Clinical Updates on Pediatric Dermatology

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: closed (15 February 2024) | Viewed by 4094

Special Issue Editors


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Guest Editor
1. Head, Pediatric Dermatology Service, Soroka University Medical Center, Beer Sheva, Israel
2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
Interests: atopic dermatitis; hemangioma; leishmaniasis; acne; hidradenitis supporativa; prurigo nodularis

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Guest Editor
Pediatric Dermatology Sevice, Department of Dermatology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
Interests: genodermatoses; atopic dermatitis; prurigo nodularis; cutaneous graft versus host disease; acne

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Guest Editor
1. Department of Dermatology, Pediatric Dermatology Service, Sheba Medical Center, Ramat Gan, Israel
2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Interests: atopic dermatitis; psoriasis; alopecia areata; immunodeficiencies; genodermatosis

Special Issue Information

Dear Colleagues,

Advancements in technology and research have continued to shape the field of pediatric dermatology in recent years. The development of new treatments and diagnostic tools, mainly advances in genetic and molecular testing, has improved our understanding of the pathophysiology of pediatric skin diseases and opened up new avenues for novel therapies. The scope of this Special Issue is to provide an overview of recent advances in pediatric dermatology and to provide a platform for researchers and clinicians to share their ongoing research by publishing high-quality manuscripts. The ultimate goal is to extend our understanding of pediatric skin diseases and improve clinical practice. Therefore, researchers in the field of pediatric dermatology are encouraged to submit an original article or review to this Special Issue (case reports and short reviews will not be accepted).

Dr. Amir Horev
Dr. Vered Molho-Pessach
Dr. Ayelet Ollech
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric dermatology
  • screening
  • prevention
  • management
  • biomarkers
  • genetics
  • atopic dermatitis

Published Papers (4 papers)

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Research

12 pages, 502 KiB  
Article
Dermatologic Effects of Selumetinib in Pediatric Patients with Neurofibromatosis Type 1: Clinical Challenges and Therapeutic Management
by Paola Borgia, Gianluca Piccolo, Andrea Santangelo, Cristina Chelleri, Gianmaria Viglizzo, Corrado Occella, Carlo Minetti, Pasquale Striano and Maria Cristina Diana
J. Clin. Med. 2024, 13(6), 1792; https://doi.org/10.3390/jcm13061792 - 20 Mar 2024
Viewed by 617
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Clinical Updates on Pediatric Dermatology)
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10 pages, 1256 KiB  
Article
Trends of Diagnosis, Disease Course, and Treatment of Atopic Dermatitis 2012–2021: Real-World Data from a Large Healthcare Provider
by Clara Weil, Roni Adiri, Gabriel Chodick, Merril Gersten and Eran Cohen Barak
J. Clin. Med. 2024, 13(1), 281; https://doi.org/10.3390/jcm13010281 - 04 Jan 2024
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Abstract
In the last decade, new treatments for atopic dermatitis (AD) have emerged. We aimed to describe trends of the diagnosis, disease course, and treatment of AD over a decade (2012–2021) using data from Maccabi Healthcare Services (a 2.7-million-member healthcare provider in Israel). The [...] Read more.
In the last decade, new treatments for atopic dermatitis (AD) have emerged. We aimed to describe trends of the diagnosis, disease course, and treatment of AD over a decade (2012–2021) using data from Maccabi Healthcare Services (a 2.7-million-member healthcare provider in Israel). The AD prevalence was stable (4.0% on 31 December 2021 vs. 4.3% on 31 December 2012). The annual AD incidence was also stable (5.8/1000 in 2012 and 5.7/1000 in 2021). AD-related treatment use was highest in the first year post-diagnosis, and it included, among children (n = 87,414) vs. adults (n = 36,865), low-potency topical corticosteroids (TCS) (41.8% vs. 27.1%), mid-potency TCS (30.1% vs. 28.1%), high-potency TCS (34.9% vs. 60.3%), topical calcineurin inhibitor (10.8% vs. 10.1%), phosphodiesterase-4-inhibitor (0.3% vs. 0.7% overall; approved in 2019), phototherapy (0.1% vs. 2.3%), and systemic/biologic treatments (13.0% vs. 13.3%). Among children diagnosed in 2012 and followed through to 2021 (n = 5248), 21.5% had ≥1 AD diagnosis/treatment 10 years later (among 3223 adults: 38.3%). We conclude that the incidence and prevalence rates of AD were comparable to those in similar database studies and remained relatively stable over the past decade. The results underscore the burden of medication use among children and adults, particularly in the first year after AD diagnosis, and the low rate of AD diagnosis among patients originally diagnosed as children 10 years earlier. Full article
(This article belongs to the Special Issue Clinical Updates on Pediatric Dermatology)
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10 pages, 259 KiB  
Article
Epidemiological and Clinical Characteristics of Adult and Pediatric Patients with Chronic Spontaneous Urticaria
by Aviv Barzilai, Alona Baum, Moshe Ben-Shoshan, Ido Tzanani, Reman Hakroush, Dan Coster, Michal Solomon and Shoshana Greenberger
J. Clin. Med. 2023, 12(23), 7482; https://doi.org/10.3390/jcm12237482 - 03 Dec 2023
Viewed by 1075
Abstract
Chronic spontaneous urticaria (CSU) is when lesions occur for ≥6 weeks. However, its underlying mechanism remains unclear. CSU prevalence is similar in adult and pediatric patients; nevertheless, few data are available on CSU characteristics in pediatric patients. We aimed to describe the epidemiology, [...] Read more.
Chronic spontaneous urticaria (CSU) is when lesions occur for ≥6 weeks. However, its underlying mechanism remains unclear. CSU prevalence is similar in adult and pediatric patients; nevertheless, few data are available on CSU characteristics in pediatric patients. We aimed to describe the epidemiology, clinical features, and treatment approach of CSU in pediatrics and adults. In this cross-sectional study, 193 patients with CSU were treated at the Sheba Medical Center, Israel, in 2009–2022. The information collected includes age at diagnosis, reported triggers, atopic co-morbidities, autoimmune co-morbidities, treatments and their response, family background, laboratory tests, and follow-up duration. The study group was divided into pediatrics (aged ≤ 18) and adults. Metabolic syndrome was most prevalent in adults as against atopy in pediatrics. Autoimmune co-morbidities were observed in 34.7% and 34.8% of adults and pediatrics, respectively. Inflammatory bowel disease and thyroid disease were the most common in pediatrics and adults, respectively. Systemic treatments other than antihistamines were administered more frequently in adults. Adults with autoimmune disease required second-line treatment with immunomodulators compared to those without it. Co-morbidities were more common in adults than in pediatrics. Patients with autoimmune co-morbidities may be more challenging to manage; thus, escalation to biologics should be considered soon. Full article
(This article belongs to the Special Issue Clinical Updates on Pediatric Dermatology)
9 pages, 862 KiB  
Article
Treatment with Methotrexate in Infants and Toddlers with Atopic Dermatitis: A Retrospective Multi-Center Study
by Jen A. Barak Levitt, Sima Alemi, Ayelet Ollech, Shiran Reiss-Huss, Mohammad Sah, Yael Renert-Yuval, Rivka Friedland, Shoshana Greenberger and Eran Cohen Barak
J. Clin. Med. 2023, 12(16), 5409; https://doi.org/10.3390/jcm12165409 - 20 Aug 2023
Cited by 2 | Viewed by 1021
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting up to 20% of children. Methotrexate (MTX) is used off-label as a systemic treatment for AD patients unresponsive to topical therapies, but limited data exist regarding its safety and efficacy in children, especially [...] Read more.
Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting up to 20% of children. Methotrexate (MTX) is used off-label as a systemic treatment for AD patients unresponsive to topical therapies, but limited data exist regarding its safety and efficacy in children, especially in those < 4 years old. To further investigate MTX in younger patients, we screened the medical records of three referral centers between 2016 and 2022 and identified 28 infants and toddlers < 4 years old with AD treated with MTX. Mean age upon MTX initiation was 2.7 ± 1.2 years and mean investigator global assessment (IGA) score was 3.78 ± 0.4. Median duration of MTX treatment was five months. Following 12 and 24 weeks of MTX treatment, the response rate was 50% and IGA 0/1 was achieved in 14.2% and 21.4% of patients, respectively. Most treatment cessations were attributed to a lack of efficacy or parental concern. Although adverse events were reported in 57.1% of patients, MTX was discontinued due to such adverse events only in two patients (7.1%). Taken together, MTX demonstrated a high safety profile in AD patients <4 years old. MTX efficacy was moderate and presumably underestimated by parents who opted for premature treatment cessation due to concerns associated with an immunomodulatory drug. Full article
(This article belongs to the Special Issue Clinical Updates on Pediatric Dermatology)
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