Boost your pediatric dermatology skills at symposium

Pediatrician Examining a Girl s Rash

“Advice from Experts: Improving Your Pediatric Dermatology Diagnostic and Management Skills,” (S004) will be presented from 9 a.m. to noon Saturday in Grand Ballroom West.

Children are not little adults, especially when it comes to dermatologic issues. Children present very different diagnostic and management challenges compared to adults, and different age groups present different sets of challenges. Common clinical challenges, such as patch testing, nevi, and psoriasis, can require a different approach in a 4-year-old compared to a 34-year-old.

“We want to give the general dermatologist some insight into how a pediatric dermatologist approaches common conditions in kids,” said Melinda Jen, MD, assistant professor of clinical pediatrics and dermatology at the Perelman School of Medicine and pediatric dermatologist at The Children’s Hospital of Philadelphia. “There are some common, though challenging, conditions that the general dermatologist might see in everyday practice.”

Dr. Jen is course director for a symposium, Advice from Experts, “Improving Your Pediatric Dermatology Diagnostic and Management Skills,” (S009) from 9 a.m. to noon Saturday in Grand Ballroom West. Six pediatric dermatology specialists will discuss neonatal skin disorders, pediatric patch testing, psoriasis, hair disorders, atopic dermatitis, and nevi.

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Melinda Jen, MD

“Nevi can be difficult to manage in pediatric patients,” Dr. Jen said. “Kids naturally develop new nevi, and their nevi can change over time. New and changing nevi are concerning in adults, but since they commonly happen in children, they require a different approach. I’m going to discuss some specific nevi that can be challenging, including scalp nevi and Spitz nevi.”

Biopsy considerations also are different in children, especially younger children. Adults may not like biopsies, but are more accepting of the temporary discomfort involved. Performing multiple biopsies or other procedures on a child can produce lifelong attitudes toward medical procedures that could affect their willingness to undergo other treatments later in life.

Diagnosing contact dermatitis in children can be a challenge. Work-based environmental exposures are a common factor in contact dermatitis in adults, but children don’t work. They can have far more complex lifestyle exposures than many adults.

“Allergic contact dermatitis still goes back to exposures, but children have very different exposures from adults,” Dr. Jen said. “For example, kids play sports, they play with entertainment systems, and they have school-based exposures, which expose them to a different range of allergens compared to adults. Lifestyle habits can be a complex puzzle in pediatric patients.”

Patch testing is another common procedure that should be approached differently in children. The typical adult has enough skin surface to allow for a wide range of patch tests. Because children are physically smaller, they have less skin surface.

“A child has much less real estate for you to work with,” Dr. Jen said. “You have to make some thoughtful decisions about what patches you are going to put on them and where you can fit it on their bodies. You have to have an idea of what kinds of exposures are more likely for that individual and age group in order to select allergens that are more likely to be fruitful in patch testing.”

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