Pediatric atopic dermatitis and malignant melanoma top “what’s new”

On Tuesday, March 5, “What’s New in Dermatology” (S066) wrapped up the final day of the AAD Annual Meeting with a focus on looking ahead. A panel of presenters covered new technologies to assess prognosis in malignant melanoma, reviewed clinical presentations and tests to identify various infection diseases, explored techniques in dermatologic surgery and cosmetic dermatology, unveiled new developments in pediatric dermatology, and discussed new psoriasis therapies, including topical and vaccine treatments.

Lawrence F. Eichenfield, MD

Lawrence F. Eichenfield, MD, a professor of pediatric dermatology at the University of California San Diego, addressed a range of challenges in pediatric dermatitis, beginning with a look at the revolution of therapy happening in pediatric atopic dermatitis, and updates on the treatment of hemangiomas.

Addressing atopic dermatitis, Dr. Eichenfield said “diagnosis and recognition will allow us to intervene more effectively.” Additionally, he noted that new guidelines push early diagnosis and determination of the need for intervention for hemangioma. “This will force practitioners across the spectrum of care to adapt. Pediatricians should refer patients early. Dermatologists should make sure that significant hemangiomas get into the office quickly!”

New therapies and a warning

According to Dr. Eichenfield, studies of dupilumab conducted in 12- to 17-year-old patients demonstrated efficacy and safety. This is similar to adult trials, setting the stage for FDA approval for adolescents with moderate to severe atopic dermatitis.

Evolving algorithms and consensus statements incorporating newly approved medications in management methodologies for atopic dermatitis continue to roll out, he said. Meanwhile, new topical and systemic drugs are in the works, including microbiome-based bacterial probiotic transplants to impact microbiology of atopic dermatitis skin and mediate disease.

During the session, Dr. Eichenfield addressed specific genetic conditions that can present as atopic dermatitis and psoriasis. He also warned of a unique condition related to a common childhood activity.

“I am hopeful that attendees will have an improved ability to recognize slime-associated dermatitis (which I call ‘sad’). Cases of both irritant and contact dermatitis are being seen from children playing with ‘Slime.’ It can present as hand dermatitis,” he said.

Malignant melanoma outlook

Darrell S. Rigel, MD, expressed hope for the treatment of malignant melanoma.

“Five years ago, there was almost nothing for treating advanced malignant melanoma. Now there are some long-term survivors, especially when using new PD-1 inhibitors (immune checkpoint blockade therapies),” Dr. Rigel said. “Genomics are making the biggest difference.”

Dr. Rigel emphasized the importance of improving the assessment of prognosis in order to offer more appropriate and effective patient management in the disease.

What’s the best new therapy dermatologists can prescribe for melanoma?

“Early detection with removal,” he said, adding that new devices are being developed and validated to help with this.