7/24/2018

Disclosures

Updates in Pediatric Dermatology ▸ I have research grants from the following Lara Wine Lee, MD, PhD ▸ Eli Lily: psoriasis, atopic dermatitis ▸ Pfizer: atopic dermatitis

Update on Acne: Update on Acne: Diet

▸ Increase in acne in high glycemic diet1 ▸ NYC study showed teens with mod-sev acne hadmore carbs and higher glycemic load diets ▸ Serum markers of insulin resistance ▸ Men with known metabolic syndrome treated with metformin and low glycemic diet showed improvement in acne2 ▸ Milk and acne: ▸ Skim > whole milk3,4 ▸ High intake of full-fat dairy products 5 ▸ Whey protein supplements exacerbate truncal acne6

1. Burris J, et al. J Acad Nutr Diet 2017; 117:1375–1383. 2. Fabbrocini G, et al. Clin Exp Dermatol 2016; 41:38–42. 3. Adebamowo CA, et al. J Am Acad Dermatol 2005; 52:207–214. 4. LaRosa CL, et al. J Am Acad Dermatol 2016; 75:318–322. 5. Ulvestad M, et al. J Eur Acad Dermatol Venereol 2017; 31:530–535. 6. Cengiz FP, et al. Health Promot Perspect 2017; 7:106–108.

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Update on Acne: Treatment Update on Acne: Topical treatment

▸ First OTC retinoid was approved ▸ Differin ▸ Adherence to OTC routines is low ▸ 30% of patients picked up OTC benzoyl peroxide

Huyler AH, Zaenglein AL. Adherence to over-the-counter benzoyl peroxide in patients with acne. J Am Acad Dermatol 2017; 77:763–764.

Update on Acne: Systemic Treatment Update on Acne: Isotretinoin

▸ Limit use of systemic antibiotics to 3-4 months ▸ Antibiotic resistance ▸ Antibiotic monotherapy (systemic or topical) STRONGLY discouraged

Update on Vascular Anomalies: Update on Alopecia Hemangiomas

▸ 10 years of propranolol as first-line therapy for complicated hemangiomas1 ▸ No increased risk of social, emotional, behavioral or exective function dysfunction in a small study2

Droitcourt C, Kerbrat S, Rault C, et al. Pediatrics. 2018; 141(6):e20173783 Moyakine A, Koulil S, van der Vleuten C. J Am Acad Dermatol. 2017; 77:105-8

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Update on Alopecia: Treatment Update on Alopecia: Comorbidity

▸ Topical Approaches ▸ Systemic Approaches ▸ WNL: CBC, CMP ▸ TSH 260 ▸ Free T4 0.27

▸ TPO > 10,000

▸ JAK Inhibitors

Patel D, et al. JAMA Dermatol. 2017;153(12):1307- 1310.

Update in Alopecia Areata: Comorbidity

▸ AA affects 2% of population ▸ 8 year, single institution Who? ▸ Single center review: retrospective ▸ history of atopy ▸ 20% had thyroid abnromalities ▸ 298 patients with AA ▸ History of Down Syndrome ▸ 49% hypothyroid, most commonly 2/2 Hashimotos> ▸ Fhx thyroid disease Graves ▸ 20% had thyroid ▸ Signs or symptoms of ▸ More common in : abnormalities thyroid dysfunction ▹ Personal history of atopy ▸ Hypothyroid 49% ▹ Personal history of Down Syndrome ▸ Hyperthyroid 20% ▹ Family history of thyroid disease ▸ Screening? ▸ Subclinical thyroid dysfunction 12% ▸ TSH, free T4 ▸ Anti-TPO ▸ Anti-Tg

Patel D, eta l. Dermatol. 2017;153(12):1307-1310.

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