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Pediatric Dermatology

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Schools, sports programs, and day care centers provide ideal "breeding grounds" for methicillin-resistant Staphylococcus aureus infections. Any suspicious lesion should be cultured early. Comprehensive education is needed to minimize risk of transmission and to quell hysteria.

San Francisco - New research suggests that rapid growth of infantile hemangiomas requires close observation in the first months of life, and that any treatment should be undertaken promptly, Reuters Health reports.

Have you ever met anybody who is plugged in and tuned out? How about the acne patient who is listening to an ipod when you enter the room and continues to listen despite your greeting? How about the acne patient and their parent who are both listening to their own separate ipods and continuing to listen despite your greeting? What should you do?

A phase 3 double-blind, placebo-controlled study shows remarkable efficacy of etanercept for treating pediatric psoriasis, bettering even those results observed in adults. The findings could help pave the way for Food and Drug Administration approval of the biologic, which could change the face of systemic treatment of psoriasis in children.

Psoriasis has a stronger genetic component when it presents in childhood than when it presents in adulthood. In children, scalp involvement is very common if they present with psoriasis. In addition, presentation in childhood is correlated with a greater tendency for more severe psoriasis over one's lifetime.

Some current therapies of psoriasis, though effective, are marred by their poor safety profile. A new experimental drug, similar in molecular structure to cyclosporine, has been shown to be safe and effective in the treatment of moderate to severe chronic plaque psoriasis.

New research indicates that etanercept, a systemic agent, holds promise of treating moderate-to-severe psoriasis in the pediatric population and is a safe option. Clinicians currently use various off-label therapies to treat psoriasis in children and teens, including methotrexate and retinoids. One of the positive outcomes of the study was that patients did not develop a tolerance to therapy. In addition, patients who had been on placebo in the initial phase of the research did improve when they were retreated in an open-label phase of the study with etanercept. Extended follow-up of patients will establish if the therapy is safe for patients to take over the long term.

In the late 1990s and early 2000s, a good deal of media attention focused on the rising number of cosmetic-surgery procedures performed on teenagers. In 2004, for example, ABC News reported that plastic surgery on teens was on a significant rise-particularly breast augmentation, which ABC reported was up 24 percent.

The training's tough, hours can be long, and the pay ... not usually as high as what other dermatologic subspecialists make; still, pediatric dermatologists contend that the career offers doctors challenging options in dermatology and the chance to impact children's quality of life.

Pediatric scar treatments

EAST POINT, Georgia – According to the literature, new treatments for keloids and hypertrophic scars include intralesional interferon, 5-FU, doxorubicin, bleomycin, verapamil, retinoic acid, imiquimod 5 percent cream, tacrolimus, tamoxifen, botulinum toxin, TGF-beta3 and rhIL-10. Unfortunately, none of these treatments have been proven to be safe in the pediatric population. A growing body of evidence suggests, however, that imiquimod 5 percent cream is an effective and appropriate treatment for hypertrophic scars and keloids after surgery or trauma in pediatric patients.

Systemic corticosteroids ormedical intervention is indicated for hemangiomas of infancy. Recenliterature reports describe favorable experience with off-label use of imiquimod cream 5 percent (Aldara, Graceway), becaplermin gel 0.01percent (Regranex, Ortho-McNeil) and vincristine.

A retrospective, longitudinal cohort study was undertaken to analyze the effects of the FDA advisory on off-label topical calcineurin inhibitor (TCI) treatment practice patterns for infants with atopic dermatitis (<2 years of age). The results show a reduction in overall utilization of AD-related medications and reduced utilization of TCIs coupled with early introduction of topical corticosteroid treatment after the advisory compared to the period preceding the advisory.

Vascular laser surgery for port wine stains has led the way in pediatric dermatology surgery and can significantly improve the condition. The period from six to 18 months offers a good window for treatment.

The standard treatment for uncomplicated infantile hemangiomas continues to be active nonintervention, but researchers are making headway in offering faster options than the watch-and-wait approach.

Techniques for tots

Achieving good cosmetic surgical outcomes in children can be challenging, as issues of compliance play a pivotal role in maximizing outcomes. According to one specialist, success hinges on following some tricks of the pediatric trade.

Studies to date have revealed interesting findings in the structure aInd function of healthy infant skin and how those features change during infancy. This research may lead to the development of better infant skincare products.