Pediatric Dermatology, Part II: More Hot Topics in Pediatric Dermatology Nanette Silverberg MD PII: DOI: Reference:
S0738-081X(14)00301-0 doi: 10.1016/j.clindermatol.2014.12.002 CID 6917
To appear in:
Clinics in Dermatology
Please cite this article as: Silverberg Nanette, Pediatric Dermatology, Part II: More Hot Topics in Pediatric Dermatology, Clinics in Dermatology (2014), doi: 10.1016/j.clindermatol.2014.12.002
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
T
Pediatric Dermatology, Part II: More Hot Topics in Pediatric Dermatology
SC
RI P
Nanette Silverberg, MD
NU
Nanette Silverberg, MD Director, Pediatric Dermatology
ED
Clinical Professor of Dermatology
MA
St. Luke’s-Roosevelt Hospital Center and Beth Israel Medical Centers
PT
Icahn School of Medicine at Mt. Sinai
CE
1090 Amsterdam Avenue, Suite 11D
AC
New York, NY 10025 (212) 523-6003
Fax (212) 523-5027 [email protected]
ACCEPTED MANUSCRIPT The expansion of the field of pediatric dermatology has created an expansion in publications and understanding of dermatologic diseases in childhood. Pediatric dermatology is a small but
T
vibrant subspecialty in the United States, with the first pediatric dermatology board having been
RI P
offered to eligible dermatologists with pediatrics/ pediatric dermatology training since 2004, with 232 individuals nationwide (as of September 8, 2014) having become board certified by the
SC
American Board of Dermatology since that time With the ten year span since the first board
NU
examination, initially board certified pediatric dermatologists are now completing the ten year cycle of the Maintenance of Certification program. Due to the small size of the field, the majority
MA
of children are seen in general dermatology practices. Therefore, reviews on core issues of
ED
pediatric skin care are vital adjuncts to the dermatologist at large.
PT
The recent expansion of the field of pediatric dermatology also fosters more focused pediatric
CE
dermatologic education in residency programs. A recent survey of dermatology residents has shown that pediatric dermatology fellowship training improves learning and satisfaction with
AC
pediatric dermatology learning opportunities.1 There are 31 pediatric dermatology fellowship, which began participation with the match program in 2009, that are approved by the American Board of Dermatology (as of September 8, 2014) and for the 2014 year 21 fellows trained nationwide up from 13 in 2009. The presence of pediatric dermatology fellowship training has allowed the specialty to expand rapidly, with numbers expanding in the Society for Pediatric Dermatology (SPD)from about 500 in 2004 to about 1,100 in 2014. The expansion of the SPD has created a new emphasis on publication and collaborative research in pediatric dermatology, as evidenced in this second special issue on Pediatric Dermatology.
ACCEPTED MANUSCRIPT
In the first issue on Pediatric Dermatology, a variety of important pediatric dermatology topics
RI P
T
were reviewed including the changing landscape of vitiligo2, recent trends in drug reactions of childhood3, the use of oral contraceptives in the care of female adolescents with acne, 4 the new
SC
topic of auto-inflammatory syndromes,5 diaper dermatitis trends in the United States,6 and in
NU
depth reviews of the current management of infantile hemangiomas.7 8 Overview
MA
Part II highlights many of the advances that have come about in the understanding of pediatric dermatology through collaborative research and expanded efforts to publish within this
ED
fascinating field. Several areas that reflect the expansion of pediatric dermatology are
PT
reviewed in this issue; these include a better understanding of the epidemiology (atopic dermatitis) and comorbidities (psoriasis) of common childhood skin diseases, therapeutics of
CE
severe skin disease (atopic dermatitis and alopecia areata), better molecular understanding of
AC
pigmentary alterations of childhood (nevi and pigmentary syndromes), recently reported trends in pediatric infectious diseases including newer disease manifestations (atypical hand foot mouth disease) and a better overview of the pharmacotherapy of infectious diseases (onychomycosis and lice), adverse cutaneous reactions to vaccines, allergic contact dermatitis (nickel), ultraviolet light and it’s risks (indoor tanning legislation and the skin cancer epidemic in Hispanics) and a review of the ancient texts on an old but persistent foe, i.e. cradle cap. Highlights This issue reviews vexing issues in cutaneous inflammatory disorders of childhood. Visscher provides a rare and comprehensive review of infantile skin development which is an important
ACCEPTED MANUSCRIPT reference in infantile skin care. 9 In the field of atopic dermatitis Garg and Silverberg review the epidemiology of atopic dermatitis, highlighting the important recent trend in the literature that
T
supports atopic dermatitis as a systemic inflammatory illness with cutaneous features. Given the
RI P
number of cases of atopic dermatitis seen by dermatologists and pediatric dermatologists, this will be an invaluable contribution for practitioners.10 Slater and Morrell provide a beautiful
SC
overview of the systemic therapeutic options for patients with severe atopic dermatitis,
NU
highlighting the fact that severe cases need to be addressed based on reduction of systemic
MA
inflammation. 11
Bunata et al offer a review of the usage of squaric acid for alopecia areata of childhood,12 while
ED
Gutmark-Little and Shah provide a careful and thorough review of the role of obesity in pediatric psoriasis. This will be the definitive reference on this topic. 13
PT
Sheinfeld examines in detail prepubertal hidradenitis suppurativa14 while Tuchman et al review
CE
the ubiquitous entity of nickel contact dermatitis, addressing current trends of this cutaneous
AC
allergy, including the role of systemic exposure in severe disease. 15 Other sensitivities discussed include the presentation by Rosenblatt and Stein on adverse cutaneous reactions to vaccines, an important topic for both pediatric practitioners and pediatric dermatologists. 16 Feldstein et al address the current therapeutic landscape of pediatric onychomycosis, an increasingly common entity in clinical practice. 17Ventarola et al look at the fascinating manifold presentations of hand foot mouth disease seen with a focus on the recent Coxsackie serotype A6 trend.18 Wadowski et al provide a comprehensive overview of lice, an old foe with a new “pharmamentarium” of therapeutic options.19 Thambyayah etal also address an old foe, seborrheic dermatitis or cradle cap of infancy, providing the first English translation and review
ACCEPTED MANUSCRIPT of the ancient Siddha text on the topic and proving that pediatric skin disease has vexed people for centuries. 20
RI P
T
Genetic alterations in key regulatory genes of pigmentation can result in either genetic syndromes with pigmentary alteration or melanocytic lesions, such as nevi or melanoma.
SC
Treadwell highlights well known pigmentary syndromes and our improved understanding of the
NU
genetic basis of these diseases. 21
The trend towards increased cases of pediatric melanoma is alarming in the United States, with a
MA
2% increase per annum from 1973-2009.22 Schaffer reviews the current literature on pediatric nevi and highlights current standard of care and how to identify suspicious lesions and at risk
ED
children over normal maturational changes. This is an excellent reference work for clinical practice.23 Pan et al review the legislation surrounding youth access to tanning beds, a known
CE
PT
carcinogen that can promote melanoma risk24 Conclusions
AC
This issue should be comprehensive and enjoyable to the reader looking for new and informative pediatric dermatology literature. The contributions herein and in the last issue create a comprehensive overview of new trends and hot topics in pediatric dermatology. These reviews should provide a solid foundation for new trends in epidemiology, newer or recently emerging entities, expanded recommendations for screening and a greater understanding of common and not so common conditions for practitioners caring for children in their dermatology practice.
1
Nijhawan RI, Mazza JM, Silverberg NB. Pediatric dermatology training survey of United
States dermatology residency programs. Pediatr Dermatol. 2014;31:131-137.
ACCEPTED MANUSCRIPT
Silverberg NB. Recent advances in childhood vitiligo. Clin Dermatol. 2014;32:524-530.
3
Song JE, Sidbury R. An update on pediatric cutaneous drug eruptions. Clin Dermatol.
T
2
RI P
2014;32:516-523.
Lam C, Zaenglein AL. Contraceptive use in acne. Clin Dermatol. 2014;32:502-515.
5
Dávila-Seijo P, Hernández-Martín A, Torrelo A. Autoinflammatory syndromes for the
dermatologist. Clin Dermatol. 2014;32:488-501.
Klunk C, Domingues E, Wiss K.An update on diaper dermatitis. Clin Dermatol. 2014;32:477-
NU
6
SC
4
MA
487.
Gontijo B. Complications of infantile hemangiomas.Clin Dermatol. 2014; 32:471-6.
8
Blei F, Guarini A. Current workup and therapy of infantile hemangiomas. Clin Dermatol. 2014
ED
7
;32:459-470.
Visscher MO, Adan R, Brink S, Odio M. Newborn Infant Skin: Physiology, Development and
PT
9
Garg N, Silverberg JI. New developments in the epidemiology of childhood atopic dermatitis.
Clin Dermatol 11
AC
10
CE
Care. Clin Dermatol.
Slater NA, Morrell D. An Updated Review of Systemic Therapy for Pediatric Atopic
Dermatitis. Clin Dermatol 12
Bunata K, Hill ND, Hebert AA. Treatment of alopecia areata with squaric acid dibutylester.
Clin Dermatol 13
Gutmark-Little I, Shah KN. Obesity and Metabolic Syndrome in Pediatric Psoriasis. Clin
Dermatol
ACCEPTED MANUSCRIPT
14
Scheinfeld N. Hidradenitis Suppurativa in Pre-Pubescent and Pubescent Children. Clin
Tuchman M, Silverberg JI, Jacob SE, Silverberg NB. Nickel Contact Dermatitis in Children.
RI P
15
T
Dermatol.
Clin Dermatol
Rosenblatt AE, Stein SL. Cutaneous reactions to vaccinations. Clin Dermatol.
17
Feldstein S, Totri C, Fallon Friedlander S. Antifungal therapy for onychomycosis in children.
NU
SC
16
MA
Clin Dermatol.
Ventarola D, Bordone L, Silverberg NB. Update on Hand Foot Mouth Disease. Clin Dermatol.
19
Wadowski L, Balasuriya L, Price HN, O’Haver J. Lice Update: New solutions to an old
ED
18
Thambyayah M, Silverberg NB, Amuthan A. Infantile Seborrheic Dermatitis: A Paediatric
CE
20
PT
problem. Clin Dermatol.
Siddha Medicine treatise
Treadwell PA. Systemic conditions in children associated with pigmentary changes. Clin
Dermatol. 22
AC
21
Wong JR, Harris JK, Rodriguez-Galindo C, Johnson KJ. Incidence of childhood and
adolescent melanoma in the United States: 1973-2009. Pediatrics. 2013;131:846-584. doi: 10.1542/peds.2012-2520. Epub 2013 Apr 15.
23
Schaffer J. Melanocytic nevi in children. Clin Dermatol.
24
Pan M, Geller L. Update on Indoor Tanning Legislation in the United States. Clin Dermatol.
S0738-081X(14)00301-0 doi: 10.1016/j.clindermatol.2014.12.002 CID 6917
To appear in:
Clinics in Dermatology
Please cite this article as: Silverberg Nanette, Pediatric Dermatology, Part II: More Hot Topics in Pediatric Dermatology, Clinics in Dermatology (2014), doi: 10.1016/j.clindermatol.2014.12.002
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
T
Pediatric Dermatology, Part II: More Hot Topics in Pediatric Dermatology
SC
RI P
Nanette Silverberg, MD
NU
Nanette Silverberg, MD Director, Pediatric Dermatology
ED
Clinical Professor of Dermatology
MA
St. Luke’s-Roosevelt Hospital Center and Beth Israel Medical Centers
PT
Icahn School of Medicine at Mt. Sinai
CE
1090 Amsterdam Avenue, Suite 11D
AC
New York, NY 10025 (212) 523-6003
Fax (212) 523-5027 [email protected]
ACCEPTED MANUSCRIPT The expansion of the field of pediatric dermatology has created an expansion in publications and understanding of dermatologic diseases in childhood. Pediatric dermatology is a small but
T
vibrant subspecialty in the United States, with the first pediatric dermatology board having been
RI P
offered to eligible dermatologists with pediatrics/ pediatric dermatology training since 2004, with 232 individuals nationwide (as of September 8, 2014) having become board certified by the
SC
American Board of Dermatology since that time With the ten year span since the first board
NU
examination, initially board certified pediatric dermatologists are now completing the ten year cycle of the Maintenance of Certification program. Due to the small size of the field, the majority
MA
of children are seen in general dermatology practices. Therefore, reviews on core issues of
ED
pediatric skin care are vital adjuncts to the dermatologist at large.
PT
The recent expansion of the field of pediatric dermatology also fosters more focused pediatric
CE
dermatologic education in residency programs. A recent survey of dermatology residents has shown that pediatric dermatology fellowship training improves learning and satisfaction with
AC
pediatric dermatology learning opportunities.1 There are 31 pediatric dermatology fellowship, which began participation with the match program in 2009, that are approved by the American Board of Dermatology (as of September 8, 2014) and for the 2014 year 21 fellows trained nationwide up from 13 in 2009. The presence of pediatric dermatology fellowship training has allowed the specialty to expand rapidly, with numbers expanding in the Society for Pediatric Dermatology (SPD)from about 500 in 2004 to about 1,100 in 2014. The expansion of the SPD has created a new emphasis on publication and collaborative research in pediatric dermatology, as evidenced in this second special issue on Pediatric Dermatology.
ACCEPTED MANUSCRIPT
In the first issue on Pediatric Dermatology, a variety of important pediatric dermatology topics
RI P
T
were reviewed including the changing landscape of vitiligo2, recent trends in drug reactions of childhood3, the use of oral contraceptives in the care of female adolescents with acne, 4 the new
SC
topic of auto-inflammatory syndromes,5 diaper dermatitis trends in the United States,6 and in
NU
depth reviews of the current management of infantile hemangiomas.7 8 Overview
MA
Part II highlights many of the advances that have come about in the understanding of pediatric dermatology through collaborative research and expanded efforts to publish within this
ED
fascinating field. Several areas that reflect the expansion of pediatric dermatology are
PT
reviewed in this issue; these include a better understanding of the epidemiology (atopic dermatitis) and comorbidities (psoriasis) of common childhood skin diseases, therapeutics of
CE
severe skin disease (atopic dermatitis and alopecia areata), better molecular understanding of
AC
pigmentary alterations of childhood (nevi and pigmentary syndromes), recently reported trends in pediatric infectious diseases including newer disease manifestations (atypical hand foot mouth disease) and a better overview of the pharmacotherapy of infectious diseases (onychomycosis and lice), adverse cutaneous reactions to vaccines, allergic contact dermatitis (nickel), ultraviolet light and it’s risks (indoor tanning legislation and the skin cancer epidemic in Hispanics) and a review of the ancient texts on an old but persistent foe, i.e. cradle cap. Highlights This issue reviews vexing issues in cutaneous inflammatory disorders of childhood. Visscher provides a rare and comprehensive review of infantile skin development which is an important
ACCEPTED MANUSCRIPT reference in infantile skin care. 9 In the field of atopic dermatitis Garg and Silverberg review the epidemiology of atopic dermatitis, highlighting the important recent trend in the literature that
T
supports atopic dermatitis as a systemic inflammatory illness with cutaneous features. Given the
RI P
number of cases of atopic dermatitis seen by dermatologists and pediatric dermatologists, this will be an invaluable contribution for practitioners.10 Slater and Morrell provide a beautiful
SC
overview of the systemic therapeutic options for patients with severe atopic dermatitis,
NU
highlighting the fact that severe cases need to be addressed based on reduction of systemic
MA
inflammation. 11
Bunata et al offer a review of the usage of squaric acid for alopecia areata of childhood,12 while
ED
Gutmark-Little and Shah provide a careful and thorough review of the role of obesity in pediatric psoriasis. This will be the definitive reference on this topic. 13
PT
Sheinfeld examines in detail prepubertal hidradenitis suppurativa14 while Tuchman et al review
CE
the ubiquitous entity of nickel contact dermatitis, addressing current trends of this cutaneous
AC
allergy, including the role of systemic exposure in severe disease. 15 Other sensitivities discussed include the presentation by Rosenblatt and Stein on adverse cutaneous reactions to vaccines, an important topic for both pediatric practitioners and pediatric dermatologists. 16 Feldstein et al address the current therapeutic landscape of pediatric onychomycosis, an increasingly common entity in clinical practice. 17Ventarola et al look at the fascinating manifold presentations of hand foot mouth disease seen with a focus on the recent Coxsackie serotype A6 trend.18 Wadowski et al provide a comprehensive overview of lice, an old foe with a new “pharmamentarium” of therapeutic options.19 Thambyayah etal also address an old foe, seborrheic dermatitis or cradle cap of infancy, providing the first English translation and review
ACCEPTED MANUSCRIPT of the ancient Siddha text on the topic and proving that pediatric skin disease has vexed people for centuries. 20
RI P
T
Genetic alterations in key regulatory genes of pigmentation can result in either genetic syndromes with pigmentary alteration or melanocytic lesions, such as nevi or melanoma.
SC
Treadwell highlights well known pigmentary syndromes and our improved understanding of the
NU
genetic basis of these diseases. 21
The trend towards increased cases of pediatric melanoma is alarming in the United States, with a
MA
2% increase per annum from 1973-2009.22 Schaffer reviews the current literature on pediatric nevi and highlights current standard of care and how to identify suspicious lesions and at risk
ED
children over normal maturational changes. This is an excellent reference work for clinical practice.23 Pan et al review the legislation surrounding youth access to tanning beds, a known
CE
PT
carcinogen that can promote melanoma risk24 Conclusions
AC
This issue should be comprehensive and enjoyable to the reader looking for new and informative pediatric dermatology literature. The contributions herein and in the last issue create a comprehensive overview of new trends and hot topics in pediatric dermatology. These reviews should provide a solid foundation for new trends in epidemiology, newer or recently emerging entities, expanded recommendations for screening and a greater understanding of common and not so common conditions for practitioners caring for children in their dermatology practice.
1
Nijhawan RI, Mazza JM, Silverberg NB. Pediatric dermatology training survey of United
States dermatology residency programs. Pediatr Dermatol. 2014;31:131-137.
ACCEPTED MANUSCRIPT
Silverberg NB. Recent advances in childhood vitiligo. Clin Dermatol. 2014;32:524-530.
3
Song JE, Sidbury R. An update on pediatric cutaneous drug eruptions. Clin Dermatol.
T
2
RI P
2014;32:516-523.
Lam C, Zaenglein AL. Contraceptive use in acne. Clin Dermatol. 2014;32:502-515.
5
Dávila-Seijo P, Hernández-Martín A, Torrelo A. Autoinflammatory syndromes for the
dermatologist. Clin Dermatol. 2014;32:488-501.
Klunk C, Domingues E, Wiss K.An update on diaper dermatitis. Clin Dermatol. 2014;32:477-
NU
6
SC
4
MA
487.
Gontijo B. Complications of infantile hemangiomas.Clin Dermatol. 2014; 32:471-6.
8
Blei F, Guarini A. Current workup and therapy of infantile hemangiomas. Clin Dermatol. 2014
ED
7
;32:459-470.
Visscher MO, Adan R, Brink S, Odio M. Newborn Infant Skin: Physiology, Development and
PT
9
Garg N, Silverberg JI. New developments in the epidemiology of childhood atopic dermatitis.
Clin Dermatol 11
AC
10
CE
Care. Clin Dermatol.
Slater NA, Morrell D. An Updated Review of Systemic Therapy for Pediatric Atopic
Dermatitis. Clin Dermatol 12
Bunata K, Hill ND, Hebert AA. Treatment of alopecia areata with squaric acid dibutylester.
Clin Dermatol 13
Gutmark-Little I, Shah KN. Obesity and Metabolic Syndrome in Pediatric Psoriasis. Clin
Dermatol
ACCEPTED MANUSCRIPT
14
Scheinfeld N. Hidradenitis Suppurativa in Pre-Pubescent and Pubescent Children. Clin
Tuchman M, Silverberg JI, Jacob SE, Silverberg NB. Nickel Contact Dermatitis in Children.
RI P
15
T
Dermatol.
Clin Dermatol
Rosenblatt AE, Stein SL. Cutaneous reactions to vaccinations. Clin Dermatol.
17
Feldstein S, Totri C, Fallon Friedlander S. Antifungal therapy for onychomycosis in children.
NU
SC
16
MA
Clin Dermatol.
Ventarola D, Bordone L, Silverberg NB. Update on Hand Foot Mouth Disease. Clin Dermatol.
19
Wadowski L, Balasuriya L, Price HN, O’Haver J. Lice Update: New solutions to an old
ED
18
Thambyayah M, Silverberg NB, Amuthan A. Infantile Seborrheic Dermatitis: A Paediatric
CE
20
PT
problem. Clin Dermatol.
Siddha Medicine treatise
Treadwell PA. Systemic conditions in children associated with pigmentary changes. Clin
Dermatol. 22
AC
21
Wong JR, Harris JK, Rodriguez-Galindo C, Johnson KJ. Incidence of childhood and
adolescent melanoma in the United States: 1973-2009. Pediatrics. 2013;131:846-584. doi: 10.1542/peds.2012-2520. Epub 2013 Apr 15.
23
Schaffer J. Melanocytic nevi in children. Clin Dermatol.
24
Pan M, Geller L. Update on Indoor Tanning Legislation in the United States. Clin Dermatol.
