Whole-Patient Care in Pediatric Dermatology: Lessons From SPD 2026

The Society for Pediatric Dermatology (SPD) 2026 Annual Meeting, held in Minneapolis, Minnesota, from July 22 to 25, brought together pediatric dermatologists to share updates on topics such as hair care, vitiligo, atopic dermatitis, vascular anomalies, genetics, and mental health. The sessions underscored SPD 2026's broad scope, pairing molecular and therapeutic advances with an emphasis on communication, cultural competence, and whole-patient care in pediatric dermatology.

Textured Hair Care, Genetics, and Cultural Competence

Brandi Kenner-Bell, MD, FAAD, a pediatric dermatologist at Ann & Robert H. Lurie Children's Hospital of Chicago, opened her session on textured hair care by addressing the social context around curly and coily hair, including beauty standards and implicit bias, before diving into biology.

She explained that the curl pattern depends on follicle shape and disulfide bond architecture, reminding attendees that hair type is genetically fixed. "This is really important to emphasize with your patients: You cannot change the hair that God gave," she said. "You can modify it with things that probably damage it, but you can't use a product and change the nature of your hair...it's genetically predetermined."

Kenner-Bell covered cleansing frequency, deep conditioning, moisture layering methods (liquid, oil, cream vs liquid, cream, oil), and protective styling risks such as traction alopecia, urging clinicians to provide individualized, culturally informed guidance. "We've got to teach people how to start to learn to love their hair, to live with their hair, to work with their hair," she said.

Evidence-Based Strategies and Consensus Guidelines for Vitiligo

Nanette Silverberg, MD, chief of pediatric dermatology and clinical professor of pediatrics and dermatology at the Icahn School of Medicine at Mount Sinai, presented an evidence-based framework for tailoring vitiligo treatment by disease extent and activity during the master class sessions. She emphasized facial repigmentation as a priority, noting, "It's been demonstrated that patients see the face as 8 times more consequential than other parts of the body, so we really do concentrate first on clearing the face."

Silverberg reviewed the most recent pediatric vitiligo consensus guidelines, which identify topical corticosteroids, calcineurin inhibitors, and topical ruxolitinib as first-line options for limited disease, whereas systemic steroids, minocycline, and narrowband UVB phototherapy are recommended for more extensive or rapidly progressing cases. Oral Janus kinase inhibitors remain off-label in children, though she noted approvals may be forthcoming. She also drew on data from Mount Sinai’s pediatric vitiligo registry and other upcoming research, noting that anemia, thyroid disease, and other endocrine diseases are some of the most clinically significant comorbidities in children with vitiligo.

Managing Vascular Anomalies and Pigmentary Disorders

Rounding out the master class, Sarah Chamlin, MD, attending dermatologist at the Ann & Robert H. Lurie Children’s Hospital of Chicago and professor of pediatrics and dermatology at the Northwestern University Feinberg School of Medicine, reviewed management of ulcerated infantile hemangiomas, identifying high-risk sites (diaper area, lips, neck folds) and endorsing oral propranolol as first-line therapy for accelerating healing, alongside wound care, timolol, laser, or surgery as needed.

Jonathan Dyer, MD, professor and chair of the Department of Dermatology at the University of Missouri in Columbia, then addressed café au lait macules (CALMs), reminding attendees that 6 or more CALMs is a diagnostic criterion for neurofibromatosis type 1; however, he cautioned against premature diagnosis, given overlapping conditions such as Legius syndrome. He advocated longitudinal follow-up and expanding use of molecular testing.

Addressing Mental Health and Inclusive Care in Youth

Markus Boos, MD, PhD, attending pediatric dermatologist at Seattle Children's, delivered a talk titled "Storytelling, Love, and Caring for Gender Minority Youth," emphasizing that the narratives clinicians help write in the exam room shape patient outcomes. He countered misconceptions about gender-affirming care, noting that surgeries and hormone prescriptions are rare among minors. "This narrative that people are going to their pediatrician, and there's a bowl full of estrogen and spironolactone on their way out...it's just not true," he said. Boos outlined practical steps for inclusive care, asking patients their name and pronouns, spending part of visits alone with adolescents, and training entire clinical teams—summarizing his approach simply: "The most important thing that you can do is ask."

Child and adolescent psychiatrist Monique Jericho, MD, of the University of Calgary, urged dermatologists to recognize body dysmorphic disorder (BDD) as a serious psychiatric condition rather than an ordinary appearance concern. She described BDD's intrusive, self-reinforcing obsessive-compulsive cycle and linked rising smartphone and social media use to adolescent anxiety and body image distress, positioning dermatology visits as a critical window for early recognition and mental health referral.

Emphasizing Global Outreach and Interdisciplinary Collaboration

In the Hurwitz Lecture, Mark Koh, MD, of KK Women's and Children's Hospital in Singapore, discussed advances in pediatric histiocytosis, including BRAF/MEK-targeted therapies, as well as the growing diagnostic role of dermatopathology and biopsy-based genetic testing. As secretary of the International Society of Pediatric Dermatology and president of the Asian Society of Pediatric Dermatology, Koh also highlighted efforts to expand free membership and educational outreach globally.

The theme of collaboration continued as Adnan Mir, MD, PhD, a pediatric dermatologist at Montefiore Medical Center and Albert Einstein College of Medicine and a dermatopathologist at Dermpath Diagnostics in New York, spoke to nurse practitioners and physician assistants about strengthening ties with dermatopathology labs. He emphasized the use of detailed requisition forms and open communication when biopsy results don't match clinical impressions. "We're a team when we are working on a patient together…. If things don't make sense, I need to hear about it, because I may not have the whole picture just based on what's written on the requisition form. It's as simple as sending an email or calling," he said.

References

1. Silverberg JI, et al. Recommendations for the management of vitiligo in pediatric, adolescent, and young adult patients. JAMA Dermatol. 2024;160(4):453-461.
2. Krowchuk DP, Frieden IJ, Mancini AJ, et al. Clinical practice guideline for the management of infantile hemangiomas. Pediatrics. 2019;143(1):e20183475. doi:10.1542/peds.2018-3475. PubMed