Research studies effects of skin diseases in children

Michael J. Cork, MD, PhD, discussed the use of dupilumab in pediatric patients.

Studies regarding the development of skin diseases and the care of skin conditions in children were presented Saturday during “Late-Breaking Research: Clinical Studies/Pediatric” (F072).

Vascular birthmarks linked to pathway mutations
Vascular birthmarks are caused by post-zygotic, somatic activating mutations in cell signaling pathways, according to “The Birthmark-Cancer Connection: Unraveling the Complex Genetic Spectrum of Vascular Birthmarks Through Cancer Genomic,” Abstract 5126.

Dermatologists often see children for evaluation of vascular birthmarks. These disorders are heterogeneous, ranging from simple staining of the skin to debilitating skeletal overgrowth and abnormalities of the brain and eye. Despite these severe complications, clinicians lack guidelines for screening, and there are no FDA-approved drugs to treat the complications.

The study identified eight somatic variants described in the setting of cancer, but novel in vascular birthmarks. Researchers used somatic variant detection technology that is also used in diagnostic cancer genomics to reach their conclusion.

Improved understanding of the genetic underpinnings of vascular birthmarks will guide diagnostic algorithms and ultimately move the field beyond antiquated diagnostic classifications to a pragmatic genotype-based therapeutic focus, concluded presenter Beth Drolet, MD, professor of dermatology and pediatrics at the Medical College of Wisconsin.

Dupilumab found to be safe for children
The biologic drug dupilumab is as safe and efficacious for children as it is for adults, according to “Pharmacokinetics, Safety, and Efficacy of Dupilumab in a Pediatric Population With Moderate-to-Severe Atopic Dermatitis: Results From an Open-Label Phase 2a Trial,” Abstract 5279.

The non-linear pharmacokinetic profile of dupilumab was consistent with adults, said presenter Michael J. Cork, MD, PhD, a pediatric dermatologist at Children’s Hospital, Sheffield in the United Kingdom. Data from adult trials confirm the significant clinical benefit for the Th2-mediated pathophysiology for atopic dermatitis in children.

Skin care treatment varies among races, ethnicities
Abstract 5293 explored the differences among children of different ethnicities and races in the treatment of their skin disease, independent of skin disease severity.

“Racial/Ethnic Disparities in Healthcare Utilization and School Attendance Among Children With Atopic Dermatitis: A Cross-Sectional Analysis of the Pediatric Eczema Elective Registry,” was presented by lead author Junko Takeshita, MD, PhD, MSCE. She is an assistant professor of dermatology and epidemiology at Perelman School of Medicine at the University of Pennsylvania.

New research data shows potential racial/ethnic disparities in health care utilization and school attendance among children with atopic dermatitis. Compared to white children, African-American and Hispanic children were more likely to have visited the emergency room and less likely to have seen a dermatologist for their skin disease. In addition, African-American, Hispanic, and Asian children were more likely to have missed school due to their skin disease, independent of disease severity, according to the abstract.

Skin microbiota of infants evolves after birth
Skin microbiota evolved to an infant-like skin microbial profile within the first week of life through the use of a skin regimen, according to Abstract 5324, “Longitudinal Development of the Skin Microbiome During the Neonatal Period.”

“Previously, we demonstrated that after one month, the skin microbiota has evolved from birth, where it’s dominated by vaginal and/or environmentally acquired microbes, to an infant skin microbial profile. Changes in the skin microbiota throughout the neonatal period (first month) have not been well described and may provide insights into the links between establishment of skin microbiota in early life and disease,” according to the abstract.

The microbiota is dominated by 75 percent Staphylococcus and Streptococcus species, in contrast to infants older than one month, where 50 percent of the skin microbiota consists of those species. The skin microbiota changes over the neonatal period, largely through increased evenness, and represents an early view of the evolution of the skin microbiome, according to the abstract.

The lead author of the abstract is Kimberly Capone, PhD, head of the Microbiome Platform, Emerging Science and Innovation at Johnson & Johnson Consumer Inc.

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