Pediatric Dermatology Research Alliance
Wynnis Tom, MD
UCSD
This is a prospective, observational study of traditional systemic agents for severe, refractory atopic dermatitis in children. We are comparing the efficacy and safety of oral cyclosporine, azathioprine, mycophenolate mofetil, and methotrexate, guided by consensus-derived dosing and administration protocols.
Enrollment is complete. Next steps for this study include data review and manuscript preparation.
Megha Tollefson, MD
Mayo Clinic
Amy Paller, MD
Northwestern University
Children on anti-TNF agents have been reported to develop psoriasis, but the majority of the literature is in the gastrointestinal (GI) literature and focuses on infliximab and inflammatory bowel disease. Not much is known about other primary disease processes and other medications, nor risk factors to develop this paradoxical reaction. This study is a retrospective multi-center review to further characterize this process.
Enrollment is complete, and a manuscript is being prepared for publication.
Wynnis Tom, MD
UCSD
Comorbidities are a significant burden for psoriasis patients, and this burden may be exacerbated in pediatric patients. PeDRA’s Psoriasis Investigator Group (PsIG) members and other multidisciplinary experts worked to develop the first set of pediatric psoriasis comorbidity screening guidelines in 2017.
The pediatric psoriasis comorbidity screening guidelines were published in JAMA Dermatology in 2017 (see publications page). A web app is now being created to guide health care providers in the use of these guidelines.
Jeff Yu, MD
Massachusetts General Hospital
Allergic contact dermatitis (ACD) is a delayed-type hypersensitivity reaction. Detection of through patch testing and avoidance of offending allergens are important for resolution of dermatitis. This condition has been underrecognized in children as this was once thought to be rare in children. The true incidence of ACD in children remains unknown due to limited published studies. However, recent data demonstrate the prevalence of ACD in children to be as high as 24%, similar to rates reported in adults. In 2018, a multi-center, prospective pediatric ACD registry was initiated at Massachusetts General Hospital (MGH) in efforts to gather data on the incidence and prevalence of ACD and identify evolving trends of allergen sensitization in children (<18 years old) in North America.
Eight academic medical centers across North America have joined this registry. If you are interested in joining this study, please contact Dr. Jeff Yu. Data collection is underway across sites. We anticipate publishing our study findings in July 2020 and every two years thereafter.
Minnelly Luu, MD
University of Southern California
Wynnis Tom, MD
University of California, San Diego
Although atopic dermatitis (AD) affects all races and skin types with shared features of relapses and pruritus, it is a heterogeneous disease phenotypically. Anecdotal reports have noted that lesional morphology may depend on racial and ethnic background; however, few studies have systematically evaluated and quantified these clinical observations.
To address the gap in our understanding of morphologic variability across racial/ethnic groups, we are conducting a multicenter, prospective study to compare the frequency of defined morphologic subtypes in U.S. and Canadian children with untreated or minimally treated AD. As a secondary objective, we will characterize the morphologic presentation of pediatric patients with severe, recalcitrant AD. Lastly, we will build a patient registry with detailed morphologic data that can be utilized for future related biomarker studies.
We expect the findings to inform and improve therapeutic approaches and guide future studies to identify unique pathways and distinguishing biomarkers of AD across racial/ethnic groups.
This study was funded as a 2017 PeDRA Team Grant and is currently underway.
Christine Lauren, MD
Columbia University
Active design.
Alana McEvoy, MD
University of Ottawa
Our group has developed and validated an illustrated eczema action plan (EAP) that uses the advantages of infographics, simple language, and multidimensional function as an educational tool, prescription, and method of communication with other healthcare professionals to improve the ability of patients and parents to manage eczema. The objective of this study is to assess the impact of the EAP on eczema severity, quality of life, and retention of key counselling points.
In this is a prospective study, in which new eczema patients are randomly assigned to receive either 1) standard verbal counselling 2) an illustrated EAP along with standard verbal counselling. Objective eczema severity at 3 months is the primary outcome (EASI). Secondary outcomes include: severity of eczema as rated by the parents/caregiver or patient (POEM and PO-SCORAD); and the patient’s quality of life with atopic dermatitis (DLQI, CLDQI, or IDQOL) as well as comprehension and recall of key information about eczema. These outcomes are evaluated at baseline, one-month, and 3 months after the initial visit.
We anticipate that the EAP will have a positive impact of the severity of the child’s eczema and the child’s QoL. We also anticipate an improvement in comprehension and recall of eczema-related information.
This study was funded as a 2018 PeDRA Pilot Grant and a manuscript is currently under review for publication.
