H E FSO R T review - Society for Pediatric Dermatology · The Society for Pediatric Dermatology (SPD) is the only national organization in the United States specifically dedicated

SPDreviewVolume 6, Issue 4 • Fall 2012

PEDIATRIC DERMATOLO

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THE S

OCIETY FOR

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Society for Pediatric Dermatology8365 Keystone Crossing, Suite 107

Indianapolis, IN 46240

(317) 202-0224

fax (317) 205-9481

[email protected]

www.pedsderm.net

In ThIS ISSue2012 Annual Meeting Recap & Candids ..............1-8

2012 Sponsors ..............................................................9

2012 Poster Awards ....................................................10

Presidents Message ....................................................12-13

New Members ..............................................................13

2013 Pre-AAD Agenda ...............................................14

Foundation Support ...................................................16

Literature Review .........................................................20-25

Job Opportunities .......................................................25

Visiting Lectureship Program ..................................26

25th Pre-AAD MeetingFebruary 28, 2013Miami Beach, FL

39th Annual MeetingJuly 11-14, 2013Milwaukee, WI

26th Pre-AAD MeetingMarch 20, 2014Denver, CO

40th Annual Meeting July 9-12, 2014Coeur d’Alene, ID

uPCOMInG MeeTInGS

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The SPD’s 38th Annual Meeting was held July 11-14 in charming Monterey, California. Over 350 attendees swapped blistering summer heat for cooler temperatures, coastal fog and a stun-ning seaside setting. The overarching theme for this meeting was the “Art and Science” of Pediat-ric Dermatology, and we sought to provide clini-cal and scientific updates that attendees could take home to apply to their practices. Wednesday’s Opening Reception was full of food, drink and lively conversation; new collegial ties were formed and existing ones were invigo-rated. The meeting opened Thursday with the first of 3 daily CPCs presented by the mother-daughter duo of Drs. Amy and Anita Gilliam from the Palo Alto Medical Foundation. This session was new this year, and chock-full of high yield, clinically relevant teaching points that were very well received. We think it’s a keeper! The opening morning also included an outstanding review of giant congenital nevi by Dr. Ashfaq Marghoob and an entertaining talk on Signature Nevi by Dr. Jean Bolognia. This year’s Hurwitz lecturer was Dr. Eli Sprecher from Tel Aviv Sourasky Medical Center in Israel. His first lecture, “Combing the Pathogenesis of Genetic Hair Disorders” gracefully untangled a complicated topic. The Developing Country Award was presented to Dr. Didi Motsepe from Princess Marina Hospital in Gabarone, Botswana who educated us about the challenges of treating pediatric skin disease, including the skin manifestations of HIV, with limited resources. The SPD has seen tremendous growth in the amount and quality of research being per-formed by pediatric dermatologists, as evidenced by the 45 posters on display during the meeting. In addition, 3 abstracts about Hutchinson-Gilford progeria syndrome, gene dis-covery in disorders of keratinization, and care of epidermolysis bullosa were selected for oral presentation during an inaugural research forum. Dr. Jeff Sugarman also presented this year’s grant awardees. The William Weston Research Award Grant was awarded to Dr. Yvonne Chiu. Three Pilot Project Awards were given this year to Drs. Lisa Arkin, Erin Mathes and Elena Pope. Drs. Markus Boos and Elena Hawryluk were also honored for their

Didi Motsepe of Botswana receives the 2012 SPD Developing Country Award

from Anna Bruckner.

Peds Derm “Art and Science” & Cool Temps highlight SPD 2012 Annual Meeting

Society for Pediatric Dermatology 2

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PReSIDenTSheila Friedlander, MD San Diego, CA

PReSIDenT-eLeCTRichard Antaya, MD - New Haven, CT

SeCReTARY-TReASuReRAnthony Mancini, MD - Chicago, IL

IMMeDIATe PAST PReSIDenTMaria Garzon, MD - New York, NY

MeMBeRS AT LARGeJonathan Dyer, MD - Columbia, MODenise Metry, MD - Houston, TXKaren Wiss, MD - Worcester, MA

eDITORS, PeDIATRIC DeRMATOLOGYLawrence Eichenfield, MD - San Diego, CAIlona Frieden, MD - San Francisco, CA

neWSLeTTeR eDITORHarper Price, MD - Phoenix, AZ

eXeCuTIVe DIReCTORKent Lindeman, CMP

PEDIATRIC DERMATOLO

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HE SOCIETY FOR

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executive Board

SPD MISSIOn The Society for Pediatric Dermatology (SPD) is the only national organization in the United States specifically dedicated to the field of Pediatric Dermatology. The Society’s objective is to promote, develop and advance education, research and care of skin disease in all pediatric age groups. The organization holds meetings twice a year to educate physicians about advances in pediatric dermatology, help them support children with dermatological diseases and improve the care of these children.

Mentorship Grant awards. The awards presentation ended with two Travel Awards given out this year to Dr. Catalina Matiz and Valerie Carlberg. Thurs-day’s sessions were concluded by Dr. Louanne Hudgins, director of medical genetics at Stanford University, who reviewed a practical approach to patients with suspected genetic disorders, and the first session of the beloved “Sam Weinberg’s Cases of the Year,” moderated by Dr. Kimberly Horii. The optional activities held on Thursday afternoon offered glimpses into what is special about the Monterey Bay area. The brave members of the SPD endured rough waters in order to see nature’s largest mammals, whales, frolick-ing in the Pacific Ocean. Nature lovers were treated to the unique habitats of Point Lobos State Reserve, while the shoppers in the group enjoyed the quaint boutiques and galleries of Carmel. A leisurely tour of the 17-mile drive high-lighted the iconic scenery of the California coast. Drs. Amy and Anita Gilliam started out Friday morning with the second installment of daily pediatric dermatology CPCs. Dr. Nathaniel Jellinek, a dermatologist and Mohs surgeon with a special interest in nail surgery, then discussed the differential diagnosis and management of “Longitudinal Mela-nonychia in Children” in the day’s first lecture. This year’s Founder’s Lecturer, Dr. Elaine Siegfried, entertainingly discussed our beloved specialty’s history and upcoming challenges in her talk “Pediatric Dermatology: Past, Present & Future.” Back by popular demand, the Controversies in Pediatric Dermatology panel, led by Dr. Anita Haggstrom, had the audience wanting even more time to discuss these challenging diagnoses that we all face on a regular basis. The dynamic duo of Drs. Ilona Frieden and Chris Dowd from UCSF imparted invaluable pearls of wisdom in “An Unusual Pairing: A Pediatric Dermatologist and Neurointerventional Radiologist Share Lessons from 21 Years in a Mul-tidisciplinary Vascular Anomalies Clinic.” Dr. Denise Adams, from Cincinnati

SPD 2012 Annual Meeting Reportcontinued from page 1

Our wonderful 2012 Program Chairs, Brandi Metz, Anna Bruckner, and Kelly Cordoro.

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Children’s Hospital, gave a hematologist’s perspective on “Che-motherapy for Vascular Anomalies.” Then Dr. Jeffrey Benabio from Kaiser Permanente in San Diego lightened things up a bit by addressing a topic foreign to many of us, “Using Social Media Safely in Your Practice.” In the Junior Faculty & Fellows Forum, led by Drs. Latanya Benjamin and Erin Mathes, 3 “up & coming” pediatric dermatologists were able to present their research: Dr. Harkamal Randhawa discussed Oral Nadolol for Infantile Hemangiomas, Dr. Patrick McMahon reviewed a large academic center’s experience with Pediatric Dermatology Inpa-tient Consultations, and Dr. Julianne Mann presented a series of cases of Allergic Contact Dermatitis from “Tagless” Clothing Labels. The afternoon’s parallel sessions offered a variety of topics. Those intrigued to use the internet to build their practice were able to dive deeper into the details of Facebook and other social media sites in “Social Media Tools Workshop,” led by Dr. Bena-bio. Drs. Al Lane and David Magnus led the informative and thought-provoking session “Ethics in Pediatric Dermatology.” In the “Optimizing Your Career in Pediatric Dermatology” ses-sion led by Dr. Aimee Smidt, attendees were able to interact with a varied panel consisting of pediatric dermatologists in aca-demic, private and research settings. Finally, a “MOC Self-As-sessment: Pediatric Dermatology” session offered participants an opportunity to acquire valuable MOC credits. Saturday morning started early with the Annual SPD Busi-ness Meeting which entailed a detailed review of the year’s busi-ness and an overview of future goals. The gavel was passed from outgoing President, Dr. Maria Garzon, to incoming President, Dr. Sheila Friedlander. A set of large worry beads was bestowed to Dr. Friedlander, who promised to put them to good use as she navigates our Society in the year to come. Conference at-tendees were then treated to another day of outstanding ses-sions, and none looked worse for wear despite a late evening the night before at the Reception and Dinner held in the spec-tacular Monterey Bay Aquarium. Attendees enjoyed fine food and friends among displays of large fish, playful otters and an interactive “petting pool.” Dr. Dawn Siegel, Chair of the Poster Committee, presented the poster awards to 3 deserving recipi-ents: Dr. Erin Mathes received 1st place for her poster titled, “Characterization of Cutaneous Findings in the Coxsackievirus Outbreak of 2011-2012,” 2nd place was awarded to Dr. Denise Metry for “Propranolol Use in PHACE Syndrome with Cervical

and Intracranial Arterial Anomalies: Collective Experience in 32 Infants,” and 3rd place was given to Dr. Nicole Weitz for “Char-acterizing Capillary Malformation-Arteriovenous Malforma-tion Syndrome: A Case Series.” Dr. Javed Mohammed, winner of the Resident Research Award, presented his work on the use of infrared thermography to assess proliferation and involution of infantile hemangiomas. This was followed by a superb talk on Management of Cutaneous Lymphoproliferative Disorders in Children by Dr. Youn Kim from Stanford University. We were delighted by the elegant manner in which Dr. Eli Sprecher pre-sented complex concepts in a simplified and easy to understand format during Part 2 of the Hurwitz Lectures, entitled “Rare is Common: Disorders of Ectopic Calcification as a Paradigm.” Dr. Bob Silverman showed us that the Maintenance of Certification process is not as daunting as it seems as he deconstructed the procedure into what we need to know. Audience members who stayed until the end were rewarded in spades with 3 beautiful and high-impact talks that truly embodied the “Art and Science” theme of the meeting. These were delivered by our own SPD members and included “Pearls for Diagnosis & Treatment of Connective Tissue Diseases in Children” by Dr. Eulalia Baselga, “The Changing Pace of Puberty” by Dr. Renee Howard, and the useful and humorously delivered “Year in Review: Pediatrics and Dermatology” by Dr. Megha Tollefson. The meeting concluded with the second session of “Sam Weinberg’s Cases of the Year.” The SPD 2012 Annual Meeting was a tremendous success and we are truly honored and thankful to have had the opportunity to present this meeting. See you in Miami Beach!

SPD 2012 Annual Meeting Reportcontinued from page 2

Mother/Daughter Duo, Amy and Anita Gilliam


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SPD 2012 Annual Meeting Candids

Ashfaq Marghoob

Latanya Benjamin

Chris Dowd and Ilona Frieden

Group sharing a moment at the Opening Reception. John Browning, Aimee Smidt and Jane Bellet at the Young Leaders Reception.

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Rich Antaya and Maria Garzon

Larry Eichenfield deep in conversation.

Maria Garzon, Beth Drolet and Kelly Cordoro

Bernice Krafchik, Anne Lucky, and Judith Williams enjoying the opening reception.

Lenny Kristal and Jeff Sugarman share a smile.


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Moise Levy and Meena Julapalli Andrew Margileth and Joe Morelli

Penny Lee, Catherine McCuaig and Orli Wargon are all smiles at the Aquarium!

Harper Price and Jon Dyer Residents pose for the camera.

Attendees share insights over coffee and poster viewing.

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Looks like a few attendees snuck off from the meeting to enjoy the beach!

Dawn Siegel presenting the 2012 Poster Awards.

Elaine Siegfried and Jean Jacques Voisard at the Aquarium.

2012-2013 SPD Leadership

Eulalia Baselga-Torres


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Attendees enjoying the beautiful Monterey weather.

Enjoying the Whale Watching tour. Whale sighting!

Albert Yan and family.

Fun was had by all at the Monterey Bay Aquarium!

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SPONSORSThe Society for Pediatric Dermatology gratefully acknowledges the following companies who have provided grants to support our 2012 educational programs and initiatives.

PLATINUM LEVEL$25,000 or more

GOLD LEVEL$15,000 - $24,999

SILVER LEVEL$7,500 - $14,999

BRONZE LEVEL$2,000 - $7,499

The Society for Pediatric Dermatology gratefully acknowledges the following companies who have provided grants to support our 2012 educational programs and initiatives.

2012 Sponsors


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2012 SPD Poster Awards

SPD 2013 Annual Meeting PreviewThursday, July 11, 2013 - Sunday, July 14, 2013The Pfister Hotel • Milwaukee, WisconsinFeatured topics and speakers include:• OralContraceptives-Cameron Trenor• PolycysticOvarianSyndrome-Kanade Shinkai• BasalCellNevusSyndrome-Ervin Epstein• MetabolicRisksofPediatricPsoriasis-Kelly Cordoro• HidradenitisSuppurativa-Andrea Zaenglein• InheritedConnectiveTissueDiseases-Michael Earing• LangerhansCellHistiocytosis-Kenneth McClain• OralAnatomyandPathology-Catherine Flaitz• IntroductiontoBoneMarrowTransplant-David Margolis• UpdateonLasers-Lawrence Eichenfield• PhotoprotectionforVulnerablePopulations-Bari Cunningham

andallyourSPDfavorites,includingGuesstheDiagnosis,CasesoftheYear,YearinReviewforDermatologyandPediatrics,andposters.

1st Place ($250) Erin Mathes, MD, UCSF, Ilona Frieden, MD, UCSF, Renee Howard, MD, UCSF, Kelly Cordoro, MD, UCSF, Carol Glaser, MD, UCSF, Julie Schaffer, MD, New York University, Leonard Kristal, MD, SUNY Stonybrook, Sheilagh Maguiness, MD, Harvard University, Richard Antaya, MD, Yale University

Characterization of Cutaneous Findings in the Coxsackievirus Outbreak of 2011-2012

2nd Place ( $150)Denise Metry, MD, Baylor College of Medicine/Texas Children’s Hospital

Propranolol Use in PHACE Syndrome with Cervical and Intracranial Arterial Anomalies: Collective Experience in 32 Infants

3rd Place ($100)Nicole Weitz, BA, Columbia University, Christine T. Lauren, MD, Columbia Uni-versity, Kimberly D. Morel, MD, Columbia University, Maria C. Garzon, MDColumbia University

Characterizing Capillary Malformation-Arteriovenous Malformation Syndrome: A Case Series

Enjoying the poster session.

Erin Mathes

Denise Metry

Nicole Weitz

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What a great pleasure it is to share the “State of the Peds Derm Nation” in my first message as your president. The past tradition has been to speak of the past, present, and future of our society, and it is fitting to start out with a recap of our most recent Annual Meeting. Anna Bruckner, Kelly Cordoro

and Brandie Metz staged a remarkable Annual Meeting in Monterey this past July. As usual, we all got up early to fight for those front seats, and were rewarded with an amazing pro-gram. The quality of the presentations was outstanding (dis-claimer: I do NOT biopsy all melanocytic nail lesions) and the research presented by SPD members was equally impressive. The competition for the Poster Awards is at an all-time high, and rumors of “ballot-stuffing” and hanging chads are com-pletely false according to Erin Mathes, the grand prize award-ee who brought us the many colors and blisters of Coxsackie A6. A special thanks to Joe Lam, who interviewed meeting attendees and assembled a fantastic “testimonial” video of the event. “Feel the Love” only starts to describe the high happi-ness quotient documented by the always-effervescent Dr. Lam. If you haven’t seen it, please go to the SPD website home page - it definitely captures the “spirit” of what our association is all about. And who could forget the amazing “Whale Watch & Retch” trip, where we all got to channel “Moby Dick” fantasies and watch our friends turn green. Special kudos to Teri Kahn & Fred Ghali for antiemetic advice and aid on this trip. Humor aside, there is much to celebrate regarding our society. We are now more than 1,000 members strong, and a recognized academic and clinical force. Because the group is so collegial and generous-spirited, many have given time to work on concerns facing our specialty. We are currently work-ing on a series of Strategic Planning initiatives, addressing the most pressing issues facing the field of pediatric dermatol-ogy. Under the direction of President Maria Garzon, this past year has focused on areas such as workforce, education, finance, membership and member services, as well as advance-ment of pediatric dermatology collaborative research efforts. I’m pleased to report that we continue to meet many of the goals that have been set. In the area of Education, we provided new Maintenance of Certification (MOC) resources via a live session at our Annual Meeting (this will be repeated at the 2013 meeting – thanks

to Andrea Zaenglein and Howard Pride for spearheading this program). We also developed two recorded webinars – one each on Pediatric Acne and Eczema in Children – as an on-line learning instrument for pediatricians/pediatric residents. Thanks to Caroline Piggott and Sheila Galbraith for their spectacular work on these projects. Two new additional Pilot Research Grants of $7,500 each were created within our Advancement of Pediatric Dermatol-ogy effort. The Research Taskforce was instrumental in exe-cuting 2 highly attended educational programs at the Society for Investigative Dermatology’s (SID) Annual Meeting this past May.The Workforce Group is currently working on a new “White Paper” outlining the challenges in this area and it has been approved to run in the editorial section of the JAAD once it is completed. The number of residents placed into peds derm fellowship programs through the SPD’s Match Program was the highest ever (21) and the number of ABD-approved fellowship pro-grams is now approaching 30. The SPD also introduced a Pe-diatric Dermatology Visiting Lectureship program to provide increased exposure to dermatology residency programs who do have have access to a pediatric dermatologist. Initial visits to Drexel and Southern Illinois University will occur this Fall.There were several initiatives in Membership that helped to improve the “experience” of current members as well as attract new physicians to the SPD. We published the results of a new Compensation Survey at the end of 2011 and are still working to collect and analyze important Relative Value Unit data from pediatric dermatology centers across the US. A new Clinical Practice segment was added to the website Forum and a vir-tual seminar addressing specific pedi derm coding issues was led by Ken Bloom in early 2012. The Young Leaders/Fellows Committee held a dynamic session on “Optimizing Your Ca-reer in Pediatric Dermatology” at SPD 2012 that was geared toward addressing career and professional development issues for younger members. In Finance, the Society established the SPD Foundation and exceeded our initial 2011 goal of $30,000 to help nuture the field of pediatric dermatology through clinical, teaching, and research efforts.. The generosity of our donors enables us to support the academic and research mission of our So-ciety and help to assure a vital future for our members. Don’t forget to include the SPD in your “giving” plans at we move

President’s Message: State of the Peds Derm nation

Dr. Sheila Friedlander

continued on page 13

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Jill Anderson, MD - Chicago, IL

Sarah Asch, MD - San Rafael, CA

Michael Bax, MD - Buffalo, NY

Michelle Bayer, MD - Wauwatosa, WI

Rachna Bhandari, MD, PhD - Williamsville, NY

Benjamin Bohaty, MD - Chicago, IL

Megan Brelsford, DO - San Diego, CA

Adam Byrd, MD - Woodbury, MN

Valerie Carlberg, B.S. - Portland, OR

Michael Chang, MD - Rochester, MN

Michael Crandall, MD - Oceanside, CA

Lindsey Craw, MD - Toronto, ON – Canada

Courtney Csikesz, MD - Lincoln, RI

Natalie Cunningham, MD - Halifax, NS

Stephanie Daniels, MD - Dallas, TX

Yee Wah Foong, MBBS, MD - Singapore

Erin Fuller, MD - Buffalo, NY

Elizabeth Grieshaker, MD - New Orleans, LA

Lesley Hawley, MD - San Diego, CA

Julie Heringhausen, MD - Ann Arbor, MI

Ronald Hamrick, MD - Little Canada, MN

Van Hoang, MD - New York, NY

Meghan Hughes, MD - San Diego, CA

Mahwish Irfan, MD - Beachwood, OH

Jamie Johnson - Newburgh, IN

Alana Ju, BA - San Francisco, CA

Filamer Kabigting, MD - New York, NY

Ravneet Kaur, MD - Brooklyn, NY

Laura Keck, MD - Albuquerque, NM

Sherri Korman, MD - Chicago, IL

Angela Lamb, MD - New York, NY

Valerie Laniosz, MD, PhD - Rochester, MN

Amanda LaReau, MD - Chicago, IL

Bailey Lee, MD - Minneapolis, MN

Danielle Levine, MD - Brookline, MA

Erin Luxenberg, MD - Minneapolis, MN

Catherine Manabat, MD - Saint Louis Park, MN

Dana Marshall, MD - New Orleans, LA

Marjorie Montanez-Wiscovich, MD - Shaker Heights, OH

Cindy DenisseValencia Moran, MD - Zapopan, Jalisco - Mexico

Margaret Moye, MD - Iowa City, IA

Euphemia Mu - Baltimore, MD

Rajiv Nijhawan, MD - New York, NY

Monica Rani, MD - Minneapolis, MN

Nianda Reid, MD - Providence, RI

Caitriona Ryan, MD - Dallas, TX

Stephanie Savory, MD - Dallas, TX

Ryan Sells, MD - Boston, MA

Jonathan Silverberg, MD, PhD, MPH - New York, NY

Leah Spring, DO - San Diego, CA

Heather Summe, MD - New York, NY

Bobbye Thompson, MD - New York, NY

Welcome new MembersThe Society for Pediatric Dermatology extends a special welcome to our newest members:

President’s Messagecontinued from page 12

toward the end of the calendar year. One great way to give is to allocate any honoraria you might receive for lecture or other reimbursed endeavors - many of our members are now donat-ing their advisory board honoraria directly to the Society. In the coming year, we will continue to work on initiatives that require constant focus, with Workforce related-issues continu-ing to be at the very top of this list. The SPD is well positioned to tackle a number of new initiatives that relate to the five areas of our Strategic Plan, with the support of energetic leaders and

members that truly care about the organization and the people in it. Not only are we vigorous, but we now have some of the smartest young people around within our ranks. We need all of your talents to improve our field and society. Please join us in our endeavors; it is fun and fulfilling! And please, contact me (858 775-3038 or [email protected]) if you have any suggestions about how to make the SPD a more productive, effective organization.


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25th Annual Society for Pediatric Dermatology Pre-AAD Meeting Thursday, February 28, 2013 • Miami Beach, FL

You Are Invited!SPD Resident/Fellow ReceptionFriday, March 1, 2013 • 5:00 pm - 7:00 pm

Location TBA

Call for Case PresentationsAttendees are invited to submit case presentations for the Cases of the Year segment of the 2013 Pre-AAD Meeting. Ten (10) cases will be presented on Thursday, February 28 in Miami Beach. Cases of the Year includes cases with a known diagnosis, diseases that were difficult to diagnose or cases presenting management challenges. These cases should have attendant teaching value. Selected cases will be given four (4) minutes to present their cases, followed by a two (2) minute question & answer period. Case summaries must be submitted through SPD’s on-line case sub-mission system. Please visit www.pedsderm.net for full details.

Deadline for submission: January 4, 2013Authors of selected cases will be notified: January 21, 2013

$1,000 Travel Award AvailableTravel awards are now available on a competitive basis to fellows, residents, and medical students who present Cases of the Year at SPD’s Pre-AAD Meeting. This is an effort to encourage participation among trainees in-terested in pediatric dermatology and helps provide recognition for ex-ceptional work as well as financial assistance to attend the meeting. There will be one (1) $1,000 award available for the 2013 Pre-AAD meeting in Miami Beach. Members who qualify will apply through the SPD website at the time of submission of cases. The SPD’s Awards & Goals Committee will evaluate the quality of the case, focusing on whether it presents “new” information, is relevant to care of children with skin diseases, quality of data, and approved consent process.

Deadline for submission: January 4, 2013

For more details and to register, please visit www.pedsderm.net/sections/meetings_preAAD2013.php

Program ChairsElizabeth Alvarez Connelly, MDUniversity of Miami

Ana M. Duarte, MDChildren’s Skin Center, PA

Agenda12:00 pm – 12:10 pm Introduction

12:10 pm – 12:45 pm ESTERLY LECTURE Lessons Learned From Editing Four Editions of the Pediatric Dermatology TextbookLarry Schachner, MD, University of MiamiRon Hansen, MD, Phoenix Children’s Hospital

12:45 pm – 1:30 pm Dermoscopy Pearls for Hair and Nail Disorders Antonella Tosti, MD, University of Miami

1:30 pm – 2:05 pm New Understanding of Wound Healing from Bench to Bedside Marjana Tomic-Canic Ph.D., University of Miami

2:05 pm – 2:30 pm Break

2:30 pm – 2:35 pm SPD 2013 Annual Meeting PreviewYvonne Chiu, MD, Beth Drolet, MD, Shelia Galbraith, MD, Kristin Holland, MD, & Valerie Lyon, MD, Medical College of Wisconsin

2:35 pm – 3:10 pm Update on Vascular LasersRoy Geronemus MD, Laser & Skin Surgery Center of New York

3:10 pm – 3:50 pmUse of Interventional Radiology for the Treatment of Vascular Malformations in Pediatric PatientsAlejandro Berenstein, MD, Hyman-Newman Institute for Neurology

3:50 pm – 4:50 pm Cases of the Year Kim Horii, MD (moderator), Children’s Mercy Hospital

4:50 pm – 5:00 pm Closing Remarks

7:00 pm – 9:00 pm Dinner Party at Nikki Beach/Pearl on South BeachTicket required.

Lawrence Schachner, MDUniversity of Miami

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Program ChairsElizabeth Alvarez Connelly, MDUniversity of Miami

Ana M. Duarte, MDChildren’s Skin Center, PA

Agenda12:00 pm – 12:10 pm Introduction

12:10 pm – 12:45 pm ESTERLY LECTURE Lessons Learned From Editing Four Editions of the Pediatric Dermatology TextbookLarry Schachner, MD, University of MiamiRon Hansen, MD, Phoenix Children’s Hospital

12:45 pm – 1:30 pm Dermoscopy Pearls for Hair and Nail Disorders Antonella Tosti, MD, University of Miami

1:30 pm – 2:05 pm New Understanding of Wound Healing from Bench to Bedside Marjana Tomic-Canic Ph.D., University of Miami

2:05 pm – 2:30 pm Break

2:30 pm – 2:35 pm SPD 2013 Annual Meeting PreviewYvonne Chiu, MD, Beth Drolet, MD, Shelia Galbraith, MD, Kristin Holland, MD, & Valerie Lyon, MD, Medical College of Wisconsin

2:35 pm – 3:10 pm Update on Vascular LasersRoy Geronemus MD, Laser & Skin Surgery Center of New York

3:10 pm – 3:50 pmUse of Interventional Radiology for the Treatment of Vascular Malformations in Pediatric PatientsAlejandro Berenstein, MD, Hyman-Newman Institute for Neurology

3:50 pm – 4:50 pm Cases of the Year Kim Horii, MD (moderator), Children’s Mercy Hospital

4:50 pm – 5:00 pm Closing Remarks

7:00 pm – 9:00 pm Dinner Party at Nikki Beach/Pearl on South BeachTicket required.

Lawrence Schachner, MDUniversity of Miami

The Dermatology Foundation is pleased to offer two research awards in Pediatric Dermatology and is now accepting applications for the 2013 funding year. The DF has expanded its award portfolio this year with the addition of the Pediatric Dermatology Career Development Award. This three-year award offers the recipient $55,000 in annual salary support and is designed to support the future intellectual leaders, educators, clinical scholars and/or translational investigators in Pediatric Dermatology.

This new CDA in Pediatric Dermatology is offered in addition to the Fellowship in Pediatric Dermatology. Co-sponsored by the Dermatology Foundation and the Society for Pediatric Dermatology, the fellowship offers a $45,000 salary stipend for one year. The award eligibility requirements have been updated, so please review the award description carefully. All required forms and detailed application instructions are available on the DF website, www.dermatologyfoundation.org. It is strongly suggested that candidates carefully read the Applicant Instructions provided on the website before beginning any paperwork. All application packages are due to the Foundation on or before October 15, 2012. Please note each institution is limited to one sub-mission for each award.

Should you have any questions, please contact the Dermatology Foundation staff at 847 328-2256 or via email to [email protected].

Dermatology Foundation Offers Two Research Awards in Pediatric Dermatology

Call for Pediatric Dermatologists Interested in Collaborative Research

Before the SPD Annual Meeting in July, a small group of pediatric dermatologists met to formally initiate a collaborative research network which will be known as the Pediatric Dermatology Research Alliance (PeDRA). This multisite, collab-orative network will ideally be a platform to facilitate high quality clinical, translational and basic science research with the ultimate goal of improving pediatric skin health and the care of children with skin disease. PeDRA is modeled after success-ful pediatric research collaboratives, such as the COG (Children’s Oncology Group) and CARRA (Childhood Arthritis & Rheumatology Research Alliance). It will also build upon on the long history of collaboration among pediatric dermatologists. We feel this is an ideal time for such a network to form. We have seen rapid advances in science and are eager to have pediatric dermatology both benefit from them and contribute to future advances. There has been an increasing interest in pediatric dermatology research. The SPD strategic planning sessions recognized the important role of promoting research and created a new SPD Research Task force. If you are interested in participating in the planning phase of PeDRA, we’d love to get you involved now in our planning phase. In this case, please contact Amy Paller ([email protected]) or Larry Eichenfield ([email protected]). In the future, we will call for all interested pediatric dermatologists to participate in planned research. We hope that large num-bers will be interested in joining as investigators and collaboratively promoting advances for our patients as we move forward with an organized network of pediatric dermatology researchers.


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SUPPORT THE SPD FOUNDATION Enhancing SPD’s Educational, Research & Training Programs

2012 HONOR ROLL PRESIDENT’S CIRCLE ($1,000+) Adelaide A. Hebert, MD, University of Texas - HoustonAndrew Margileth, MD, University of FloridaElaine Siegfried, MD, St. Louis UniversityKaren Wiss, MD, University of MassachusettsAdam Rubin, MD, University of Pennsylvania Health System

PLATINUM ($500 - 999) Sheila Friedlander, MD, UCSD/Rady Children’s Hospital San DiegoGail Kleman, MD, Billings ClinicPatricia Witman, MD, Nationwide Children’s HospitalAlbert Yan, MD, Children’s Hospital of Philadelphia

GOLD ($250 - 499)Anna Bruckner, MD, Children’s Hospital Colorado Dawn Davis, MD, Mayo Clinic RochesterA. Howland Hartley, MD, George Washington UniversityLawrence A. Schachner, MD, University of MiamiJoyce Teng, MD, Stanford UniversityMary Williams, MD, UCSF

SILVER ($100 - 249) Craig Burkhart, MD, University of North CarolinaRonald Hansen, MD, Phoenix Children’s HospitalMarilyn Liang, MD, Children’s Hospital James Nigro, MD, Nigro Dermatology GroupHarper Price, MD, Phoenix Children’s HospitalEmily Prosise, MD, Austin DermcareLucy Schmidt, MDBarbara J. Schrodt, MD, Dermatology AssociatesTor Shwayder, MD, Henry Ford Medical CenterHazel Vernon, MD, VCU

BRONZE ($25 - 99) Anna Belloni-Fortina, MD, Universita di PadovaGiovanna Ciocca, MD, Ciocca Dermatology PARobert Hayman, MD, SUNY StonyBrookKimberly Morel, MD, Columbia UniversityIlene Rothman, MD, SUNY – BuffaloSam Stafford III, MD, Mt. Pleasant DermatologyJoan Tamburro, MD, Cleveland Clinic

Did you know that our 2012

Research Award Grants were funded

from Foundation donations by SPD members just like

you?

The SPD Foundation provides a mechanism by which individual members can give back to the society and support the next generation of pediatric dermatologists so that they may fully realize their professional goals. Members can provide a general donation or designate their support for a specific program or award, such as Weston or Pilot Project Research Grants, Mentorship Grants, Pediatric Dermatology Fellowships or Resident/Fellow Research Awards. You may also donate to honor the memory of a colleague or leader in our field, or as part of individual estate or tax planning.

2012 Reseach Grant Recipients (L-R): Yvonne Chiu, MD, Lisa Arkin, MD,

Erin Mathes, MD & Elena Pope, MD

Please consider making a donation to the Foundation - remember that donations are 100% tax deductible. Please visit http://www.pedsderm.net/sections/foundation.php and click on “SPD Foundation” to make a donation on-line. On behalf of the SPD Foundation Committee, we thank you for your consideration and generosity.

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Special thanks to Stiefel, a GSK company for their support of the

Society for Pediatric Dermatology as a Corporate Sustaining Member

for 2012-2013

CORPORATE SUSTAINING MEMBER


FALL 2012

SPD Leadership & Committee Appointments

The Society for Pediatric Dermatology would like to congratulate the recently appointed Executive Board

Members, committee chairs, and committee members.

President, 2012-2013Sheila Friedlander, MD

UCSD/Rady Children’s Hospital – San Diego

President, 2013-2014Rich Antaya, MD, Yale University

President, 2014-2015Beth Drolet, MD, Medical College of Wisconsin

MeMber-at-Large

Karen Wiss, MD, University of Massachusetts

CoMMittee Chairs

Nominations – Teresa Wright, MDBaylor College of Medicine

CoMMittee MeMbers awards and goaLs

Denise Metry, MD, Baylor College of MedicineKimberly Morel, MD, Columbia University

Foundation

Maria Garzon, MD, Columbia UniversityAlbert Yan, MD, Children’s Hospital of Philadelphia

Fundraising

Fred Ghali, MD, Pedi Derm of NW Texas

International Task ForceEulalia Baselga, MD

Hospital de la Santa Crue i Sant Pau Madrid, Spain

Meetings

James Treat, MD, University of Pennsylvania

MeMbershiP

Lesley Lawley, MD, Emory University

MentorshiP

Moise Levy, MD, Dell Children’s Medical Center

noMinations Aimee Smidt, MD, University of New Mexico

website John Browning, MD, University of Texas-San Antonio

Wynnis Tom, MD, UC San Diego

The University of Colorado School of Medicine Depart-ment of Dermatology is seeking nominations and appli-cations for a faculty position in pediatric dermatology. This appointment will be at the level of Assistant, Associ-ate, or full Professor, depending on the experience and qualifications of the applicant. The predominant criteria for this position are demonstrated excellence in patient care and teaching, as well as a strong academic focus or area of expertise relevant to pediatric dermatology. The successful candidate should have an MD or DO degree and must be board certified in dermatology and board certified or board eligible in pediatric dermatol-ogy. Candidates with board certification in pediatrics and dermatology and with relevant clinical experience will be considered on a case-by-case basis. An academic niche as evidenced by publications, lecturing, or other scholarly endeavors is also desirable. The applicant must have ex-cellent clinical skills and be committed to teaching medi-cal students and residents. Salary is commensurate with skills and experience. The University of Colorado offers a full benefits package. Information on University benefits programs, including eligibility, is located at http://www.cu.edu/pbs/. Applications will only be accepted electronically at www.jobsatcu.com, job posting #818647. Applications will be accepted until the position is filled. Applicants must submit the following items:

• A cover letter detailing why their skills and experience meet the minimum and preferred qualifications of the position.

• A current CV that includes dates of employment.

• The names, addresses, daytime telephone numbers and e-mail addresses for three professional references.

Questions should be directed to [email protected]. The University of Colorado is committed to diversity and equality in education and employment and is dedi-cated to ensuring a safe and secure environment for our faculty, staff, students and visitors. To assist in achieving that goal, we conduct background investigations for all prospective employees prior to their employment.

Outstanding Opportunity in Pediatric Dermatology

Metro Denver Area, Colorado

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2012 ICHTHYOSIS CLINICAL SCHOLAR PROGRAM The Foundation for Ichthyosis & Related Skin Types (FIRST) is currently accepting applications for an Ichthyosis Fellow. The broad goals of the Fellowship Program are to identify and train the next generation of clinicians who will treat patients with ichthyosis and who, through their own clinical and laboratory investigations, advance understanding of this group of diseases. The successful candidate will be a Board certified or eligible dermatologist in a tertiary care academic institution and must be nominated by their institution and mentor, who will attest to the likelihood of his/her opportunities to continue his/her interest in patients with ichthyosis. Requirements for the fellowship include:

1. Active involvement in a clinical setting likely to provide exposure to patients representing a wide range of diagnoses of disorders of keratinization . (IV, RXLI, EHK, LI, CIE, DD, ILC/Neth, EKV, KID, HI, PRP, PSS, PPK, syndromic disease plus ichthyosis). A “curriculum” assuring that the fellow will have training in the evaluation, diagnosis, treatment and longitudinal follow-up of patients with ichthyosis is an essential component of this fellowship experience.

2. Active involvement with FIRST and related patient-support activities, including participation in biennial family or regional conference; writing and editing brochures, articles for the newsletter; monitoring medical content on the website; and handling medical questions received by the office or support network

3. Conduct research directly related to ichthyosis as a PI or co-PI on IRB-approved clinical trial involving patients with ichthyosis; or hunt for new gene in well-characterized group of patients with ichthyosis; or lab-based treatment discovery effort or similar.

The Fellowship award is $40,000. It is not intended to be the primary source of salary support. This award can be used in addition to other awards, where permitted, and/or to supplement institutional salary support. If salary has been guaranteed through another mechanism, this award can be used to support the fellow’s research and ichthyosis-related clinical effort. The deadline for applications is November 16, 2012. The application is available online at www.firstskinfoundation.org, or by emailing [email protected] or 2616 N. Broad Street, Colmar, PA 18915, 215.997.9400.

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Literature Review - Fall 2012

ALLeRGY AnD IMMunOLOGY

Atopic Dermatitis

Dabade TS, Davis DM, Wetter DA, et al. Wet dressing therapy in conjunction with topical corticosteroids is effec-tive for rapid control of severe pediatric atopic dermatitis: Experience with 218 patients over 30 years at Mayo Clinic. J Am Acad Dermatol. 2012; Jul;67(1):100-106.

This retrospective study of 218 pediatric patients addresses the efficacy of wet dressings to control pediatric atopic dermatitis. The majority of the patients had failed prior treatment with im-munomodulating agents, phototherapy, dietary manipulation, and/or contact allergen avoidance. At the Mayo Clinic in Roch-ester, Minnesota hospitalization for wet dressings with topical corticosteroids is a primary intervention for pruritic dermatoses. The topical steroid utilized was most commonly triamcinolone cream for the trunk and extremities and hydocortisone cream for the face and body folds. Gauze was moistened with water or dilute acetic acid. The mean patient age was 5.97 years. Improve-ment was documented in all patients during hospitalizations last-ing a mean of 3.61 days. Wet dressings are a highly effective, well-known but under-utilized therapy. However, inpatient hos-pitalization is resources-intensive and demands a great deal from our pediatric patients and their families. A home-based regimen is likely more feasible for the majority of patients. This article reminds us of the need to include wet dressings as a primary in-tervention for severe atopic dermatitis. (Submitted by Larisa Speetzen)

Ernst E. Homeopathy for eczema: A systematic review of controlled clinical trials. Br J Dermatol. 2012;166(6):1170-1172.

Homeopathy is a treatment based on the ‘like cures like’ prin-ciple. Homeopaths usually employ highly diluted remedies in order to stimulate the self-healing properties of the body. De-spite the facts that homeopathy originates from the prescientific era of medicine and that its value for treating eczema (or any other condition) is based on experience or anecdotal data, it is still highly popular.

editor: Harper Price, MD

Contributors:

Khalid Al-Aboud, MD - Saudi and Middle Easternliterature

Khalid Al-Hawsawi, MD - Saudi and Middle Easternliterature

Eulalia Baselga, MD - Spanish Literature

Jane Bellet, MD - Lancet, Plast Reconstr Surg

Paula Boggio, MD - Latin American Literature

Eric Cherng, MD - N Engl J Med

Vanessa Fonseca, MD - Pediatrics

Deborah Goddard, MD - J Pediatr Heamtol Oncol

Fatemeh Jafarian, MD - JBC, Exper Dermatol, J Dermatol Sci

Meena Julapalli, MD - J Pediatr

Brandi Kenner-Bell, MD - Pediatr Infect Dis J

Joseph Lam, MD - Br J Dermatol

Carla Lee, MD - Arch Dis Childhood

Kate Marks, MD - J Ped Surg, Pediatric Research

Sahra Niazi, MD - JAMA, J Clin Pediatrics

Noah Scheinfeld, MD - J Am Acad Dermatol

Larisa Speetzen – J Am Acad Dermatol,BMJ

Glenda Swetman, MD - Arch Dermatol

Yong-Kwang Tay, MD - Acta Derm Venereol (Stockh),Clin Exp Derm, Int J Dermatol,, J Dermatol Treat

Megha Tollefson, MD - Arch Pediatr Adolesc Med

Interested in being a reviewer for this section? Contact Dr. Price at [email protected]

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In this study, electronic searches were conducted in Medline, Embase and the Cochrane Library for controlled trials of ho-meopathy in patients with eczema. One randomized and two nonrandomized clinical trials met the inclusion criteria. All were methodologically weak and none demonstrated the efficacy of homeopathy. The most surprising result of this systematic re-view is the fact that only three controlled trials of homeopathy have been published. At present, the totality of the evidence from controlled clinical trials fails to suggest that homeopathy is an efficacious treatment for eczema.(Submitted by Joseph M. Lam, MD)

Other

Sartori S, de la Peña A, Ulibarrie A. Dermatosis neglecta: A case report. Dermatol Argent. 2012; 18(2):47-48.

Dermatosis neglecta is a condition characterized by scrupulous avoidance of scrubbing the involved area, leading to a buildup of hyperpigmented, adherent, cornflake-like scales. Washing with soap and a washcloth can lead to clearing. The scale, however, can be more promptly removed with alcohol swabbing, which also serves as a diagnostic tool.The authors present an 8-year-old Caucasian boy, who complained about an asymptomatic, hy-perpigmented and keratotic plaque, on the dorsum of his penis that appeared 6 months previously, a few days after a surgical procedure of phimosis. Main clinical diagnosis was dermatosis neglecta. The parents were instructed to clean the affected area daily with a gauze and a lotion of urea 10% urea. A week later, the lesion had completely resolved. (Submitted by Paula Boggio, MD)

InFeCTIOnS

Viral

Pinninti SG, Angara R, Feja KN, Kimberlin DW, Leach CT, Conrad DA, et al. Neonatal herpes disease following ma-ternal antenatal antiviral suppressive therapy: A multicenter case series. J Pediatr. 2012;161:134-138.

Currently, the American College of Obstetricians and Gynecol-ogists recommends cesarean delivery for pregnant women with a history of HSV who are symptomatic or who have active lesions; otherwise, they are offered antiviral suppressive therapy starting at 36 weeks of gestation to prevent perinatal transmission to their newborn during vaginal delivery. HSV cultures are not routinely performed on asymptomatic pregnant women. This multicenter retrospective case series described 8 neonates who contracted HSV disease despite treatment of their mothers with acyclovir prior to delivery, thereby highlighting the need for physicians to remain suspicious of HSV infection in ill neonates as antenatal antiviral suppressive therapy may not be adequate for prevention of viral shedding and transmission.(Submitted by Meena R. Julapalli, MD)

Netchiporouk E, Cohen BA. Recognizing and managing ec-zematous id reactions to molluscum contagiosum virus in children. Pediatrics. 2012;129;e1072-e1075.

This is a case series of 3 children with id reactions to Molluscum contagiosum (MC). In all 3 cases, erythematous, scaly plaques surrounding the MC papules heralded the resolution of the virus 1 to 2 months later. The authors postulate that the incidence of this type of hypersensitivity reaction to MC is much higher than the previously reported 10 percent. They also advocate for the conservative management of MC and related id reactions with emollients, antibiotics, and short courses of topical corticoste-roids on an as-needed basis.(Submitted by Vanessa Fonseca, MD)

Fungal

Martin EB, Gastañaduy PA, Camacho-Gonzalez AF et al. Primary Cutaneous Aspergillosis in Two Pediatric Trauma Patients. Pediatr Infect Dis J. 2012;31(4):427-428.

The authors report 2 cases of previously healthy children who developed primary cutaneous aspergillosis (PCA) after motor ve-hicle accidents. Both children ages 2 and 6 years suffered multiple traumatic injuries and subsequently developed acute respiratory

FALL 2012



distress syndrome requiring broad spectrum antibiotics and sys-temic corticosteroids. One patient developed erythematous bul-lous lesions which underwent necrosis and central ulceration on the arm, the other developed multiple indurated erythematous papules with central eschar on her extremities. Wound cultures grew Aspergillus fumigatus and both patients were treated with voriconazole. The authors review the possible pathophysiology including post-traumatic alterations in cellular and humoral im-munity combined with corticosteroids and broad-spectrum anti-biotics. (Submitted by Brandi Kenner-Bell, MD)

SYnDROMeS AnD heReDITARY DISORDeRS

Ida JB, Livshitz I, Azizkhan RG, Lucky AW, Elluru RG. Up-per airway complications of junctional epidermolysis bul-losa. J Pediatr. 2012;160:657-661.

Individuals with junctional epidermolysis bullosa have a high rate of upper airway involvement, including excessive granula-tion tissue, ulceration, swelling, stenosis, obstruction, and laryn-gomalacia, manifestations which can lead to airway compromise. This article highlights the importance of evaluation of airway in-volvement, which may require endoscopy and surgical interven-tion, but also emphasizes that this must be done by physicians ex-perienced with precautionary measures that may minimize tissue damage and further complications in JEB patients with fragile skin and mucosa. The authors also addressed the need for discus-sion about palliative care with families of severely affected JEB patients as the risks of any surgical intervention may outweigh any benefits. (Submitted by Meena R. Julapalli, MD)

Yuksekkaya H, Ozbek O, Keser M, Toy H. Blue rubber bleb syndrome: Successful treatment with sirolimus. Pediatrics. 2012;129;e1080-e1084.

This is a case report of an 8 year-old female with blue rubber bleb syndrome complicated by significant gastrointestinal bleed-ing, successfully treated with sirolimus. The patient failed a vari-ety of therapeutic interventions: prednisolone at 1-2 mg/kg for 10 months, interferon-alpha at 5 MU/m2 for 12 months, pro-pranolol at 1-1.5 mg/kg, and aminocaproic acid at 1 g/day. Con-tinued severe GI bleeding and resultant iron deficiency anemia

prompted the addition of sirolimus (dosed at 0.05-0.1 mg/kg) to the patient’s course of propranolol 2 months after it was initiated. They were administered concurrently for 2 months, and then si-rolimus was used as sole therapy for an additional 2 months. The patient’s venous malformations decreased in size and number, and her anemia resolved with concurrent iron supplementation. Her melena recurred soon after sirolimus was discontinued, so it was reinitiated. At 23 months of follow-up, the patient did not have recurrence of soft tissue hemorrhage or anemia. Pre-exis-tent malformations grew slightly and small, new ones developed whenever the sirolimus serum level dropped to <2 mg/dL fol-lowing transient holidays in therapy due to febrile illnesses. No adverse drug reactions, aside from a rise in cholesterol from 170 mg/dL to 198 mg/dL, developed. This case illustrates the po-tential utility of sirolimus in treating blue rubber bleb syndrome complicated by significant GI bleeding.(Submitted by Vanessa Fonseca, MD)

Galve J, Vicente A, Gonzalez-Enseñat MA, et al. Neonatal erythroderma as a first manifestation of Menkes disease. Pe-diatrics. 2012;130;e239-e242.

This is a case of Menkes disease (MD) in an 11-day old male with congenital erythroderma, sparse and brittle hair, and hypo-tonia. The patient also had dysmorphic facial features consisting of a flattened nasal bridge, low-set ears, horizontal eyebrows, and prominent cheeks. His family history was significant for 2 mater-nal uncles who died in infancy. While the erythroderma resolved spontaneously at 2 months of age, lethargy and focal clonic sei-zures ensued. This prompted an investigation for MD. MRI evidence of occipital lobe hemorrhages; x-rays showing spurs of the long bones, widened metaphyses, and wormian bones; EM microscopy of hair revealing pili torti; and decreased serum ce-ruloplasmin and copper levels were strongly suggestive of MD. The finding of a deletion in the ATP7A gene confirmed the di-agnosis of MD, a lethal disorder of copper metabolism with an X-linked recessive inheritance pattern. Prompt diagnosis of MD and initiation of copper-histidine supplementation during the early neonatal period can preserve neurologic function. As such, the authors encourage the inclusion of serum ceruloplasmin and copper studies and light microscopy of hair in the work-up of neonatal erythroderma. (Submitted by Vanessa Fonseca, MD)

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Gray PEA, Bock V, Ziegler DS, Wargon O. Neonatal sweet syndrome: A potential marker of serious systemic illness. Pediatrics. 2012;129;e1353-e1359.

A literature review of 20 cases of neutrophilic dermatoses occur-ring within the first 6 months of life finds that the subset of cases developing within 6 weeks of life are most likely to be associated with a serious systemic disorder. Skin biopsy results showing a dense neutrophilic dermal infiltrate in the absence of vasculitis are only reported for 3 of the cases; whether skin biopsies were done on the remaining 17 patients is not reported. Of the 20 cases, 6 were attributed to a viral etiology, 4 to primary immu-nodeficiencies, 3 to neonatal lupus syndrome, 1 to presumptive Crohn disease, 1 to HIV, and 5 to genetic causes. This latter group includes 2 kindreds with no extracutaneous disease and 3 cases of CANDLE (chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature) syndrome. Cases of chronic granulomatous disease, myelodysplastic syndrome, and common variable immunodeficiency are represented in the group of reported immunodeficiencies. Children >6 weeks of age account for 9 of the 20 cases of neutrophilic dermatoses in this series. Of these, 6 were attributed to probable viral infections. The authors note that those cases presenting at or later than 3 months of age and accompanied by viral prodromes seem to have a better prognosis and a greater likelihood to go into remission.(Submitted by Vanessa Fonseca, MD)

Knipstein JA, Ambruso DR. Sweet syndrome in an infant with chronic granulomatous disease. J Pediatr Hematol On-col. 2012;34:372-374.

While viral and bacterial infections are common in the few weeks prior to the onset of Sweet’s symptoms, nearly 60% of children with Sweet’s syndrome have an associated underlying disease, in-cluding immunodeficiency. In the literature, there have been two previously reported cases of Sweet’s syndrome in young children who were subsequently diagnosed with chronic granulomatous disease (CGD). The authors report a case of an 11 month old male infant with previously diagnosed CGD who developed methicillin-sensitive Staphylococcus aureus lymphadenitis and subsequently developed Sweet’s syndrome. The patient’s fever, lymphadenopathy and vesiculopustular lesions resolved with 2 mg/kg/day of oral prednisolone in addition to antibiotics. This

case highlights that CGD patients are prone to infections, but also demonstrate a propensity toward non-infectious inflamma-tory conditions including Sweet’s syndrome. (Submitted by Deborah Goddard, MD)

TuMORS

Huynh KT, Takei Y, Kuo C et al. Aberrant hypermethylation in primary tumours and sentinel lymph node metastases in paediatric patients with cutaneous melanoma. Br J Derma-tol. 2012;166(6):1319-1326.

Thirty-seven pediatric patients with American Joint Commit-tee on Cancer stage I–III cutaneous melanoma were analysed to determine the clinical relevance of epigenetic (methylation) regulation of several tumour-related genes (TRGs) in sentinel lymph node (SLN) metastases and primary tumours. Gene pro-moter methylation of several TRGs known to be significant in adult melanoma progression (TRGs RASSF1A, RARβ2, WIF1 and APC) was evaluated and matched to adult cutaneous mela-nomas by Breslow thickness and ulceration. Hypermethylation of all four TRGs in SLN(+) pediatric patients with melanoma was equivalent to or less than in adults and may account for why SLN(+) pediatric patients have different clinical outcomes. Pe-diatric patients with melanoma with SLN(+) and hypermethyl-ation of > 1 TRG had the worst outcomes. The authors advocate for SLN biopsy in pediatric patients with cutaneous melanoma for staging and postulate that epigenetic analysis with SLN bi-opsy may prove to be a valuable prognostic tool. It may be im-portant to note, however, that performing SLN biopsy has not be shown to improve survival rates in pediatric melanoma.(Submitted by Joseph M. Lam, MD)

VASCuLAR LeSIOnS

Castro C, Suar L, Olivera A, Gutiérrez A, Burgos F, de la Calle R, Botto H, Bonavia P, Valdéz R. Propranolol treat-ment for infantile hemangiomas: Report of 12 new cases. Dermatol Argent. 2012; 18(1):36-43.

Infantile hemangiomas (IH) are the most common soft-tissue tumors of infancy. Most of them have an uncomplicated course


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and do not require treatment. If needed, corticosteroids were the main therapeutic option. In 2008 Léauté-Labrèze et al. obtained excellent responses when they treated them with propranolol, a beta-blocker. The authors made a retrospective review of pa-tients with complicated IH who where treated with propranolol in the Department of Pediatric Dermatology at the “Hospital Universitario Austral” between June 2008 and April 2010. Pro-pranolol was administered to 12 children (9 girls and 3 boys). Most lesions were localized in the head and neck, only one had genital localization. Age at the beginning of treatment was less than 1 year in 11 patients, only one was 3-years-old. Propranolol was given orally at a dose of 2 mg/kg/day. Five patients had re-ceived previous oral corticosteroid therapy. Relapses were mild and responded to retreatment. Side effects were limited and mild (1 patient developed a mild hypoglycemia, 1 patient had bron-chospasm and 1 transitory nausea) and they did not require stop-ping the administration. They conclude that in their experience propranolol was an effective and safe modality of treatment for problematic. (Submitted by Paula Boggio, MD)

DRuGS AnD TheRAPY

Drugs

Ostlie DJ, Juang D, Aguayo P, et al. Topical silver sulfadia-zine vs collagenase ointment for the treatment of partial thickness burns in children: A prospective randomized trial. J Pediatr Surg. 2012;47:1204-1207.

The initial treatment of partial thickness burns is debridement and coverage with a topical agent that provides antibacterial cov-erage and allows for burn eschar separation. The two most com-monly used topical therapies for partial thickness burns are silver sulfadiazine (SSD) and collagenase ointment (CO). This study evaluated the use of these two topical agents in children admitted to The Children’s Mercy Hospital (Kansas City, MO) with par-tial thickness burns less than 48 hours from thermal injury. After initial debridement on admission, all patients were dressed with SSD for the first 2 days. After 2 days, patients were then random-ized to continue daily debridement with either SSD or CO for up to 10 days. Polymyxin was added to the CO because it has no antibacterial properties. Patients who completed 10 days of the assigned treatment regimen and did not achieve burn heal-

ing were treated with skin grafting. There were no differences in clinical course, outcome, or need for skin grafting. The two major criticisms of CO are infection risk and expense. The data revealed that there were more suspected infections in the CO group compared to the SSD group, although these were not sta-tistically significant. The difference in cost for the CO was $842, which the authors felt was a small amount within the overall hos-pitals charges. The authors feel that there are no differences in outcomes between topical SSD and CO in the management of childhood burns. (Submitted by Kate Marks, DO)

MISCeLLAneOuS

Acne

Ong MW, Bashir SJ. Fractional laser resurfacing for acne scars: A review. Br J Dermatol. 2012;166(6):1160-1169.

This review examined 26 studies published between 2003 and January 2011 which looked at the effectiveness of ablative and nonablative fractional photothermolysis (FP) lasers for treating facial acne scars. Outcomes included subjective and objective as-sessment of scar appearance, pre- and postoperative treatment, side-effects and pain scores. There were significant limitations in comparing published articles on this subject. In particular, the various parameters studied differed in each study, and most stud-ies did not have a control or comparison group. Even allowing for methodological variability, ablative FP had an improvement range of 26–83% whereas nonablative FP had an improvement range of 26–50%. Patients who underwent treatment with an ablative FP laser experienced longer duration of erythema, post-inflammatory hyperpigmentation and a higher pain score in comparison with patients who opted for the nonab-lative FP laser. More good-quality information and convincing evidence from RCTs are still needed and there is also a lack of information on long-term efficacy of fractional laser resurfacing. (Submitted by Joseph M. Lam, MD)


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Other

Lawson EF, Hersh AO, Applebaum MA, Yelin EH, Okumura MJ, von Scheven E. Self-management skills in adolescents with chronic rheumatic disease: A cross-sectional survey. Pediatr Rheumatol. 2011;9:35.

Adolescents with chronic rheumatologic disease are faced with a lifelong challenge of developing self-management skills, which include medication adherence, medication regimen knowledge and independence in heath care tasks. Previous studies have shown that medication non-adherence is associated with poorer self-esteem, health perceptions, mental health and social func-tioning. This study was a cross-sectional survey of 52 adolescent patients being seen in the Pediatric Rheumatology Clinic at the University of California, San Francisco. Of these 52 patients, 44% had juvenile idiopathic arthritis, 35% had lupus and 8% had juvenile dermatomyositis. Approximately half of patients reported perfect adherence to medications, while 40% report-ed missing 1-2 doses per week. Forgetfulness was cited as the most common reason for missing medications (54%) but 10% stated they intentionally missed doses. Among health care tasks, there was an age-related increase in ability to fill prescriptions, schedule appointments, arrange transportation, ask questions of doctors, manage insurance, and recognize symptoms of illness. Interestingly, ability to take medications as directed, know medi-cation names, keep a calendar of appointments, and maintain a personal medical file did not improve with age. The authors con-clude that adolescents with chronic rheumatic disease may need additional support to achieve independence in self-management and facilitate their transition of care to adult rheumatologic spe-cialists. (Submitted by Deborah Goddard, MD)

Luna PC, Solé J, Amartino H, Casas G, Larralde M. Scler-ederma in coup de sabre/Parry Romberg syndrome. Treat-ment in a toddler. Dermatol Argent. 2012; 18(2):56-59. Sclerederma in coup de sabre and Parry Romber syndrome are considered two poles of the same disease. Beside skin lesions, patients can also develop neurologic, ophthalmologic and oral compromise. It is a very rare disease and there is no consensus about its treatment. The authors report the case of a four-year-

old boy with scleroderma in coupe de sabre/Parry Romberg syndrome and mild neurologic symptoms that was treated with pulses of methylprednisolone and oral methotrexate. (Submitted by Paula Boggio, MD)

Rao SS, Davison SP. Gone in 30 Seconds: A Quick and Sim-ple Technique for Subcutaneous Lipoma Removal. Plast Re-constr Surg. 2012;130(1):236e-238e.

This is a very nice technique that pediatric dermatologists who perform surgery can easily employ for the removal of lipomas. A linear incision is made directly over the lipoma and then the lipoma is “squeezed”, enabling it to pop out of the incision site, without any further dissection. The authors report no complica-tions in a series of 140 lipoma excisions performed in this man-ner and recurrence of only two. The article includes a video clip demonstrating the technique. (Submitted by Jane S. Bellet, MD)


Recent Pediatric Dermatology Job Opportunities

Ann Arbor, MI

Aurora, CO

Cleveland, OH

Columbus, OH

Farmington, CT

Jackson, MS

Kansas City, MO

Millburn, NJ

San Diego, CA

Scottsdale, AZ

Stanford, CA

Please visit www.pedsderm.net to view all available job and fellowship opportunities.


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nancy esterly Pediatric Dermatology Visiting Lectureship

The Society for Pediatric Dermatology is pleased to announce the Nancy Esterly Pedi-atric Dermatology Visiting Lectureship 2013. The purpose of the Visiting Lectureship is to encourage those dermatology residency pro-grams without access to an expert in pediatric

dermatology to benefit from a two day visit from a pediatric dermatologist. The visiting lecturer would spend two days at the host in-stitution conducting lectures, seminars, or rounds with derma-tology residents, medical students, and faculty.

PrograM eLigibiLitYACGME-approved dermatology residency programs in the US or programs accredited by the Royal College of Physicians and Surgeons of Canada are eligible to submit applications for this program.

CaLL For aPPLiCationsApplications will be forwarded to all eligible US and Canadian dermatology residency programs in mid-October; the dead-line for submission will be January 10, 2013. The successful applicant program(s) may then schedule the visit for any time during the calendar year 2013.

nuMber oF Visiting LeCtureshiPsTwo (2) visiting professorships awarded annually.

how are reCiPient PrograMs seLeCted?Awarded lectureships will be selected based on the need of the program and those that would most benefit from a visit.

ConFLiCt with aaP tunnessen Visiting ProFessorshiP?While the programs would be similar in structure, the main difference is that the SPD Program would focus on derma-tology residency programs, instead of pediatric residency pro-grams.

Visiting LeCtureshiP sPeaKers needed! We need SPD members who would be willing to serve as a Visiting Lecturer in this program. If you are interested, please contact Jill Thompson, SPD’s Membership Manager, at [email protected] or (317) 202-0224.

For more information on the Nancy Esterly program or to request an application, please visit: http://www.pedsderm.net/sections/VisitingLectureship.php or contact the SPD directly.

SPD Approves use of Forum for Survey Circulation to Members

The SPD Executive Committee has approved a mechanism that would permit members to participate in online surveys which contribute greatly to various pediatric dermatology-related research projects and publications, but in a way that does not directly inundate individuals with numerous requests for survey participation. A new “Research Survey” section has been added to the SPD Forum that will allow members to post these surveys on-line and announce them to other SPD members through the daily Forum email Digest. This will include a short description (aims, objectives) and a direct link to the survey. Please note the following guidelines that have been estab-lished related to member surveys:

1) Only SPD members are allowed to submit requests to post surveys.

2) The request would require a one-paragraph narrative description of the aims and objectives of the research study or publication that would require surveying and data collection from the pediatric dermatologists who are SPD members.

3) The Website Committee will review survey requests and approve/reject requests. Approved surveys will be reviewed by the SPD President prior to posting on the Forum.

4) Surveys will be posted in a separate “Research Survey” section of the SPD Forum. Language should include “Proceeding with this web-based survey will imply your consent to participate in this study.”

5) IRB approval of the survey is required before posting surveys, as it is often a requirement for publication. Language should include “This survey was IRB approved by_________.”

If you have any questions, please contact Sheila Galbraith, SPD’s Website Chair at [email protected] or Jill Thompson, SPD’s Communications Manager at [email protected].

Documents

H E FSO R T review - Society for Pediatric Dermatology · The Society for Pediatric Dermatology (SPD) is the only national organization in the United States specifically dedicated