diaper borders or toilet seats. Limitations of this review include potential underreporting and the inclusion of low‐quality study designs and evidence. [ABSTRACT FROM AUTHOR]

Background/Objectives: Disease improvement for difficult‐to‐control pediatric atopic dermatitis may be more challenging to achieve when directed by single specialties due to disjointed and conflicting dialogue with patients. Methods: The Multidisciplinary Atopic Dermatitis Program (MADP) was developed through collaborations with the Rady Children's Hospital and UC San Diego Health Divisions of Dermatology, Allergy & Immunology and Clinical Pharmacy, to create team‐based evaluation and management of children and adolescents with atopic dermatitis (AD). The MADP allows concurrent, comprehensive evaluations by multiple specialists to develop treatment plans. The program includes extensive patient education to support shared decision making, incorporating patient and family's perspectives along with those of clinical experts into their care. Objective severity measures and patient reported outcome data were collected, along with assessment of patient and family satisfaction with the MADP. Results: Data showed significant improvement in AD severity as assessed by providers, patients and families by the first follow‐up visit. BSA mean percentage decreased by up to 56% by the 7th visit, and pruritus (NRS), CLDQI and POEM mean scores decreased by more than 4 points, 12 points, and over 11 points, respectively. After management was initiated in the MADP, 72.73% of patients achieved an EASI 50 and 47.73% achieved an EASI 75 from a baseline mean of 21.7. Patients who continued in clinic beyond the second visit showed further clinically significant decreases in disease measures. Conclusions: The multidisciplinary approach shows success in the treatment of difficult‐to‐control AD patients with improvements in clinician and patient reported outcome measures. [ABSTRACT FROM AUTHOR]

Background and Objective: Current regulatory labeling recommends avoiding live vaccine use in dupilumab‐treated patients. Clinical data are not available to support more specific guidance for live or live attenuated vaccines administration in dupilumab‐treated patients. Methods: Children (6 months–5 years old) with moderate‐to‐severe atopic dermatitis (AD) enrolled in a phase 2/3 clinical trial of dupilumab (LIBERTY AD PRESCHOOL Part A/B; NCT03346434) and subsequently participated in the LIBERTY AD PED‐OLE (NCT02612454). During these studies, protocol deviations occurred in nine children who received measles, mumps, rubella (MMR) vaccine with or without varicella vaccine; five with a ≤12‐week gap between dupilumab administration and vaccination and four with a >12‐week gap after discontinuing dupilumab. Results: Nine children (1 female; 8 male) had severe AD at baseline (8–56 months old). Of the nine children, five had a ≤12‐week gap ranged 1–7 weeks between dupilumab administration and vaccination who received MMR vaccine (n = 2) or MMR and varicella vaccines (n = 3); among these, one resumed dupilumab treatment as early as 2 days and four resumed treatment 18–43 days after vaccination. No treatment‐emergent adverse events, including serious adverse events and infections, were reported within the 4‐week post‐vaccination period in any children. Conclusions: In this case series of dupilumab‐treated children with severe AD who received MMR vaccine with or without varicella vaccine, no adverse effects (including vaccine‐related infection) were reported within 4 weeks after vaccination. Further studies are warranted to evaluate the safety, tolerability, and immune response to live attenuated vaccines in dupilumab‐treated patients. [ABSTRACT FROM AUTHOR]

Background: Concerns about the use of topical corticosteroids (TCS) in pediatric eczematous dermatitis management often hinder effective treatment. Limited data exist regarding the prevalence of these concerns and the effectiveness of interventions. This study aimed to assess the prevalence of TCS concerns among caregivers and determine the effectiveness of video education in mitigating these concerns. Methods: A single‐center prospective study was conducted from 2022 to 2023, involving caregivers of children under 18 years with eczematous dermatitis. Baseline and post‐intervention questionnaires were administered after a 4‐week period. Caregivers received video education on TCS use, and the TOPICOP score was evaluated before and after viewing the video. Results: The study included 150 caregivers, 85.3% female and 74% had a child with atopic dermatitis. The prevalence of TCS concerns among Thai caregivers was 62%. Following video education, the prevalence of TCS concerns significantly decreased to 10.7%. Mean belief score decreased from 43.81 ± 13.45 to 31.85 ± 16.56, mean worry score decreased from 56.22 ± 18.27 to 40.41 ± 18.55 and mean total TOPICOP score decreased from 50.02 ± 12.65 to 36.13 ± 13.52 (p‐value <.001). The intervention also resulted in reduced disease exacerbations, duration of the rash, and duration of TCS use. The optimal TOPICOP cut‐off score to predict TCS concerns was identified as 43.06. Conclusion: Video education effectively alleviated TCS concerns among caregivers, addressing beliefs, worries, disease exacerbations, and side effects. Integration of this intervention into the management of pediatric eczematous dermatitis can yield optimal outcomes. [ABSTRACT FROM AUTHOR]

Cutaneous warts are an exceedingly common cutaneous viral infection for which existing treatment options are often painful, expensive, and only marginally effective. Extensive warts may occur in the setting of primary immunodeficiencies, wherein they can co‐occur with other diseases of immune dysfunction, such as atopic dermatitis (AD). Dupilumab, an IL‐4 receptor α (IL‐4Rα)‐blocking monoclonal antibody, is a biologic agent recently approved for the treatment of moderate‐to‐severe eczema. Here, we report a case of a young girl with both severe AD and diffuse filiform warts, which resolved shortly after initiating treatment for AD with dupilumab. [ABSTRACT FROM AUTHOR]

Phototherapy is broadly utilized for treatment of inflammatory skin conditions affecting pediatric patients. However, there are no specific guidelines or recommendations for implementing phototherapy in pediatric populations leading to variability in treatment procedures. Here, we present findings from a cross‐sectional, survey‐based study investigating the implementation of phototherapy in pediatric patients across the United States. A total of 39 sites from 19 different states identified via the National Psoriasis Foundation (NPF) Health Care Provider Directory responded. Common practices included a signed informed consent prior to performing phototherapy (86.4%, n = 32), no minimum age requirement for pediatric patients (91.8%, n = 34), the use of Fitzpatrick skin type to determine dosing protocol (100%, n = 37), and allowing parents to accompany their children into the lightbox (65%, n = 20). Our results provide insights into current common practices and themes for further study. [ABSTRACT FROM AUTHOR]

Background/Objectives: Itch is one of the hallmarks of atopic dermatitis (AD), which has a significant impact on the quality of life of pediatric patients with AD and their caregivers. We aimed to conduct a systematic review and meta‐analysis to evaluate the antipruritic effects of systemic AD treatments in pediatric patients with AD. Methods: PubMed, EMBASE, Cochrane, and Web of Science databases were searched, including studies providing original data on the effects of systemic treatment on pruritus in pediatric patients (<18 years) with AD. Placebo‐controlled trials reporting a Peak Pruritus Numerical Rating Scale 4 (PP‐NRS4) response were included in a meta‐analysis. Results: A total of 30 studies were included, with most evidence available for dupilumab. Overall, marked improvements of pruritus (50% or greater reduction in pruritus outcome measurements) were found for treatment with cyclosporin A (2–16 years), dupilumab (6 months–17 years), abrocitinib, and upadacitinib (both 12 and 17 years). Nemolizumab (12–17 years) may be promising in reducing pruritus in pediatric patients; however, data are limited. Only five randomized controlled trials could be included in our meta‐analysis, in which dupilumab, abrocitinib, and upadacitinib showed a significantly higher probability of achieving a PP‐NRS4 response compared with placebo. Our study was limited by a lack of homogeneity of included studies. Conclusions: Cyclosporin A, dupilumab, abrocitinib, and upadacitinib are all effective in decreasing pruritus and, therefore, in improving the quality of life in children with AD. As more systemic treatments for AD become available, it will be imperative to incorporate patient‐oriented treatment goals such as reduction of pruritus into therapeutic decision‐making. [ABSTRACT FROM AUTHOR]

Background: Dupilumab is approved for moderate‐severe atopic dermatitis (AD) in patients aged ≥6 months by the US Food and Drug Administration and Health Canada; however, there are little real‐world data because providers have limited practical experience with this recently approved therapy. Objectives: To describe the real‐world effectiveness and safety in patients aged <12 years with moderate‐severe AD currently receiving or previously having received dupilumab. Methods: A multicenter retrospective study was conducted at six Canadian sites. Cases were divided into Group 1 ≤2 years old, Group 2 >2 to <6 years old, and Group 3 ≥6 to <12 years old. Medical history and details of dupilumab treatment were collected. The primary outcome was to measure the improvement in eczema area and severity index. Secondary outcomes examined included the children's dermatology life quality index/infant's dermatitis quality of life, peak pruritus numerical rating scale, and delay to dupilumab access for patients who were considered off‐label for dupilumab due to their age. Results: Sixty three pediatric patients (37 males) with moderate‐to‐severe AD were included; the mean age was 6.4 years old (range: 2–11) when dupilumab treatment was started. Overall, 75% (36/48) achieved EASI‐75% and 71% (34/48) achieved EASI‐90. EASI‐75 and EASI‐90 were achieved in 90% (17/19) and 73% (12/19) in patients <6 years old, and 76% (22/29) and 59% (17/29) in patients >6 years old, respectively. No serious adverse events were reported. Conclusions: Dupilumab is safe and effective for patients under the age of 12. However, even for experienced providers, access to the medication was challenging. [ABSTRACT FROM AUTHOR]

The nummular phenotype of atopic dermatitis is clinically characterized by pruritic, coin‐shaped plaques that are frequently recalcitrant to treatment. In this study, a retrospective chart review was conducted to evaluate the effectiveness and safety of dupilumab in children with nummular lesions of dermatitis. Twelve out of 14 patients demonstrated significant clinical improvement at a median time of 2.5 months (interquartile range, 1–4) after dupilumab initiation. A single case of paradoxical psoriasiform eruption was the only side effect reported in our cohort. [ABSTRACT FROM AUTHOR]

Trichothiodystrophy (TTD) is a rare congenital disorder caused by genetic mutations, leading to hair and skin abnormalities. We report successful treatment of a TTD case using dupilumab, a monoclonal antibody targeting IL‐4Rα. The patient, a 7‐year‐old boy, exhibited significant improvement in skin and hair conditions, suggesting the potential of dupilumab as a therapeutic option for TTD. Further research is needed to elucidate its mechanism and efficacy in TTD treatment. [ABSTRACT FROM AUTHOR]

Purpose: Environmental factors such as bathing may play a role in atopic dermatitis (AD) development. This analysis utilized data from the Community Assessment of Skin Care, Allergies, and Eczema (CASCADE) Trial (NCT03409367), a randomized controlled trial of emollient therapy for AD prevention in the general population, to estimate bathing frequency and associated factors within the first 9 weeks of life. Methods: Data were collected from 909 parent/newborn dyads recruited from 25 pediatric and family medicine clinics from the Meta‐network Learning and Research Center (Meta‐LARC) practice‐based research network (PBRN) consortium in Oregon, North Carolina, Colorado, and Wisconsin for the CASCADE trial. Ordinal logistic regression was used to conduct a cross‐sectional analysis of the association between bathing frequency (measured in baths per week) and demographic, medical, and lifestyle information about the infant, their family, and their household. Variables were selected using a backwards‐stepwise method and estimates from the reduced model are reported in the text. Results: Moisturizer use (OR = 2.03, 95% CI: 1.54–2.68), Hispanic or Latino ethnicity (OR = 1.97, 95% CI: 1.42–2.72), a parental education level lower than a 4‐year college degree (OR = 2.48, 95% CI: 1.70–3.62), living in North Carolina or Wisconsin (compared to Oregon; OR = 2.12 and 1.47, 95% CI: 1.53–2.93 and 1.04–2.08, respectively), and increasing child age (in days; OR = 1.02, 95% CI: 1.01–1.02) were significantly associated with more frequent bathing, while pet ownership (OR = 0.67, 95% CI: 0.52–0.87) was significantly associated with less frequent bathing. Conclusions: We found significant ethnic, geographic, and socioeconomic variation in bathing frequency before 9 weeks of age that may be of relevance to AD prevention studies. [ABSTRACT FROM AUTHOR]

Background: Race and socioeconomic status are thought to influence the severity of atopic dermatitis (AD), but findings differ between countries and measures used. The role of social determinants of health versus biologic factors in causing these differences is poorly understood. Objective: We hypothesized that spatially‐derived factors correlate with AD severity and patient‐reported outcome (PRO) in a pediatric cohort from Chicago, USA. Methods: Children with AD and caregivers were enrolled from February 2018 to April 2019 in this single‐site cross‐sectional study. Severity was self‐ and physician‐assessed using validated measures. Patient addresses were geocoded and linked to census tract IDs. Deprivation index (DI) was calculated using variables of the 2018 American Community Survey. Results: Among 216 children aged 5–17 years old, 111 (51.4%) lived in urban, 104 (48.1%) suburban, and one (0.5%) in rural areas. Race was self‐classified as White in 31.0%, Black 24.5%, other or mixed 25.0%, and Asian 19.4%; 24.5% were Hispanic. Median DI was 0.32 (range 0.03–0.72), with higher scores indicating more deprivation. DI correlated with insurance type, family income, ethnicity, race, and parental education, and weakly with selected PRO T‐scores. However, no correlations between any AD severity score and DI, race, ethnicity, income, education, or insurance type were found. Conclusion: The impact of socioeconomic factors on AD severity in our study population was less pronounced than expected. This could be because of regional differences, including access to high‐quality care. The role of access as a deciding factor in the impact of socioeconomic status on AD outcome deserves further investigation. [ABSTRACT FROM AUTHOR]

The presence of atopic dermatitis (AD) in youth has been linked to a variety of mental health concerns including disruptive behavior, symptoms of anxiety and depression, and diagnoses of attention deficit/hyperactivity disorder and autism spectrum disorder. However, the factors accounting for these relationships are not well understood. The current review summarizes possible mechanisms identified in previous research and highlights areas for future investigation. Among the primary mechanisms studied to date, child sleep is the only factor that has been characterized in relative detail, with findings generally supporting the mediating role of sleep problems in the relationship between AD and psychological symptoms. There is substantial evidence suggesting a negative impact of child AD on parent mental health and the impact of parent mental health on child psychological functioning, although the latter has not been assessed specifically in populations of children with AD. There is also preliminary support for other mechanisms, including pruritus and pain, atopic comorbidities, social functioning, and systemic antihistamine use, in the development of mental health concerns in pediatric AD. Furthermore, research suggests the presence of bidirectional relationships between AD and psychological functioning via inflammatory responses to stress and impaired treatment adherence. Overall, significant additional research is needed to better characterize the nature and magnitude of the relationships among these multiple mechanisms and various psychosocial outcomes. Nevertheless, the findings to date support routine screening of psychological health in patients with AD as well as screening for potential risk factors, which may also serve as targets of therapeutic intervention. [ABSTRACT FROM AUTHOR]

Recently, alopecia areata (AA) treatment via the Janus kinase (JAK)‐signal transducer and activator of transcription pathway has been reported. However, as baricitinib, a JAK1/2 inhibitor is only approved for adult patients, children, and adolescent patients still lack treatment options. We present a case that showed improvement of severe AA in an adolescent patient on upadacitinib, which has been approved by the Food and Drug Administration (FDA) for use in patients with rheumatoid disease or atopic dermatitis (AD) in children aged 12 years or older and weighing 40 kg or more. Herein, we suggest that upadacitinib can be a good alternative for adolescent patients with AA, particularly those who may also have AD. [ABSTRACT FROM AUTHOR]

Background: Dupilumab is the first biologic approved for the treatment of moderate‐to‐severe atopic dermatitis (AD) in children and adolescents. Previous systematic reviews explored the effectiveness and safety of dupilumab in adults with AD. However, the underlying mechanisms of AD can vary among different age groups, emphasizing the need for separate investigation into the use of dupilumab in children and adolescents with AD. Objective: To evaluate the efficacy and safety of dupilumab in children and adolescents with AD based on evidence from clinical trials and observational studies. Methods: The process of meta‐analysis was conducted according to preferred reporting items for systematic reviews and meta‐analyses guidelines. Results: Seven clinical trials and 11 observational studies involving 1275 children and adolescents with AD were eligible for quantitative analysis. Overall, the pooled percentages of eczema area and severity index (EASI) 50, EASI 75, EASI 90, EASI 100, and investigator's global assessment (IGA) 0/1 were 72.9% (95% CI: 61.6%–81.9%), 57.4% (48.1%–66.2%), 31.3% (24.0%–39.7%), 29.7% (23.3%–37.0%), and 35.2% (29.3%–41.5%). With prolonged treatment time, an increase was seen in the pooled rate of EASI response, indicating that dupilumab may provide sustained benefits for children and adolescents over the long term. The reported adverse events were primarily mild and manageable, with an overall incidence rate of 7.2% across clinical trials and 7.6% across observational studies. Conclusion: Dupilumab was an effective and safe treatment option for children and adolescents with AD, with positive results observed from long‐term use and an acceptable safety profile. More long‐term, high‐quality, controlled studies in different regions are needed for further verification. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a chronic skin condition that is associated with significant patient burden and decreased health‐related quality of life (HRQoL). We report results of the real‐world Epidemiology of Children with Atopic Dermatitis Reporting on their Experience study in Japanese pediatric patients, focusing on the impact of AD severity on disease burden. Methods: Children and adolescents aged 6 months to 17 years (or their caregivers/parents) completed an online survey between September 26, 2018, and March 5, 2019. Patients with diagnosed AD (i.e., met International Study of Asthma and Allergies in Childhood criteria and had a self‐reported AD diagnosis) were evaluated for disease severity using the Patient‐Oriented Eczema Measure (POEM). Impact of AD severity on AD symptoms (itching, pain, and sleep disturbance), disease flares, atopic comorbidities, healthcare resource utilization, school days missed, and HRQoL were assessed. Results: Of 5702 Japanese pediatric patients, 547 had diagnosed AD and were included in this analysis. Based on POEM scores, AD severity was clear/mild in 346 patients (63.3%), moderate in 177 (32.5%), and severe in 24 (4.4%). Across all age groups (i.e., less than 6, 6–11, and 12–17 years), increased AD severity was associated with increased AD symptom severity, number of flares, atopic comorbidities, healthcare resource utilization, and school absences, as well as worsened HRQoL. Conclusions: This population‐based study of Japanese children and adolescents showed that greater AD severity had a high impact on disease burden. [ABSTRACT FROM AUTHOR]

Eczema herpeticum (EH) is a cutaneous infection with herpes simplex virus, typically in the context of atopic dermatitis. Pediatric hospitalizations for EH have increased over the past several decades, yet few studies have investigated comorbidities or epidemiology of pediatric EH inpatients. We searched the 2016 Kids' Inpatient Database and recorded demographics, comorbidities, and associated costs for patients with EH. We found bacterial infections were a common comorbidity which affected nearly half (47.4%) of hospitalized patients, suggesting the importance of regular monitoring of pediatric EH inpatients for bacterial coinfection. [ABSTRACT FROM AUTHOR]

Background/Objectives: Diagnostic criteria for atopic dermatitis (AD) are limited in their performance and/or usability. The American Academy of Dermatology (AAD) consensus criteria include hierarchical categories of disease features to improve these metrics but have not been validated. Our objective was to create and validate a checkbox form of the AAD consensus criteria in the pediatric population. Methods: We performed a cross‐sectional study of 100 pediatric patients with AD (n = 58) and diseases in the differential diagnosis of AD (n = 42). Results: Having three or more "Essential," ≥2 "Important," ≥1 "Associated" features of the AAD criteria was optimal for the diagnosis of AD in children. This combination was 91.4% (95% CI, 84.2%–98.6%) sensitive and 95.2% (88.8%–100%) specific. The UK working party criteria and the Hanifin–Rajka criteria had sensitivities of 96.6% (95% CI 91.9%–100%) and 98.3% (95% CI 94.9%–100%) and specificities of 83.3% (95% CI 72.1%–94.6%) and 71.4% (95% CI 57.8%–85.1%), respectively. The AAD criteria had significantly greater specificity than the Hanifin–Rajka criteria (p =.002). Conclusions: This study represents an important step in validating the AAD consensus criteria and formulating a useable checkbox form for diagnosing AD in the pediatric population. [ABSTRACT FROM AUTHOR]

Nagashima‐type palmoplantar keratoderma (PPK) is an autosomal recessive PPK. We report four patients, highlight two new genetic variants, and emphasize the possibility of misdiagnosing the condition. Concomitant atopic dermatitis, specifically, may make correct diagnosis challenging. Clinicians should consider the diagnosis of Nagashima‐type PPK in patients presenting with mild PPK with transgrediens and understand the importance of individualized multimodal treatment regimens. [ABSTRACT FROM AUTHOR]

Background: Moisturizers are first‐line therapy for treatment of atopic dermatitis (AD). Although there are multiple types of moisturizers available, head‐to‐head trials between different moisturizers are limited. Objective: To evaluate if a paraffin‐based moisturizer is as effective as ceramide‐based moisturizer in children with AD. Materials and Methods: In this double‐blind, randomized comparative trial of pediatric patients with mild to moderate AD, subjects applied either a paraffin‐based or ceramide‐based moisturizer twice daily. Clinical disease activity using SCOring Atopic Dermatitis (SCORAD), quality of life using Children/Infants Dermatology Life Quality Index (CDLQI/IDLQI), and transepidermal water loss (TEWL) were measured at baseline and at follow‐up at 1, 3, and 6 months. Results: Fifty‐three patients were recruited (27 ceramide group and 26 paraffin group) with a mean age of 8.2 years and mean disease duration of 60 months. The mean change in SCORAD at 3 months in the ceramide‐based and paraffin‐based moisturizer groups was 22.1 and 21.4, respectively (p =.37). The change in CDLQI/IDLQI, TEWL over forearm and back, amount and days of topical corticosteroid required, median time to remission and disease‐free days at 3 months were similar in both groups. As the 95% confidence interval (CI) of mean change in SCORAD at 3 months in both groups (0.78, 95% CI: −7.21 to 7.52) was not within the predefined margin of equivalence (−4 to +4), the conclusion of equivalence could not be proven. Conclusion: Both the paraffin‐based and ceramide‐based moisturizers were comparable in improving the disease activity in children with mild to moderate AD. [ABSTRACT FROM AUTHOR]

Bleach baths are an important adjunct in the management of atopic dermatitis. However, many homes do not have bath tubs. We tried to overcome this by soaking a cotton pajama suit or Indian kurta pajama in dilute bleach solution and then having the child wear it for ten minutes. This is done two to three times a week, as in standard bleach tub baths. We have tried this technique in eleven patients with satisfactory outcomes and no adverse effects. [ABSTRACT FROM AUTHOR]

Background/objectivesCrisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate atopic dermatitis (AD). This pooled post hoc analysis of two phase 3 trials (NCT02118766, NCT02118792) assessed improvement and time to improvement in Investigator's Static Global Assessment (ISGA) and Severity of Pruritus Scale (SPS) outcomes in pediatric patients with mild-to-moderate AD.MethodsPatients aged ≥2 years were randomly assigned 2:1 to receive twice-daily crisaborole or vehicle for 28 days. Patients aged 2-17 years were pooled for this analysis. Proportions of patients and time to achieving ISGA success (clear [0] or almost clear [1] with ≥2-grade improvement from baseline), ISGA clear/almost clear, ≥1-grade improvement in ISGA, SPS success (SPS score ≤1 with ≥1-grade improvement), or ≥1-grade improvement in SPS score were analyzed and stratified by baseline ISGA.ResultsAt first postbaseline assessment (day 8), significantly higher proportions of crisaborole- than vehicle-treated patients achieved ISGA success, ISGA clear/almost clear, ≥1-grade ISGA improvement, SPS success, or ≥1-grade improvement in SPS regardless of baseline ISGA. Differences were significantly greater over time for all outcomes for patients with moderate baseline ISGA and numerically greater for those with mild baseline ISGA. Median times to ISGA and SPS outcomes were shorter for crisaborole versus vehicle.ConclusionImprovement in ISGA and SPS outcomes were observed with crisaborole in pediatric patients with mild-to-moderate baseline AD.

There is a paucity of literature on pediatric skin conditions in skin of color, of which old epidemiological data are likely to become outdated as the ethnic diversity in developed countries such as Australia continues to grow. We analyzed the prevalence of presenting conditions of pediatric patients with skin of color attending an urban dermatology clinic in Melbourne, Australia over an 18‐month period. The major presenting issues were vitiligo, atopic dermatitis, and acne vulgaris, the majority of which did not significantly differ by ethnicity; however, there was a statistically significantly higher proportion of Chinese and Indian patients presenting with atopic dermatitis. Given the varying presentations of these conditions in skin of color, our findings highlight the importance of increasing education for dermatologists and health personnel in pigmentary disorders and the need for further focused studies comparing the prevalence of skin disease across ethnicities. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a common and chronic inflammatory skin disease that can adversely affect quality of life and carry significant burdens on physical, emotional, and social health. Recent evidence suggests that AD may also impair cognition, including attention and memory. In a pilot study of six children with AD, we administered a comprehensive battery of assessments to evaluate cognition and behavior and found that this approach was feasible and practical, which will enable the conduct of future larger-scale studies to characterize the impact of AD on cognitive function. [ABSTRACT FROM AUTHOR]

Topical corticosteroids (TCS) are the most commonly prescribed treatment for children with atopic dermatitis and are supported by the American Academy of Dermatology (AAD) atopic dermatitis treatment guidelines with level I strength A evidence; however, fear regarding their use, coined “steroid phobia,” is widespread. In this study, we analyzed steroid phobia-related content on popular social media platforms. We found much of this content consists of patients describing negative personal experiences with TCS and subsequently discouraging viewer use. We conclude that social media may contribute to steroid phobia, and we hope that our study motivates dermatologists with social media platforms to combat common misconceptions surrounding TCS use. [ABSTRACT FROM AUTHOR]

Swimming is an excellent form of aerobic exercise and is an essential life skill. Many children with atopic dermatitis (AD) are advised not to swim because of concerns about negative impacts on their skin disease, and some children with AD do not swim because they are self-conscious about the appearance of their skin. We aimed to perform a narrative review of the available literature on swimming and AD and scientifically analyze the potential impact of all components of swimming in AD—water, skin barrier, swimming gear, and exercise. Studies examined the impact of swimming on the skin barrier and the relative contraindications to swimming. Constituents of water which may affect AD include hardness, pH, temperature, antiseptics, and other chemicals. Potential interventions to reduce damage included emollient application, special swim gear, and showering post-submersion. The benefits of swimming as a form of exercise in AD included reduced sweating, cardiorespiratory fitness, and maintenance of healthy weight. Drawbacks of swimming as a form of exercise in AD included the limited benefit on bone mineral density. Future research should examine the impact of swimming on flares of AD using noninvasive biomarkers as well as clinical severity assessment and assess the role for different types of emollient as an intervention for optimal eczema control. This review highlights gaps in the scientific literature on swimming and AD and provides evidence-based guidance on interventions to minimize deleterious effects on skincare and maximize opportunities for children with AD to swim. [ABSTRACT FROM AUTHOR]

Morphea is a rare multifactorial autoimmune disorder characterized by a complex and dynamic interplay between Th1 and Th2 signaling. Active clinical trials are currently investigating the safety and efficacy of dupilumab for the treatment of primary morphea. Here, we present two cases of morphea that developed in pediatric atopic dermatitis patients treated with dupilumab. These findings may support a causal relationship between IL-4 receptor blockade and the development of the early inflammatory phase of morphea. [ABSTRACT FROM AUTHOR]

Nonsteroidal topicals and systemic therapies are often utilized for atopic dermatitis (AD) in children with inadequate response to topical corticosteroids. We sought to characterize patient factors associated with prescriptions for nonsteroidal topical (tacrolimus, pimecrolimus, crisaborole), systemic immunosuppressant (methotrexate, mycophenolate, cyclosporine, azathioprine), and systemic corticosteroid therapy among children with AD. In a cross‐sectional study of patients <18 years old with AD seen at a large children's hospital between 2009 and 2017, we found that nonsteroidal topical and systemic medication prescriptions were associated with older age of the patient, male sex, comorbid atopy, greater healthcare utilization, specialist care, and race/ethnicity. Compared to White patients, Black and Hispanic patients were less likely to be prescribed nonsteroidal topicals and non‐White patients were less likely to be prescribed systemic medications, suggesting that further examination of potential disparities in pediatric AD treatment is needed. [ABSTRACT FROM AUTHOR]

Background/Objectives: Atopic dermatitis (AD) can be a debilitating skin condition, often leading to hospitalization due to severe AD exacerbations or infectious complications. As both AD exacerbations and infectious complications can present similarly, it can be difficult to distinguish the two conditions. Thus, we aimed to evaluate if there is any difference in serum IgE levels in children with AD who were hospitalized for AD exacerbation and for AD‐associated infectious complications. Methods: A retrospective chart review was performed on hospitalized children with AD exacerbations and AD‐associated infectious complications over a 17‐year span. Data including length of stay, primary diagnosis, systemic antibiotics, laboratory, and bacterial culture results were collected. Serum total immunoglobulin E (IgE) levels were adjusted by age. Age, length of stay, total IgE levels, and age‐adjusted IgE levels were compared using t‐test. Logistic regression was used for age‐adjusted IgE levels. Results: The mean serum total IgE level in subjects with AD exacerbation was 9603 ± 15,873 kU/L, which was significantly higher than that of subjects with infectious complications at 3167 ± 5486 kU/L (p =.029). Logistic regression revealed that subjects with an age‐adjusted IgE of >4 had more than 3‐fold odds of having AD exacerbation than infectious complications. Conclusions: Our results suggest that total IgE levels are higher in children who were hospitalized for AD exacerbation than those with AD‐associated infectious complications. [ABSTRACT FROM AUTHOR]

Hereditary alpha tryptasemia (HaT), an autosomal dominant condition first described in 2014, has previously been associated with multiple dermatologic, allergic, gastrointestinal, neuropsychiatric, autonomic, and connective tissue abnormalities. We describe a pediatric patient with predominantly mixed cutaneous inflammatory manifestations and atopic manifestations resistant to treatment who was found to have HaT. HaT should be considered in individuals with refractory inflammatory dermatologic disease and signs and/or symptoms concerning for mast cell activation. [ABSTRACT FROM AUTHOR]

Background: A high burden of bacterial skin infections (BSI) is well documented in remote‐living Indigenous children and young people (CYP) in high‐income countries (HIC). Atopic dermatitis (AD) is the most common chronic inflammatory skin condition seen in CYP and predisposes to BSI. Despite the rate of urbanization for Indigenous people increasing globally, research is lacking on the burden of AD and BSI for urban‐living Indigenous CYP in HIC. Indigenous people in HIC share a history of colonization, displacement and subsequent ongoing negative impacts on health. Objective: To provide a global background on the burden of AD and BSI in urban‐living Indigenous CYP in HIC. Methods: A systematic review of primary observational studies on AD and BSI in English containing epidemiologic data was performed. MEDLINE, EMBASE, EMCARE, Web of Science, and PubMed databases were searched for articles between January 1990 and December 2021. Results: From 2278 original manuscripts, 16 were included: seven manuscripts documenting eight studies on AD; and nine manuscripts documenting nine studies on BSI. Current and severe symptoms of AD were more common in urban‐living Indigenous CYP in HIC compared with their non‐Indigenous peers, with children having a higher prevalence than adolescents. Urban‐living Indigenous CYP in HIC had a higher incidence of all measures of BSI compared with their non‐Indigenous peers, and were over‐represented for all measures of BSI compared with their proportion of the background population. Limitations include incomplete representation of all Indigenous populations in HIC. Conclusion: A significant burden of AD and BSI exists in urban‐living Indigenous CYP in HIC. [ABSTRACT FROM AUTHOR]

Background: Latin American patients in the United States experience significant health disparities. Community health workers (promotoras de salud) reduce disparities by providing culturally appropriate education. While educational interventions have been studied in atopic dermatitis (AD), a chronic dermatologic condition affecting children, none have evaluated the use of promotoras in Spanish‐speaking pediatric patients in the United States. Objective: To create and evaluate a promotora‐led education program for Spanish‐speaking caregivers of Latin American, pediatric patients with AD through a randomized, controlled, evaluator‐blinded study. Methods: Children with moderate/severe AD (n = 48) were recruited from the pediatric dermatology clinic at Children's Health℠ in Dallas, TX and randomized to receive clinic education (n = 26) or clinic education plus promotora home visits (n = 22). The primary outcome was overall adherence to topical emollients over the 12‐week study, quantified by MEMSCap™ devices; several secondary endpoints were evaluated. Results: Intention‐to‐treat analysis revealed a trend toward increased overall adherence to emollients over the 12‐week study period in promotora (median [interquartile range, IQR]: 43% [26%–61%]) versus non‐promotora (median [IQR]: 20% [11%–49%]) (p =.09) groups. SCORAD, AD knowledge, and Spanish‐language Parental Quality of Life Questionnaire for AD (Sp‐PIQoL‐AD) improved in both groups, although there was no statistically significant difference between groups. There was a trend toward increased AD knowledge at Week 4 (p =.06) in the promotora group. Conclusions: A promotora‐led educational intervention is a promising approach in increasing caregiver medication adherence in pediatric, Latin American patients with AD in the United States. Further research using creative and culturally appropriate strategies to increase medication adherence is necessary to reduce health disparities in other racial and ethnic minority populations in the United States. [ABSTRACT FROM AUTHOR]

Background: A body of research has examined the role of fatty acid (FA), vitamin, and mineral supplementation as adjunctive treatment for atopic dermatitis (AD); however, results are conflicting and concrete recommendations are lacking. The objective of this study is to highlight the role of these nutrients in alleviating AD severity and provide the clinician with consolidated information that can be used to make recommendations to the pediatric patient and caretaker, where this topic is of high interest. Methods: A review of the PubMed and Embase databases was conducted to identify and qualitatively analyze all randomized controlled trials, systematic reviews, and meta‐analyses conducted within the last 21 years regarding use of these nutrients to alleviate symptoms of AD. Inclusion criteria include AD diagnosis, non‐infant age groups, and AD severity outcomes; exclusion criteria include preventative studies, predominantly maternal or infant demographics, or nonclinical outcomes. Results: Sixty‐nine studies were included. Evidence regarding FA supplementation is inconclusive; however, targeting an ideal omega‐3:omega‐6 FA ratio may play a small role in alleviating AD symptoms. Studies results regarding vitamin/mineral supplementation are inconsistent and supplementation should not be advised unless the patient has a documented deficiency. Conclusion: Pediatric AD patients should lead a healthy lifestyle with an emphasis on consumption of wholesome foods. Nutritional supplementation can play a role in improving AD symptoms; however, this should be evaluated on a case‐by‐case basis. Limitations include heterogeneity of studies. [ABSTRACT FROM AUTHOR]

Purpose: To describe secondary care health care resource utilization (HCRU) for children and adolescents with atopic dermatitis (AD). Patients and Methods: This UK chart review of patients with moderate‐to‐severe AD was conducted in four National Health Service hospitals. Cohorts were defined by age (children 6–11 years, adolescents 12–17) at first consultation. Eligible patients were selected consecutively, starting with the most recently consulting patient. At least 12 months' data were abstracted from medical records. Data were collected on HCRU, demographics/clinical characteristics, treatment, and patient‐reported outcomes. Results: Data were abstracted for 55 patients. Most patients (80%) had severe AD at first referral, a mean (SD) of 3.2 (10.7) patient‐reported flare episodes/patient/year‐of‐observation, and 18.5 (16.7) tests/scans/procedures/patient/year. Mean (SD) observation duration was 3.6 (1.8) years. Patients had tried mean (SD) 7.9 (5.3) treatments/patient/year of observation. Topical corticosteroids (TCS; 24.5% of prescriptions) were most frequently prescribed. Mean (SD) use of emollients/moisturizers, TCS, systemic corticosteroids, and systemic immunosuppressants was 30.9 (21.3), 21.1 (23.4), 1.7 (8.3), and 7.8 (8.2) months. There was a mean (SD) of 5.3 (2.9) consultations/patient/year‐of‐observation; 116 (10.7%) for flare. Most hospitalizations (87.5%) were for children; the 8/55 (15%) hospitalized patients (mean 2.0 hospitalizations/patient during observation period) spent 6.2 (SD: 5.1) nights in hospital/hospitalization. Earliest mean (SD) Children's Dermatology Life Quality Index score was 15.3 (7.2); latest was 12.9 (7.5). Conclusion: Children and adolescents with moderate‐to‐severe AD had a high HCRU burden and small changes in quality of life, indicating that current treatments may provide suboptimal AD control in most cases. [ABSTRACT FROM AUTHOR]

Background: Ectoine is a widespread osmolyte enabling halophilic bacteria to withstand high osmotic stress that has many potential applications ranging from cosmetics to its use as a therapeutic agent. Objective: The aim of this study was to compare the efficacy and tolerability of ectoine 1% and hyaluronic acid 0.1% containing (EHA) cream with a vehicle cream in children with mild‐to‐moderate atopic dermatitis (AD). Methods: A randomized, controlled, observer‐blind, multicenter clinical trial was conducted in children aged 2–18 years, diagnosed with mild‐to‐moderate AD (SCORAD ≤20). Patients were randomized to either receiving EHA cream or vehicle cream twice daily for 4 weeks. The primary outcome measure was the mean change in objective SCORAD from baseline to the final visit. The secondary outcome measures included the mean change in Investigator's Global Assessment score, patient's judgment of efficacy and patient's assessment of pruritus. Safety of EHA cream was also assessed. Results: A total of 70 patients (35 in each group) were randomized and 57 were included in the final analysis set. Based on SCORAD measurements, patients using EHA cream achieved superior clinical improvement compared to the control group at 28 days (p <.001). EHA cream was also superior to the vehicle cream regarding all secondary outcome measures. Eight (23.5%) patients receiving EHA cream and two (5.7%) patients receiving vehicle cream experienced mild cutaneous adverse events (AEs). Conclusions: In children 2–18 years old with mild‐to‐moderate AD, EHA cream was superior to vehicle cream, with minor AEs. [ABSTRACT FROM AUTHOR]

Background/Objective: Atopic dermatitis (AD) is a chronic inflammatory skin disease. Research suggests an association between obesity and AD, although evidence is lacking from Latin American populations. This study evaluated the association of obesity with AD in children from Chile, a country with high obesity prevalence. Methods: A case‐control study was performed in children with active AD (cases) and healthy controls (HCs) from Santiago, Chile. Body mass index was evaluated by z‐score (z‐BMI), with overweight defined as z‐BMI ≥+1 and <+2, and obesity as z‐BMI ≥+2. Abdominal obesity was defined by a waist circumference‐to‐height ratio (WHR) ≥0.5. AD severity was evaluated by Scoring AD (SCORAD) index. Results: A total of 174 children with AD and 101 controls were included. AD patients had similar overweight (27% vs. 28%) and obesity (21% vs. 26%) rates as HCs (p =.65). Abdominal obesity rates were also comparable (64% vs. 62%, p =.81). In sex‐specific analyses, girls with AD had higher abdominal obesity rates than HCs (71% vs. 53%, p <.05) while boys with AD had lower abdominal obesity rates than HCs (53% vs. 75%, p =.03). Among children with AD, higher z‐BMI or WHR did not correlate with higher SCORAD, eosinophil counts or total IgE. Conclusion: In our study, Chilean children with AD had high but similar rates of obesity as HCs, but showed sex‐specific associations of abdominal obesity and AD. Further research is needed to evaluate these associations and the roles that weight excess and weight loss could play in the pathogenesis and treatment of AD. [ABSTRACT FROM AUTHOR]

Patients who undergo solid organ transplantation are at an increased risk of developing atopic dermatitis, potentially due to long‐term use of calcineurin inhibitors which results in a shift towards the Th2 immune response. The effectiveness and safety of dupilumab for atopic dermatitis in posttransplant patients is not established. Previous reports of dupilumab use in posttransplant patients have been in adult patients. In this series, we report three young posttransplant patients treated successfully with dupilumab. [ABSTRACT FROM AUTHOR]

Our objective was to examine the prevalence and predictors of delayed medical care due to transportation barriers among children with atopic dermatitis (AD) living in the United States (US). We analyzed data from the 1998–2018 National Health Interview Survey, a nationally representative survey of US households. In 2018, transport‐delayed care was reported for 3.4% of US children with AD, representing approximately 279,000 children annually given the National Health Interview Survey's weighted survey design, and was more common among patients of lower socioeconomic status. Targeted interventions aimed at reducing transportation barriers to healthcare among at‐risk AD patients may reduce health disparities related to AD. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) has a strong genetic basis. The objective of this study was to assess the association between parental atopy and AD development by 2 years. Methods: A secondary data analysis of the BASELINE Birth Cohort study was performed (n = 2183). Parental atopy was self‐reported at 2 months. Infants were examined for AD by trained health care professionals at 6, 12, and 24 months. Variables extracted from the database related to skin barrier function, early skincare, parental atopy, and AD. Statistical analysis adjusted for potential confounding variables. Results: Complete data on AD status were available for 1505 children at 6, 12, and 24 months. Prevalence of AD was 18.6% at 6 months, 15.2% at 12 months, and 16.5% at 24 months. Adjusted odds ratios (95% CIs) following multivariable analysis were 1.57 (1.09–2.25) at 6 months and 1.66 (1.12–2.46) at 12 months for maternal AD; 1.90 (1.28–2.83) at 6 months and 1.85 (1.20–2.85) at 24 months for paternal AD; 1.76 (1.21–2.56) at 6 months and 1.75 (1.16–2.63) at 12 months for maternal asthma; and 1.70 (1.19–2.45) at 6 months, 1.86 (1.26–2.76) at 12 months, and 1.99 (1.34–2.97) at 24 months for paternal asthma. Parental rhinitis was only associated with AD with maternal rhinitis at 24 months (aOR (95% CI): 1.79 (1.15–2.80)). Conclusion: Parental AD and asthma were associated with increased risk of objectively diagnosed AD in offspring in this contemporary cohort. [ABSTRACT FROM AUTHOR]

Background: An understanding of the prevalence patterns of skin diseases in children in Botswana is needed to guide national dermatological policy development, training, and resource allocation to improve patient care. Objective: To describe local skin disease patterns in children aged 0–18 years presenting for dermatologic care in Botswana. Methods: A retrospective review of records from 1st January 2011 to 31st December 2016 was conducted at the outpatient dermatology clinic of Princess Marina Hospital (PMH) in Gaborone, Botswana and outreach clinic sites. Results: There were 4413 pediatric visits constituting 18.6% of all dermatology visits. There was a slight male predominance of 1.2:1. The majority of disorders were noninfectious 80.1% (3537/4413) versus infectious 14.6% (645/4413), with 5.2% (231/4413) unclassified. In the noninfectious category, two‐thirds were inflammatory, followed by disorders of nails, skin appendages, and pigmentary disorders. Atopic dermatitis was the most common inflammatory disorder. Over half of infectious skin diseases were viral, followed by fungal and bacterial disorders. In the HIV‐related disorders, the majority were verrucae 94% (108/115) followed by Kaposi sarcoma. The nine most common skin diagnoses accounted for close to 70% of all skin diseases seen at the clinic, and these included atopic dermatitis (almost half of all cases), followed by verruca, acne, and vitiligo. Conclusion: There is a high burden of skin disorders in children in Botswana. In our cohort, a small number of skin conditions made up the vast majority of pediatric diagnoses. This information can be used to guide dermatology training and resource allocation to better manage these common diseases. [ABSTRACT FROM AUTHOR]

There is limited information on the use of websites and social media platforms among dermatology patients. This survey study of 210 children with atopic dermatitis and their caretakers who attended dermatology clinic from 6/1/2020 through 5/1/2021 revealed that 83.8% had used online sources for information related to their condition. There was wide variation in the sources used and the participants' perceived trustworthiness of these. This study highlights the importance of physicians actively engaging with the online sources used by patients with atopic dermatitis and their caregivers during counseling in clinic. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) in early childhood often precedes the development of food sensitization and allergy, but the role of treating AD to prevent food allergy remains poorly understood. Our objective was to assess the relationship between facial dermatitis and food sensitization to cow's milk, egg whites, and peanuts in early childhood, as aggressive treatment of facial dermatitis could serve as a potential opportunity for food sensitization prevention. By 3 years of age, food sensitization levels to cow's milk, egg whites, and peanuts were 48% greater in children with facial AD than in children with no facial involvement of their AD. Additional research is needed to determine if facial involvement of AD in infants and young children is associated with increased food allergy. [ABSTRACT FROM AUTHOR]

Regular moisturizing with over‐the‐counter (OTC) treatments is considered a cornerstone of atopic dermatitis (AD) management regardless of disease severity, but OTC moisturizers are not an eligible product under most state Medicaid benefits, including those of New York (NY). Removing the financial barrier to AD management may lessen both the economic burden and emotional toll of the disease for patients and their families with the added benefit of decreasing healthcare costs. Herein, the theoretical annual cost of OTC moisturizer was calculated for a patient with AD in NY to range between $35.13 to $63.35 for infants to $175.66 to $316.75 for adults, and Medicaid reimbursement rates and reported direct and indirect costs of AD were reviewed. We conclude with a discussion of Medicaid coverage criteria for drugs, cost‐effectiveness and preventative medicine, and the role of advocacy for changes in health policy. [ABSTRACT FROM AUTHOR]