Pediatric Dermatology Update: 2022’s Top Studies

James Treat, MD, dives into pediatric patients dealing with alopecia areata, sleep issues in children with atopic dermatitis, and more.

Maui Derm’s NP+PA Summer 2022 Conference began with clinical updates on top articles from this year’s literature to provide advanced insights, including updates on pediatric dermatology. Sharing his expertise was James Treat, MD, professor of clinical pediatrics and dermatology and education director, pediatric dermatology at Children's Hospital of Philadelphia, the HUB for Clinical Collaboration in Pennsylvania.1 Treat works collaboratively with patients and their families to ease anxieties and find the most effective treatment plan.2

Treat discussed the study “Parent report of sleep health and attention regulation in cross-sectional studies of infants and preschool-aged children with atopic dermatitis,” which examined sleep and attention problems in young children with atopic dermatitis (AD) and identify modifiable factors.3 The cross-sectional study of children with AD aged 1 to 4 years, categorized patients by their Patient-Oriented Eczema Measure (POEM) score, age, and racial/ethnic groups.

It also included surveys that assessed attention (Multidimensional Assessment Profile of Attention Regulation), sleep, and itch (Patient-Reported Outcomes Measurement Information System).3 Linear regression models identified predictors of sleep health and attention dysregulation, according to the study article. It was revealed that 86% of children (n=60) with moderate to severe AD suffer from significant sleep disturbances, and 50% of the children had more than 5 nights of disturbed sleep.1

“Atopic dermatitis makes a huge difference for families. Next time you see someone with really severe atopic dermatitis, think to yourself, how is the family structure going?” Treat explained that co-sleeping with parents increases among children with severe AD, as well as symptoms of anxiety, depression, and ADHD. He also emphasized the importance of treating young children with AD to help mitigate these family stressors.

Next, Treat examined the study “Oral tofacitinib for the treatment of alopecia areata in pediatric patients.” Oral tofacitinib (Xeljanz), a Janise kinase (JAK) inhibitor, has shown promising results in the treatment of alopecia areata (AA) in adults, but there are fewer studies on the clinical efficacy and tolerability among pediatric patients with AA, according to Treat. The study was a retrospective case series conducted at the University of Colorado Hospital Dermatology Clinic. It aimed to determine the clinical outcomes of pediatric AA patients treated with oral tofacitinib.4 Out of 11 patients, 73% saw hair regrowth and 27% had minimal to no hair regrowth.1

“Alopecia areata is another disease which is really life-changing for people,” Treat said. He explained that young children that suffer from AA and begin to lose their hair during their formative years of middle school are faced with unimaginable challenges.

References

  1. Rosen T, Treat J, Zirwas M. Dermatology update 2022. Presented at Maui Derm NP+PA. Held June 23-25, 2022, Colorado Springs, Colorado, and virtual.
  2. Philadelphia TCH of. James R. Treat, md. Published August 24, 2014. Accessed June 23, 2022. https://www.chop.edu/doctors/treat-james-r
  3. Zhou NY, Nili A, Blackwell CK, et al. Parent report of sleep health and attention regulation in a cross‐sectional study of infants and preschool‐aged children with atopic dermatitis. Pediatric Dermatology. 2022;39(1):61-68. doi:10.1111/pde.14889
  4. Kibbie J, Kines K, Norris D, Dunnick CA. Oral tofacitinib for the treatment of alopecia areata in pediatric patients. Pediatric Dermatology. 2022;39(1):31-34. doi:10.1111/pde.14855