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    Challenges in treating pediatric skin conditions

    Uniquely tailored strategies improve diagnosis and treatment

    Beware of the rare, ask questions of the littlest patients, and make sure to treat children as individuals with unique needs. These are the messages from dermatologists who spoke to colleagues about the special challenges of treating skin conditions in children, especially those who are far from their teen years.

    READ: Pediatric psoriasis

    “Most dermatologists are very cautious with kids and probably not as familiar with treating them,” says Leslie Castelo-Soccio, M.D., Ph.D., an assistant professor of pediatrics and dermatology at The Children's Hospital of Philadelphia, who spoke during a session about children and skin disease at the 73rd annual meeting of the American Academy of Dermatology (San Francisco, 2015).

    For example, phototherapy is often a beneficial treatment for kids with conditions like eczema, psoriasis and vitiligo. It’s typically used for inflammatory conditions when patients have failed topical and systemic therapy, Dr. Castelo-Soccio says. But many dermatologists won’t try the treatment on children under 18 even if they have the equipment, she says, despite studies that suggest early treatment is crucial for vitiligo in particular.

    In fact, “children tolerate it beautifully,” she says. “We’ve treated kids as young as 16 months up to teenagers and early adults.”

    ALSO READ: Pediatric psoriasis, eczema: Triggers and therapies

    She cautions dermatologists to consider the ages of children undergoing the treatment. Older children over 4 or 5 years old can handle going into the closet-like space of a light box on their own for a matter of seconds or minutes, she says.

    But younger children won’t tolerate being alone in a light box, so Dr. Castelo-Soccio will open the device and let the light emanate into the room. A parent stays with the child but is covered for protection from the light.

    “You partner with parents to get the child through the treatment, and you learn strategies of distraction like talking, singing and visualization that you don’t need with adults,” she says.

    NEXT: Important cautions

    Randy Dotinga
    Randy Dotinga is a medical writer based in San Diego, Calif.

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