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Acquired generalized lipodystrophy (AGL) is a rare disease characterized by variable loss of adipose tissue and concurrent metabolic derangements, typically with childhood or adolescent onset. AGL has three subclassifications: panniculitis (type 1), autoimmune disease (type 2), and idiopathic (type 3). This report highlights a rare case of AGL type 1 in a previously healthy 3‐year‐old female who presented with diffuse erythematous subcutaneous nodules, progressive lipoatrophy, and histopathological findings of a lobular panniculitis. [ABSTRACT FROM AUTHOR]

A current shortage of pediatric dermatologists limits access to dermatologic care among the pediatric population, yet comprehensive and updated data are lacking regarding access among the pediatric Medicaid population. This cross‐sectional study characterized Medicaid acceptance among actively practicing board‐certified pediatric dermatologists in the United States and revealed that of the 352 physicians compiled, 275 (78.1%) accept Medicaid. Significant differences in Medicaid acceptance status were observed based on practice type, region of practice, practice county median household income, and density of pediatric dermatologists. While the majority of practicing board‐certified pediatric dermatologists accept Medicaid, our findings suggest that differences in access to Medicaid‐accepting pediatric dermatologists exist based on practice type, geographic location, and density of pediatric dermatologists per county. [ABSTRACT FROM AUTHOR]

Background: Recent years have seen significant exploration into the potential link between allergic contact dermatitis and atopic dermatitis, yielding contradictory findings. Methods: A retrospective cohort analysis of children aged 2 to 18 who underwent patch testing at the pediatric dermatology clinic at a tertiary medical center in Israel was conducted. Results: Overall, 367 patients were included in the study, 31.6% of whom were diagnosed with atopic dermatitis. 160 children (43.6%) exhibited a positive reaction to at least one compound in the European baseline series. There was no statistically significant difference in reactivity between children with atopic dermatitis and those without (P = 0.848). Sub‐analyses based on ethnicity, gender, and age did not reveal significant differences in overall European baseline series reactivity (P = 0.612, P = 0.446, P = 0.488, respectively). Sensitivity was notably higher when patch readings were conducted 72 h after application compared to 48 h [0.95 (CI: 0.91–0.97) vs. 0.60 (CI: 0.55–0.66)]. Conclusions: Patch testing is imperative for suspected cases of allergic contact dermatitis in all children, regardless of their atopic background. Further research is warranted to potentially replace the traditional 48‐h reading with a single 72‐h reading in future guidelines, contributing to enhanced efficiency and cost‐effectiveness in clinical practice. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Pediatric pemphigus is a rare bullous disease that represents a diagnostic and therapeutic challenge;  evidence on patients' response to various treatments and long‐term surveillance data are lacking. We aimed to investigate pediatric pemphigus patients' characteristics, diagnosis, therapeutics, response, and long‐term follow‐up.This is a retrospective study of all pemphigus patients aged <18 years, diagnosed between 2000 and 2023, from three tertiary medical centers in Israel. The diagnosis was confirmed by positive immunofluorescence.Twelve pediatric pemphigus patients were included (mean age 10.7 ± 4.3 years, male:female ratio 1:1). Mean diagnostic delay was 11.1 ± 12.6 months (range 1.8–36 months). Most patients had pemphigus vulgaris with mucosal involvement (58.3%). First‐line treatment for all patients included systemic corticosteroids (sCS), with a treatment duration (including tapering down) of 28 ± 18.4 months. Hospitalization did not yield better outcomes. Only three patients achieved sustained complete response with sCS treatment (25.0%), and the rest required additional therapeutics, most commonly rituximab. Rituximab showed a good safety profile and therapeutic response. Follow‐up was recorded up to 18.1 years after diagnosis (mean: 5.6 years). Three of five patients with information available more than 5 years after the pemphigus diagnosis still exhibited disease symptoms.Pediatric pemphigus is associated with a significant diagnostic delay. While sCS can induce remission in most patients as a first‐line treatment, long‐term disease control requires additional immunomodulators. Long‐term follow‐up reveals a chronic yet mostly benign disease course in this population and advocates for the use of rituximab in pediatric pemphigus patients. [ABSTRACT FROM AUTHOR]

Cutaneous lymphoproliferative diseases in childhood are rare and they are clinically and pathologically heterogeneous, which makes their diagnosis challenging. Although there is limited long-term data and guidance on management, evidence suggests these to be different conditions from cutaneous lymphoma in adults, highlighting the need for age-appropriate patient information. We present clinical outcomes for our paediatric cohort of five patients with mycosis fungoides, emphasizing that despite diagnostic delays, mycosis fungoides in this age group tends to yield a good prognosis. It remains uncommon to provide clinical expertise together with psychological support in a dermatology paediatric service. Here, we provide our experience in offering this combined service. In conjunction with these patients, we have co-produced an accessible patient information leaflet targeted at a younger audience for support and to clarify potential misconceptions from a diagnosis of cutaneous lymphoma. [ABSTRACT FROM AUTHOR]

This document is a collection of summaries of various articles from the Australasian Journal of Dermatology. The first article discusses "pool palms," a common condition in children caused by frictional dermatitis from rubbing against rough pool surfaces. The second article presents a case of a delayed bullous drug eruption caused by Trikafta, a drug used to treat cystic fibrosis. The third article describes a case of a neonatal neurocristic cutaneous hamartoma, a rare developmental abnormality. The fourth article examines the efficacy of combination oral antifungal therapy in pediatric patients with cutaneous fungal infections. The fifth article analyzes dermatological presentations in a pediatric emergency department. The sixth article reviews plant-based therapies for treating pediculosis capitis. The seventh article explores the experiences and needs of families with children diagnosed with xeroderma pigmentosum, a skin cancer predisposition syndrome. These summaries provide a brief overview of each article's topic and findings, offering valuable information for library patrons conducting research on specific dermatological topics. [Extracted from the article]

Unwanted hair is a common concern among patients presenting to pediatric dermatology clinics, and parents and patients alike inquire about the safety of methods employed for elective removal. Various methods of hair removal exist with different levels of invasiveness and permanence, from simple mechanical depilation to light‐based therapies. All methods of hair removal appear to be safe and generally well tolerated in children, and there are no age restrictions to any modality. In this review, we aim to address the available literature on the safety and efficacy of hair removal modalities in pediatric patients and propose guidance on how to manage requests for at‐home and in‐office therapies within an ethical framework. [ABSTRACT FROM AUTHOR]

Background: The presence of a vascular, blue linear discoloration on the nasal root of infants and young children is a frequent incidental feature, rarely reported in the medical literature. It is related to the trajectory of the transverse nasal root vein (TNRV). Objective: To study the frequency and clinical characteristics of the vascular discoloration of the nasal root in children. Methods: A prospective study was performed to address the presence or absence of vascular discoloration of the nasal root in all children under 6 years of age attending a pediatric dermatology clinic from November 2022 to November 2023. Data on age and skin phototype (Fitzpatrick classification I–VI) were also collected. Results: Of 701 patients examined, 345 (49.2%) presented with a vascular discoloration of the nasal root. This was present in 97 of 193 (50.3%), 127 of 261 (48.7%), and 121 of 247 (49.0%) patients for the age groups 0–1, 1–3, and 3–6 years, respectively. The presence of vascular discoloration of the nasal root was more frequent in patients with lighter Fitzpatrick skin phototypes: 49 of 69 (71.0%) phototype II, 157 of 290 (54.1%) phototype III, and 137 of 337 (40.7%) phototype IV. Conclusions: A vascular discoloration of the nasal root is a frequent skin feature in infants and children, persisting at least until the age of 6. It does not constitute any medical problem aside from cosmetic concern and parents can be reassured of its benign nature. We propose the medical term "prominent TNRV" to describe this condition. [ABSTRACT FROM AUTHOR]

Background/Objectives: Tree canopies have dermatologic and environmental benefits, especially on school campuses. However, inequities likely exist, and tree planting initiatives may further exacerbate disparities. We sought to identify any relationship between tree canopy shade on public school campuses in Austin, TX and the socioeconomic makeup of the student population, as well as whether current initiatives appropriately address any inequities. Methods: In this cross‐sectional study, we used ArcGIS, a publicly available geographic information system (GIS), to calculate the percentage of tree canopy on campuses within the Austin Independent School District (AISD) for the years 2006 and 2022. We compared this with the percentage of students eligible for free and reduced meals (FRM) at each school. The percentages of FRM‐eligible students were also compared for "low priority" versus "high priority" neighborhoods, as assigned by Austin's Tree Priority Map. Results: Among 112 schools analyzed, schools with minority FRM‐eligible students had significantly more tree canopy compared to schools with majority FRM‐eligible students (19.9% vs. 12.4%, p <.001). When comparing tree priorities, there was a significant difference between the percentage of FRM‐eligible students in "low priority" schools compared to "high priority" schools (23.8% vs. 62.2%, p <.001). Conclusions: Additional work is needed to rectify inequities in tree canopy access for public school students. Designations such as those used in Austin's Tree Priority Map would likely help direct such efforts. We hope this study encourages future research with GIS by both dermatologists and other health care professionals to promote interdisciplinary work with urban planners. [ABSTRACT FROM AUTHOR]

Background: Retronychia is characterized by proximal ingrowing of the nail plate into the proximal nail fold. It is always associated with the presence of two or more overlapping nail plates under the proximal nail fold, clinical signs of chronic proximal paronychia refractory to antimicrobial treatment, and a yellowish nail that does not grow. It mainly affects young female adults, with less than 30 pediatric cases described in the literature so far. Methods: Retrospective and observational study of patients between 0 and 18 years with a clinical and/or ultrasound diagnosis of retronychia attending a pediatric dermatology service between December 2020 and January 2022. Results: We identified 9 patients with retronychia, 7 girls and 2 boys. In all cases, the hallux nails were affected with 5 unilateral and 4 bilateral cases. On physical examination we observed the following signs: thickened and opaque nail plate (one patient), yellowish nail plate (7 patients), double nail plate (6 patients), and erythema with edema, pain, and suppuration of the proximal nail fold (7 patients). Ultrasound was performed in 7 patients and specific findings of retronychia were found in 5 of them. All patients received topical treatment and were referred for the appropriate surgical treatment. To date, only one patient underwent nail avulsion, which was followed by complete recovery. Conclusions: Retronychia is underdiagnosed, particularly in the pediatric population. We present a series of 9 cases of retronychia in children, with clinical and ultrasonographic findings consistent with those of adults. We emphasize the importance of recognizing this entity, which will allow early and adequate treatment. [ABSTRACT FROM AUTHOR]

Background Materials and methods Results Conclusion There are a limited number of studies evaluating the effects of alopecia areata (AA) on the health‐related quality of life (HRQoL) of pediatric patients and their families. This study aimed to assess the HRQoL of pediatric patients with AA and their parents.This single‐center cross‐sectional cohort study included 72 pediatric patients diagnosed with AA. The study was conducted between December 2020 and December 2021 in the dermatology department of a single tertiary center in Turkey. The HRQoL index of the pediatric patients was assessed with the Children's Dermatology Life Quality Index (CDLQI). At the same time, their parents, who were primarily involved in the disease process, were evaluated using the Dermatological Family Impact Scale (DeFIS). An ordinal logistic regression model was used to detect predictors for CDLQI severity.The mean ± SD CDLQI of the pediatric patients who participated in our study was 8.4 ± 5.3, corresponding to moderate impairment. The highest impairment in CDLQI was observed in the symptoms and feelings domain, while the slightest impairment was observed in the domain of personal relationships (P < 0.001). There was a statistically significant positive correlation between the Severity of Alopecia Tool (SALT) score and all CDLQI domains, and the most substantial relationship was with the leisure domain (r = 0.78, P < 0.001). DeFIS scores of female patients were substantially higher than males (25.3 ± 8.6 vs. 17.6 ± 9, P = 0.001).Our study supports that AA is a disease that significantly impacts the HRQoL of affected children and their families. [ABSTRACT FROM AUTHOR]

This document contains several abstracts from a pediatric dermatology conference. The first abstract discusses the use of biologic therapies in children with epidermolysis bullosa and ichthyoses, showing improvements in quality of life and symptoms. The second abstract presents a case of a rare skin disease called Ichthyosis with confetti. The third abstract reports on the successful treatment of a patient with PTEN tumor hamartoma syndrome. The fourth abstract evaluates the long-term outcomes of bleomycin sclerotherapy for lymphatic malformations in children, showing positive results. The final abstract discusses the use of trametinib in a pediatric patient with an arteriovenous malformation, leading to significant improvement. [Extracted from the article]

Background: There are few studies focusing on pediatric teledermatology, and the impact of a large-scale pediatric teledermatology program on the accessibility and efficiency of dermatology care remains unclear. This study evaluated the impact of a state-wide implementation of a store-and-forward teledermatology program augmented by the incorporation of dermoscopy in pediatric patients visiting community health centers. Methods: It was a descriptive, retrospective cohort study of 876 pediatric dermatology referrals. Results: In the traditional referral system, only 60 patients (17.6%) were seen by dermatologists with average waiting times of 75 days due to limited access. In comparison, with an implementation of dermoscopy-aided teledermatology, all 536 teledermatology referrals received dermatological care within 24 h, of which only 64 (12%) patients requires face-to-face (F2F) consultation. Patients referred for F2F consultation via eConsults had a much lower no-show rate as compared to the traditional referral system (39% vs. 71%). Side by side comparison between general population and pediatric population has demonstrated shared features in efficiency and access improvement but revealed specific characteristics of pediatric teledermatology in terms of diagnosis and treatment. Conclusion: Coordinated store-and-forward teledermatology platform with incorporation of dermoscopy between large community care network and dermatology provider can greatly improve access to pediatric dermatology care especially in underserved population. The efficiency of teledermatology in access improvement for pediatric population is comparable with adult population in eConsults. There are also unique features and challenges in pediatric teledermatology that require further research. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Pediatric longitudinal melanonychia (LM) can exhibit atypical features that mimic red‐flag signs for subungual melanoma in adults and lead to diagnostic uncertainty. Nail biopsy may be unnecessary if clinical inspection and dermoscopy suggest a benign nature.We searched PubMed and Embase from inception to February 2023 for studies of any design reporting either the number or proportion of clinical and dermoscopic features in at least five children (≤18 years) with LM. Non‐English articles, reviews, and abstracts were excluded. We performed a systematic review and meta‐analysis to collate all existing data.A total of 1218 articles were screened and 24 studies with 1391 pediatric patients were included. Nevus was the most common diagnosis (86.3%). The most prevalent sites were fingernails (76.2%) and first digits (45.4%). Pooled proportions of common features were: dark‐color bands (69.8%), multi‐colored bands (47.6%), broad bandwidth (41.1%), pseudo‐Hutchinson sign (41.0%), irregular patterns (38.1%), Hutchinson sign (23.7%), dots and globules (22.5%), nail dystrophy (18.2%), and triangular sign (10.9%). Outcomes included progression (widening or darkening, 29.9%), stability (23.3%), and spontaneous regression (narrowing or fading, 19.9%). Only eight cases of subungual melanoma in situ were reported, and no invasive melanomas were identified.Although atypical characteristics are common in pediatric LM, the probability of malignant transformation is exceedingly low. Appropriate evaluation and management of pediatric LM includes careful clinical and dermoscopic inspection with attention to benign features followed by long‐term interval follow‐up. [ABSTRACT FROM AUTHOR]

Background: Plexiform neurofibromas (pNFs) are benign neoplasms, primarily originating from Schwann cells, posing challenges in patients with type 1 neurofibromatosis (NF1) due to pain, disfigurement, compression of vital structures and potential for malignancy. Selumetinib, a MEK1/2 inhibitor, has shown promising results in treating inoperable pNFs, with clinical trials demonstrating tumor volume reduction and improved patient-reported outcomes. Despite its efficacy, dermatologic toxicities may impact the quality of life and treatment adherence. Evaluating the frequency and spectrum of such effects is crucial for effective management. Methods: In a four-year retrospective and prospective study, pediatric NF1 patients with symptomatic, inoperable plexiform neurofibromas (pNFs) were treated with selumetinib. Eligibility criteria included significant morbidity, pNF size exceeding 3 cm or surgical inoperability, and performance status >70%. Hematological, liver, lung and cardiac assessments established baseline health. Selumetinib, orally administered at 25 mg/m2 twice, was administered for two years unless a response warranting extension occurred. Cutaneous AEs were documented and graded by severity according to CTCAE v5.0, with evaluations every three to six months. The impact on symptoms and pNF size was systematically recorded, and biopsies characterized histopathological features in those patients requiring surgery. Results: Twenty patients were enrolled, with an average age at therapy initiation of 11.6 years. Cutaneous side effects were common, with all patients experiencing at least one and a median of two per patient. Xerosis, paronychia and acneiform rash were prevalent. Notably, pre-pubertal individuals were more susceptible to xerosis. Acneiform rash had a higher incidence in older patients and those with skin phototypes II and III. Successful management involved tailored approaches, such as clindamycin for acneiform rash and topical agents for paronychia. Hair abnormalities, including color changes and thinning, occurred, with female patients at higher risk for the latter. Paronychia presented challenges, necessitating various interventions, including surgical approaches. AEs led to treatment suspension in 20% of patients, with tumor rebound observed in 75%. Conclusions: According to our experience, successful management of selumetinib-induced cutaneous AEs requires tailored strategies including surgery. AEs might indirectly determine pNF regrowth due to therapy suspension. We thus emphasize the pivotal role of addressing cutaneous reactions for effective selumetinib management in pediatric patients. [ABSTRACT FROM AUTHOR]

Juvenile xanthogranuloma (JXG) with extensive cutaneous or visceral organ involvement is often associated with high morbidity and treatment commonly involves surgical excision, radiotherapy, systemic steroids, or chemotherapy. Sirolimus, a mammalian target of rapamycin (mTOR) inhibitor, is an oral antitumor and immunosuppressive therapy used to treat various neoplastic disorders, including histiocytic disorders. We report two pediatric cases of JXG successfully treated with oral sirolimus monotherapy, and postulate that sirolimus may induce rapid disease resolution and long‐term remission for patients with both skin‐limited and multisystemic JXG. Our findings warrant further investigation of the relationship between the mTOR pathway and JXG. [ABSTRACT FROM AUTHOR]

Rheumatological disorders are considered rare in children, with a global incidence of 2% - 5%. However, this number may be higher in developing countries due to underreporting. Approximately 10% - 20% of all rheumatological disorders in adults present initially during pediatric age. Rheumatological diseases exhibit a wide array of clinical presentations involving the skin, musculoskeletal system, vasculature, and various organ systems. Skin manifestations may serve as crucial clinical features in rheumatological diseases during the initial presentation. Rheumatic diseases with diverse dermatological manifestations are well-documented. Thorough and meticulous skin examination by pediatric rheumatologists is essential for accurate diagnosis and early treatment of these diseases. Our review proposes a collaborative approach between pediatric rheumatology and dermatology for managing such cases in the future. [ABSTRACT FROM AUTHOR]

The rate of pediatric hospitalization for cutaneous pathology has been increasing in recent years, often requiring the expertise of consulting pediatric dermatologists; however, the infrastructure of inpatient pediatric dermatology consultative services remains poorly characterized. We sought to assess the structure, consult volume, physician compensation, and utilization of teledermatology in pediatric dermatology inpatient services to better understand the current care model. Our survey of 118 pediatric dermatologists revealed that 89% of respondents see between 1 and 10 new consults per week, 39% perform all inpatient consults including evening and weekends without assistance from other providers, 71% do not have protected time during the week to provide inpatient consultations, and only 10% receive financial compensation via stipend. By highlighting both the high demand for pediatric consultative dermatology as well as the significant burden placed on these providers by existing practice models, we hope to encourage a reappraisal of the current infrastructure of pediatric inpatient dermatology to increase structural and financial support for this vital service. [ABSTRACT FROM AUTHOR]

Background: Despite studies of dermatologic manifestations in adults with inflammatory bowel disease (IBD), little is known about the prevalence of IBD‐associated skin lesions and their correlation with IBD severity in children. We aimed to address these knowledge gaps in our single‐center cohort of children with IBD. Methods: Retrospective chart review of 528 children and adolescents (≤18 years old) with IBD and seen at Mayo Clinic (Rochester, MN) between 1999 and 2017 was conducted. The Chi‐Square/Fischer's exact test (with p ≤.05 to signify statistical significance) was applied to compare categorical outcomes between Crohn's disease (CD) and ulcerative colitis (UC) patients. Results: In total, 425 IBD patients (64.9% CD, 53% males) and ≥1 dermatologic diagnosis were included. Presence of ≥1 cutaneous infection was recorded in 42.8% of participants. Acne was the most common non‐infectious dermatologic condition (30.8%), followed by eczema (15.8%) and perianal skin tags (14.6%). Angular cheilitis (p =.024), keratosis pilaris (KP, p =.003), and perianal skin complications (i.e., skin tags, fistula, and abscesses; all p <.001) were more frequently diagnosed among children with CD, while fungal skin infections (p =.017) were more frequently diagnosed in UC patients. Severity of IBD correlated with higher prevalence of perianal fistula (p =.003), perianal abscess (p =.041), psoriasis (p <.001), and pyoderma gangrenosum (PG, p =.003). Conclusions: Both IBD‐specific and IBD‐nonspecific dermatologic conditions are very prevalent in childhood IBD, the most common being infectious. Children with CD are more likely to experience angular cheilitis, KP, and perianal skin findings than those with UC. Perianal disease, psoriasis, and PG are associated with more severe IBD. [ABSTRACT FROM AUTHOR]

Poliosis is defined as the absence of melanin in hair, and hair graying typically occurs with hair melanin reduction. Poliosis can occur at any age but presents in childhood in certain genetic and acquired conditions, with many families seeking evaluation from a pediatric dermatologist. Poliosis presents as white hair typically restricted to a certain location of the scalp. Children may also present with a reduction of expected hair pigmentation, referred to as pigment dilution, or the development of hair graying. This review aims to provide a streamlined diagnostic approach for pediatric dermatologists when presented with these hair findings. Poliosis should be recognized as a potential diagnostic feature or initial sign in many syndromes and thus can guide clinicians in diagnosing and managing conditions earlier in a patient's care. Since many of the genetic and acquired conditions that present with poliosis or hair pigment dilution have extracutaneous manifestations, early diagnosis is vital in establishing multidisciplinary care. [ABSTRACT FROM AUTHOR]

This document is an interview with Dr. Daniel Wallach, a prominent figure in the field of dermatology and venereology. Dr. Wallach discusses his background, education, and career, highlighting his areas of expertise, such as pediatric dermatology, atopic dermatitis, and immuno-dermatology. He also mentions his contributions to the field, including the description and classification of neutrophilic dermatoses and the first reports of IgA pemphigus. Dr. Wallach shares his experiences and lessons learned throughout his career and offers advice to younger colleagues. He also discusses the future of dermatology, including the potential impact of artificial intelligence in diagnosing skin diseases. [Extracted from the article]

A study conducted in Germany evaluated a teledermatology application that allows patients to submit information and images of their skin for evaluation by a dermatologist. The study found that the application was highly satisfactory, cost-effective, and efficient in providing therapy. The evaluation included analyzing data from 1232 patients and conducting surveys on patient and physician satisfaction. The majority of patients expressed satisfaction with the application, and many reported that their medical concerns were clarified without needing an in-person visit. The study concluded that the teledermatology application is suitable for a wide range of dermatological patients and can improve access to care. [Extracted from the article]

Background: Atopic dermatitis (AD), a relapsing, inflammatory skin disease, is associated with pruritus that can negatively affect patients' quality of life. Understanding the burden of AD is critical for informing and tailoring treatment and disease management to improve patient outcomes. This study characterized global treatment patterns and the clinical, psychosocial and economic burden of moderate‐to‐severe AD. Methods: MEASURE‐AD was a cross‐sectional 28‐country study in patients with physician‐confirmed moderate‐to‐severe AD who were either receiving or eligible for systemic therapy for AD. Patients ≥12 years were enrolled between December 2019 and December 2020 while attending routine office or clinic visit. Primary outcomes included Worst Pruritus Numeric Rating Scale (WP‐NRS; range: 0–10) and Dermatology Life Quality Index (DLQI; range: 0–30) and Children's DLQI (CDLQI; range: 0–30). Secondary outcomes included physician‐ and patient‐reported clinical, psychosocial and economic burden. Results: Of the 1591 patients enrolled, 1558 (1434 adults and 124 adolescents) fulfilled all patient selection criteria and were included in this analysis. Almost all patients (98.4%) in the total population were using AD medications and more than half (56%) were receiving systemic medication (15% systemic monotherapy). The most used systemic therapies were dupilumab (56.3%), systemic glucocorticoids (18.1%) and methotrexate (16.2%). Mean WP‐NRS was 5.3 in the total population, and most patients (≥55%) reported moderate‐to‐severe pruritus (WP‐NRS ≥4). Mean DLQI was 10.8 and mean CDLQI was 9.6. Secondary endpoints demonstrated substantial clinical, psychosocial, and economic burden of disease. Subgroup analysis demonstrated that patients receiving systemic therapy had lower disease burden than those not taking systemic medications. Conclusions: While systemic therapy lowers overall disease burden, patients with moderate‐to‐severe AD continue to have substantial multidimensional disease burden and uncontrolled disease. Overall, there is a need for effective disease management, including effective treatments that improve patients' psychosocial outcomes and reduce the economic burden of AD. [ABSTRACT FROM AUTHOR]

Background: Entrustable professional activities (EPAs) were introduced across Dutch postgraduate programmes between 2017 and 2019. We aimed to understand the extent to which residents actually were granted increased clinical responsibility upon receiving summative entrustment for an EPA, a critical feature of its use. Methods: A survey study was conducted among all Dutch residents who started dermatology training in 2018 and 2019 and all Dutch dermatology programme directors (PDs). We chose an EPA designed for early entrustment in residency (identification, treatment and care regarding a simple dermatological problem in the ambulatory setting). The survey contained two hypothetical clinical cases that aligned with this EPA. The questions were aimed to determine whether and when residents should request supervision. Similar questions were posed to PDs. Findings: Twenty four residents (56%) and 19 PDs (79%) completed the survey. The majority of the residents (65%) and PDs (63%) confirmed that competent dermatology residents (level 4) are generally allowed to perform EPA1 unsupervised, particularly when seeing patients from GPs. However, still a substantial proportion of the level 4 residents, working in University Medical Centers (36%) indicated that they had to request supervision in the assessment of these patients. For 2nd opinions, the results were typically the opposite. Discussion and Conclusion: This study demonstrated that, at least in one specialty and one country, the introduction of EPAs and entrustment decision making procedure generally led to the intended autonomy of the resident. [ABSTRACT FROM AUTHOR]

Introduction: Scabies is a common parasitic infestation caused by the mite Sarcoptes scabiei. Scabies can mimic other entities clinically, resulting in misdiagnosis. The presence of a mite in the stratum corneum on biopsy specimens is diagnostic of scabies. However, there are instances when mites are not visible, and immunohistochemical (IHC) staining may be misleading. An example is when IHC demonstrates Cluster of Differentiation 1a and S100 positivity. The main differential diagnosis for this finding is Langerhans cell histiocytosis, a group of idiopathic disorders of bone marrow-derived Langerhans cells, with manifestations ranging from isolated to life-threatening multisystem disease. Case Presentation: We present a case of a patient who was diagnosed with Langerhans cell histiocytosis based on histological findings, further review with a repeat reading and deeper sectioning of her biopsy revealed a mite in the stratum corneum, altering the diagnosis, course, and management. She subsequently developed persistent post-scabietic nodules, an underreported entity that may occur following infestation and persist for up to a year. These lesions are self-limiting and do not require repeated courses of treatment. Conclusion: Langerhans cell hyperplasia may be seen in a multitude of entities, including scabies. Familiarity with this phenomenon is crucial to avoid unnecessary invasive investigations, aggressive management and alleviate patients' concerns. [ABSTRACT FROM AUTHOR]

The Dermatology: 'Getting It Right the First Time' (GIRFT) Programme National Specialty Report recommended improving access to, and the quality of, paediatric dermatology services. Understanding referral patterns makes it easier to identify areas that can be improved. This study analysed 292 new referrals to a national care centre that provides secondary care to 50% of all Irish children. Results showed that 51% of new referrals could have been managed in primary care and 41% of new referrals were inappropriate, including 5.5% having no abnormal skin findings. These results indicate that up to 876 referrals could have been avoided over a 13-month period, freeing up resources and reducing wait times for cases more appropriate for a secondary and tertiary care centre. This would improve access for children, allowing them to be diagnosed at the right place and time, in alignment with GIRFT values. The GIRFT Programme Report urged enhancing paediatric dermatology services by improving access and quality. This study analysed 292 referrals to a national care centre and showed that up to half the patients could have been managed in primary care with appropriate supports. This would optimize resources and reduce wait times, ensuring that children receive timely and suitable care in alignment with GIRFT principles. [ABSTRACT FROM AUTHOR]

Background/Objectives: Pediatric vulvar disease has not been widely explored in the medical literature. Few studies focus on vulvar disease in skin of color. The vulvar disease can be distressing for young patients given the sensitive location, and providers may lack experience in diagnosing and managing vulvar dermatoses. We sought to characterize the conditions seen, diagnostic challenges encountered, and the racial and ethnic factors associated with vulvar diseases in our multidisciplinary pediatric dermatology‐gynecology vulvar clinic at Children's National. Methods: Medical records of 220 patients who presented to our multidisciplinary pediatric dermatology‐gynecology clinic were reviewed retrospectively. Results: Lichen sclerosus (LS) (36%, n = 80), inflammatory vulvitis (11%, n = 23), and vitiligo (9%, n = 19) were the three most frequent conditions observed. These conditions were often misdiagnosed as one another. There was a mean delay in diagnosis after symptom onset in LS patients of 16.43 months. Conclusions: LS, inflammatory vulvitis, and vitiligo are common vulvar diseases among pediatric patients. Accurate diagnosis is important because LS must be treated aggressively to prevent sequelae. Further studies are warranted to help differentiate LS and vitiligo with consideration of skin tone. [ABSTRACT FROM AUTHOR]

Dermatologic complications are common following allogeneic hematopoietic stem cell transplantation, but dermatologic complications among pediatric patients undergoing hematopoietic stem cell transplantation for the treatment of sickle cell disease have been poorly characterized. In this case series of 17 patients (<21 years old) with sickle cell disease who underwent hematopoietic stem cell transplantation, 16 (94.1%) experienced one or more dermatologic complications after transplant, with the most common complications including acute or chronic mucocutaneous graft‐versus‐host disease (GVHD) (34.1% of complications), skin eruptions of unknown origin (15.9% of complications), infections (15.9% of complications), and chemotherapy‐related pigmentary changes (11.4% of complications). Patients who developed acute or chronic skin GVHD were significantly older at the time of hematopoietic stem cell transplantation. These findings highlight the need to closely monitor for dermatologic complications in pediatric patients who undergo hematopoietic stem cell transplantation for sickle cell disease and underscore the importance of involving dermatology early on when skin complications occur, although further research with a larger multicenter study could help clarify the risk for dermatologic complications and help identify potential ways to mitigate this risk. [ABSTRACT FROM AUTHOR]

Background/Objectives: There is a paucity of pediatric hidradenitis suppurativa (HS) literature. The objective of this study was to characterize differences in management of pediatric HS patients by dermatology versus non‐dermatology clinicians. Methods: We examined a retrospective cohort of 195 pediatric patients with HS seen at our institution (3/1/19–3/1/20). Two‐sample t‐tests and two‐proportion z‐tests were performed. Results: A total of 76.1% of subjects were seen by dermatology at least once, and of these, 79.1% were referred. HS diagnosis was most often made by dermatology (36.6%), followed by pediatrics (21.6%). Patients managed by dermatology were significantly more likely to have used standard of care therapies (p <.001). Of dermatology‐managed patients, 19.7% were currently prescribed a biologic, as compared with zero patients not managed by dermatology. Those managed by dermatology were less likely to undergo surgical excision (13.3% vs. 25.5%, p =.04). Conclusions: Our results support increased likelihood of treatment escalation with medical management by dermatologists. Relatively high utilization of referral to dermatology exists, but with only moderate patient adherence. There is a need for improved access to dermatologic care and prospective studies to determine whether differences in specialty management translate to improved patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Hand‐foot‐mouth disease (HFMD) is a common childhood infectious disease. Atypical skin findings of HFMD, often associated with coxsackievirus A6 (CVA6), were first reported in 2008, with increasing reports worldwide since. Atypical lesions of HFMD often involve sites beyond the palms and soles and tend to have unusual, polymorphic morphology. Methods: A systematic review was conducted on clinical features and outcomes of pediatric HFMD with atypical cutaneous manifestations. Results: Eighty‐five studies were included, representing 1359 cases with mean age 2.4 years and a male predominance of 61%. The most reported morphologies were vesicles (53%), papules (49%), and bullae (36%). Other morphologies included eczema herpeticum‐like (19%), purpuric/petechial (7%), and Gianotti Crosti‐like (4%). Common atypical sites included the arms and/or legs (47%), face (45%), and trunk (27%). CVA6 was identified in 63% of cases. Symptoms resolved in a mean of 10 days. Overall, 16% of cases received treatment, most commonly with acyclovir, intravenous antibiotics, or topical steroids. The most common complications were nail changes (21%) and desquamation (4%) which occurred a mean of 3 and 2 weeks after symptoms, respectively. Conclusion: Due to unusual morphologies resembling other conditions, HFMD with atypical cutaneous findings may be misdiagnosed, leading to inappropriate and unnecessary investigations, hospitalization, and treatment. Greater awareness of atypical presentations of HFMD is warranted to improve patient care and counseling on infection control precautions. [ABSTRACT FROM AUTHOR]

Congenital insensitivity to pain (CIP) is a rare phenotype characterized by the inability to perceive pain stimuli with subsequent self‐injuries, whereas CIP associated with anhidrosis (CIPA) is an overlapping phenotype mainly characterized by insensitivity to noxious stimuli and anhidrosis. CIP is primarily associated with pathogenetic variants in the SCN9A gene while CIPA is associated with pathogenetic variants in NGF and NRTK genes. However, in recent years, a significant overlap between these two disorders has been observed highlighting the presence of anhidrosis in SCN9A variants. We report the cases of two siblings (age 4 and 6 years) born from consanguineous parents presenting with a previously undescribed phenotype due to a novel pathogenic variant in SCN9A clinically characterized by congenital insensitivity to pain, anhidrosis, and mild cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Psoriasis and psoriatic arthritis can present simultaneously or separately in children and may pose a diagnostic challenge. Objective: To compare the dermatological manifestations in pediatric psoriatic patients with and without arthritis. Methods: A retrospective case-control study of psoriatic patients ≤ 18 years old at Sheba Medical Center was conducted between 2011 and 2021. Patients with psoriatic arthritis versus psoriasis-only were compared according to body surface area (BSA) involvement, cutaneous distribution, severity of skin disease, response to treatment and related side effects. Results: The study cohort included 29 psoriatic arthritis and 64 psoriasis-only patients matched by age and sex. The psoriasis-only group had a significantly higher mean BSA (19.7%, SD ± 18.7) than the psoriatic arthritis group (6.1%, SD ± 11.4), (p = 0.029). The skin distribution differed with the psoriasis group showing more involvement of the extremities, scalp, trunk, and genitals. Both groups primarily experienced partial responses to methotrexate, whereas the psoriasis group mainly saw complete responses to biologics. Adverse events were rare, with a higher incidence in the psoriasis group. Conclusion: This retrospective study highlights the differences in cutaneous disease characteristics, severity, and treatment response in pediatric patients with psoriasis and psoriatic arthritis, providing valuable insights for diagnosis and disease course in the pediatric population. [ABSTRACT FROM AUTHOR]

Treat‐to‐target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermatology after adoption in several other clinical areas. Atopic dermatitis (AD), one of the most common inflammatory skin diseases, may also benefit from this structured and practical therapeutic approach. We aimed to evaluate existing data regarding the T2T approach in dermatology, with a specific focus on AD, as well as the views of International Eczema Council (IEC) members on the potential application of a T2T approach to AD management. To do so, we systematically searched for peer‐reviewed publications on the T2T approach for any skin disease in the PubMed and Scopus databases up to February 2022 and conducted a survey among IEC members regarding various components to potentially include in a T2T approach in AD. We identified 21 relevant T2T‐related reports in dermatology, of which 14 were related to psoriasis, five to AD, one for juvenile dermatomyositis and one for urticaria. In the IEC member survey, respondents proposed treatable traits (with itch, disease severity and sleep problems getting the highest scores), relevant comorbidities (with asthma being selected most commonly, followed by anxiety and depression in adults), recommended specialists that should define the approach in AD (dermatologists, allergists and primary care physicians were most commonly selected in adults), and applicable assessment tools (both physician‐ and patient‐reported), in both adult and paediatric patients, for potential future utilization of the T2T approach in AD. In conclusion, while the T2T approach may become a useful tool to simplify therapeutic goals and AD management, its foundation in AD is only starting to build. A multidisciplinary approach, including a wide range of stakeholders, including patients, is needed to further define the essential components needed to utilize T2T in AD. [ABSTRACT FROM AUTHOR]

Melanoma is one of the rarest tumors in children. Its diagnosis is generally late, due to its misleading morphology and low level of suspicion. The diagnosis of pediatric melanoma remains extremely challenging due to the existence of neoformations that present clinical and histological overlaps and therefore requires great experience of the dermatologist and pathologist. We present the case of a rare pediatric melanoma, occurred on healthy skin with a pyogenic granuloma-like appearance in a 3-year-old girl, which benefited from multidisciplinary management. [ABSTRACT FROM AUTHOR]

Background Bibliometrics refer to documents and citation-based measures that measure different aspects of performance of a journal, including impact, output and prestige. Objective The aim of this study was to collect bibliometric data of various Indian dermatology journals as well as Indian journals from other disciplines, in order to compare relative performances. Methods Journal metrics pertaining to various Indian journals, both from dermatology [Indian Journal of Dermatology, Venereology and Leprology (IJDVL), Indian Journal of Dermatology (IJD), Indian Dermatology Online Journal, Indian Journal of Pediatric Dermatology and International Journal of Trichology] and other disciplines [Indian Journal of Medical Research (IJMR), Indian Journal of Pediatrics (IJP), Indian Journal of Ophthalmology and Indian Journal of Pharmacology] were sought. Data pertaining to the following 8 metrics during the year 2021 was collected: Journal Impact factor, SCImago Journal Rank, h5-index, Eigenfactor score and normalized Eigenfactor Score, Journal Citation Indicator, Scimago Journal and Country Rank H-index, CiteScore and Source Normalized Impact per Paper. Results Among Indian dermatology journals, for the year 2021, IJDVL had the highest impact factor (2.217) and h-index (48). IJD led in terms of prestige metrics such as SCImago Journal Rank (0.403), Eigenfactor score (0.00231) and Source Normalized Impact per Paper (1.132). IJDVL underperformed with respect to an average dermatology journal on all three prestige metrics. Among selected journals from other disciplines, two (IJMR and IJP) had impact factor exceeding five, despite lagging behind IJDVL two years ago. Most had normalized scores exceeding 1, indicating better performance than an average journal from their respective fields. Limitations Non-inclusion of altmetrics related data Conclusion IJDVL is one of the leading Indian journals in the field of dermatology, followed closely by IJD. A rise in IJDVL influence is evident over the past decade, as evident by various metrics. However, the progress still trails behind the average of global dermatology journals as evident by the field-normalized journal metrics, indicating potential for further growth of journal influence. [ABSTRACT FROM AUTHOR]

Patch testing is the standard diagnostic test used for patients presenting with symptoms of allergic contact dermatitis. The grading of patch test results classically varies from 1 to 3. The assessment of these results begins with a visual inspection of the presence of erythema, vesiculation, and induration. This leads to a subjectivity in visual evaluation of a patch test. Positive patch testing results can present differently in patients with darker skin tones. A greater variety of images of allergic contact dermatitis in patients with darker skin phototypes can better guide the diagnosis of this condition in skin of color. People with darker phototypes are historically underrepresented in dermatologic images and texts; thus, identifying erythema in darker phototypes may be more difficult for dermatologists, whether or not they were trained in areas of decreased phototype diversity. In this article, we present positive patch testing findings on several different phototypes, with the intention of contributing to images of phototypes underrepresented in dermatology literature. [ABSTRACT FROM AUTHOR]

This article discusses a case of myofibroma of infancy, a rare benign tumor that commonly occurs in childhood. The patient, a female newborn, presented with a purple-red ulcerated and indurated plaque on her foot. Dermoscopy revealed specific characteristics of the lesion, and further diagnostic procedures, including a skin biopsy and imaging tests, were performed to confirm the diagnosis. The article also highlights the differential diagnoses that should be considered and discusses the management options for myofibroma of infancy. [Extracted from the article]

The burden of treatment (BOT) related to propranolol treatment for infantile hemangiomas (IH) has never previously been explored. A modified validated questionnaire, the Treatment Burden Questionnaire, and one‐on‐one semi‐structured interviews were used to assess the BOT for propranolol for IH. Out of 80 caregivers, the overall burden score was very low at 1.2 out of 10; thematic analysis of interviews grouped themes into administration, monitoring, financial, and associated anomalies. The BOT of propranolol for IH is very low but could be reduced further by offering age‐based risk stratification related to feeding frequency and risk of hypoglycemia, pragmatic advice around timing of doses before sleep, and reducing frequency of vital sign monitoring. [ABSTRACT FROM AUTHOR]

We live in an electronic world with near-ubiquitous access to smartphones and social media. One consequence of this new reality is that children and teenagers may be unduly swayed by social media influencers who promote skincare products and practices, colloquially referred to as "skinfluencers," and enjoy unfettered access to emerging trends-not all of which lead to positive results. Herein, we describe two cases of adolescents presenting to a pediatric dermatology department after trying different beauty trends endorsed by social media influencers. The first patient developed allergic contact dermatitis to "snail slime" (96% Snail Secretion Filtrate; COSRX), a popular over-the-counter skincare product that has received notable attention on social media platforms due to its purported skin hydrating effects. The second patient presented urgently due to her mother's concerns of "overnight moles," which, in fact, the patient had acquired after applying makeup using a social mediaendorsed "freckle stamp." Clinicians should be aware of these emerging trends to properly educate, manage, and treat patients susceptible to their influence-especially within the particularly impressionable teenage population. [ABSTRACT FROM AUTHOR]

Pediatric dermatofibromas are considered rare in young children and have not been well characterized, often misdiagnosed clinically. We performed a retrospective case series of children younger than 18 years with histopathologically diagnosed dermatofibromas at our institutions and evaluated age at onset and diagnosis, sex, lesion location, and size, associated symptoms, change over time, and pre‐biopsy diagnosis. Overall, dermatofibromas were most common on the back and chest (20/53; 38%), followed by the legs (15/53; 28%) and arms (12/53; 23%) with the most common pre‐biopsy diagnosis of "cyst" (23/53; 43%), followed by dermatofibroma (16/53; 30%), and pilomatricoma (12/53; 23%). Our study reinforces previous findings of truncal predominance of pediatric dermatofibromas, different from adults. [ABSTRACT FROM AUTHOR]

This article discusses a case of penile edema in a 7-year-old male. The patient presented with gradually worsening swelling of the penis over a 6-month period. The physical examination revealed marked symmetric, non-pitting, non-tender edema of the entire penile shaft. An incisional biopsy was performed, and the histopathology revealed granulomatous lymphangitis, a form of cutaneous Crohn's disease. The patient was referred to gastroenterology and diagnosed with Crohn's disease based on further evaluation. The article highlights the importance of considering underlying inflammatory bowel disease in cases of unexplained genital edema, even in the absence of gastrointestinal symptoms. Treatment options for granulomatous lymphangitis include glucocorticoids, metronidazole, and other medications. Early identification and intervention may improve patient outcomes. [Extracted from the article]

This article discusses the importance of considering color vision deficiency (CVD), or color blindness, when teaching dermatology to medical students. The authors highlight three main challenges that students with CVD may face in learning about skin-related conditions, including difficulties in recognizing the intensity of colors, distinguishing different color nuances, and neglecting the role of colors in diagnosis. The authors emphasize the need for increased awareness and discussions about CVD in dermatology education, as well as further research on its impact on diagnostic accuracy and clinical work. They also suggest that discussions about color in dermatology education can be used to address difficulties in recognizing skin conditions in patients with darker skin. [Extracted from the article]

Background: Psoriasis is a global disease that exhibits different clinical characteristics and epidemiology across various regions of the world. In India, the prevalence is high and there is a scarcity of epidemiological data in our country. Aims: The objective of this study was to assess the epidemiological and clinical characteristics of psoriasis at Nalanda Medical College and Hospital in Patna. Materials and Methods: A prospective investigation of a total of 100 patients visiting the Outpatient Department of Dermatology and Venereology of at Nalanda Medical College and Hospital in Patna, for psoriasis was done. The parameters included were age at onset of disease, current age, sex, type of disease, and distribution of lesions. Data and statistical analysis were done. Results: The mean age of patients at onset of disease was 26.4 (standard deviation = 14.3) years. M:F ratio was 2.41:1.Chronic plaque-type psoriasis was the most prevalent, accounting for 81% of cases. Plantar surface of the foot was most commonly involved. Conclusion: Psoriasis is a common dermatological disease accounting 2.9% of all dermatology patients in our center. Chronic plaque is the most common clinical subtype. The disease is more frequent in the third decade of life and has a male predominance in our region. Treatment compliance has been found to be poor. [ABSTRACT FROM AUTHOR]

Background. The global impact of coronavirus 2019 (COVID-19) has raised concerns about the management of psoriasis patients, especially among those using biologics. Methods. We conducted a survey-based research among Omicron-infected (confirmed, probable, and suspected ones) psoriasis patients in the department of dermatology, West China Hospital, Sichuan University, from January 9th to January 22nd, 2023. We collected demographic and clinical information (psoriasis- and COVID-19-related) and conducted statistics analysis. Results. Of the 240 patients enrolled, they were classified by the psoriatic treatment, as biologics (n = 138), nonbiological systematic treatment (n = 52), and topical treatment or without pharmacological treatment (n = 50). This study showed the characteristics of Omicron-related symptoms and cutaneous signs in patients. We observed that patients who received topical treatment or without pharmacological treatment had a lower risk of presenting with COVID-19 symptoms in the fully adjusted logistic model (OR = 0.40, 95% CI: 0.18–0.90, and P = 0.025). Moreover, in the model for skin manifestations, nonbiological systematic treatment (OR = 2.15, 95% CI: 1.08–4.27, and P = 0.029) and high BMI (OR = 1.10, 95% CI: 1.00–1.20, and P = 0.042) were correlative factors. Conclusions. Our data suggested that differential psoriatic treatment might be a correlative factor in developing symptomatic or asymptomatic Omicron infection and presenting cutaneous signs. [ABSTRACT FROM AUTHOR]

Patients with alopecia areata (AA) may experience episodic hair loss that follows seasonal patterns. To assess associations between seasonal variation, climate factors, and AA flare frequency in pediatric AA patients, we performed a retrospective chart review of 123 pediatric AA patients at Brown Dermatology (Providence, Rhode Island) who experienced hair loss between January 2017 and December 2019. We assessed association of seasonal variation with monthly occurrence of AA flares. We then assessed association between climate variables and monthly AA hair loss frequency using Spearman rank correlation analyses. We conducted stratified analyses in patients with and without history of atopy. The greatest proportion of hair loss episodes occurred in winter (28.1%), followed by autumn (26.3%), spring (23.8%), and summer (21.7%). We found significant correlations between AA hair loss frequency and air pressure (R = 0.61) and hours of sunlight (R = − 0.60). These correlations remained significant among patients with no history of atopic disease but were not significant among those with history of atopy. Limitations include small sample size. This regional analysis supports the role of climate in AA hair loss episodes through assessment of seasonal occurrences and identification of correlations between climate characteristics and AA flare frequency. [ABSTRACT FROM AUTHOR]

Prior research has surveyed dermatologists to develop a dermatology curriculum for medical students, which subsequently evolved into the American Academy of Dermatology's Basic Dermatology Curriculum [[4]]. Keywords: Dermatology education; Physician assistant; Physician associate EN Dermatology education Physician assistant Physician associate 2967 2970 4 11/02/23 20231201 NES 231201 Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s00403-023-02704-4. Given the need for dermatologist input in this area, we sought to delineate what knowledge dermatologists would recommend for the training of dermatology-specialized PAs. [Extracted from the article]

Introduction: Approximately one-third of psoriasis cases present in the first two decades of life. Many psoriasis treatments are approved by the U.S. Food and Drug Administration (FDA) for adults, including topical agents, systemic non-biologic agents, and systemic biologic agents. Only a handful of psoriasis treatments are FDA approved for children. Given the constantly evolving landscape of pediatric psoriasis management, our aim is to characterize how children with psoriasis are treated in the U.S. Methods: Data from the 2003–2016 and 2018 National Ambulatory Medical Care Survey (NAMCS) were used to evaluate patient demographics and treatment patterns for visits of children with psoriasis. Visits were stratified by those with a diagnosis of psoriasis and those for children with a diagnosis of psoriasis. Separate analyses for visits of children with a diagnosis of psoriasis were performed, including for sex, race, ethnicity, age, specialty of provider seen, and medications prescribed. Results: Pediatric psoriasis visits accounted for 3.3% of visits with psoriasis from 2003 to 2016 and in 2018; about one-third of those visits were to primary care providers. Children with psoriasis were prescribed a variety of topical and systemic medications, of which the most frequently prescribed treatments were topical tacrolimus, followed by topical clobetasol and topical betamethasone dipropionate or betamethasone valerate. Etanercept was the only biologic prescribed to children. At least 59% of the visits for children with a diagnosis of psoriasis included a topical prescription while at least 5.3% of the visits included a systemic prescription. Conclusion: Use of off-label treatments was common for pediatric psoriasis. Most children with psoriasis were treated with topicals, of which tacrolimus, an unapproved treatment, was the most common. The frequent use of tacrolimus could indicate an avoidance of corticosteroids in children. [ABSTRACT FROM AUTHOR]

Background: Atopic‐like dermatitis (ALD) is a common side effect of interleukin‐17A (IL‐17A) inhibitors. Objective: To determine the prevalence, risk factors, outcomes and treatment of ALD in a cohort of psoriasis patients treated with IL‐17A inhibitors. Methods: This retrospective study included 226 psoriasis patients treated with an IL‐17A inhibitor in our dermatology department between July 2020 and July 2022. The patients were reviewed over 2 years. A logistic regression model in rare events data (relogit) was used to predict the risk factors for ALD. Results: Of the 226 patients, 14 had ALD. Data including age, body mass index, IL‐17A inhibitor use, personal and family history of atopic disease, pet ownership history, and immunoglobulin E (IgE) levels were analysed using the relogit regression model. It indicated a personal history of atopic disease (odd ratio [OR] 27.830, 95% confidence interval [CI] 3.801–203.770; p = 0.001) and elevated IgE levels (OR 5.867, 95% CI 1.131–30.434; p = 0.035) as independent predictors of incident ALD. In one patient, anti‐IL‐17A therapy was discontinued, and treatment was switched to tofacitinib. Thirteen patients who continued with IL‐17A inhibitor were treated with topical therapy and/or antihistamines, and their ALD was partially or completely resolved. Conclusion: In this study, the incidence rate of ALD was 6.19%. Elevated IgE levels and a personal history of atopic disease were found to be the risk factors for ALD. Our study findings suggest that treatment should be provided based on the severity of psoriasis and incident ALD. Prior to treatment, psoriasis patients who have the risk factors for ALD should be informed of the possible development of ALD, and alternative psoriatic therapeutic options should be considered if severe ALD develops. [ABSTRACT FROM AUTHOR]