Current and Emerging Therapies in Pediatric Atopic Dermatitis.

Atopic dermatitis (AD) is the most common inflammatory skin disease seen in children. It is a heterogeneous disorder, with a variety of associated manifestations and symptoms. Cases may range from mild to severe. As a result, a spectrum of prescription and nonprescription therapies may be utilized when managing this condition. This article provides an extensive overview of these therapies, with equal consideration provided to current, emerging, and alternative options used in the pediatric population.

Dupilumab for Allergic Contact Dermatitis: An Overview of Its Use and Impact on Patch Testing.

Allergic contact dermatitis (ACD) has been estimated to affect up to 20% of the general population. Patch testing is the gold standard for identification of causative allergens. When allergen avoidance fails, current treatment options include topical and oral corticosteroids, systemic immunosuppressants, and phototherapy. Dupilumab, a monoclonal antibody targeting IL-4/IL-13, is approved by the US Food and Drug Administration for the treatment of moderate to severe atopic dermatitis. It also has been used off label with some success in the treatment of ACD. This article discusses the evidence for using dupilumab to treat ACD as well as considerations for patch testing in patients who are taking this medication.

Potential Allergens in Disposable Diaper Wipes, Topical Diaper Preparations, and Disposable Diapers: Under-recognized Etiology of Pediatric Perineal Dermatitis.

BACKGROUND: Allergic contact dermatitis in young children may be an under-recognized cause of perineal dermatitis. The diapered infant skin is uniquely susceptible to allergic contact dermatitis because of more permeable neonatal skin, a moist environment, frequent contact with irritants and resultant skin barrier breakdown, and exposure to topical products such as diaper wipes, diaper preparations, and disposable diapers. To our knowledge, potential allergens in these products have not been thoroughly catalogued or studied. OBJECTIVE: We explore and review potential allergenic ingredients in diaper wipes, topical diaper preparations, and disposable diapers. METHOD: We analyzed 63 diaper wipes, 41 topical diaper preparations, and the 3 top selling diaper brands available from two of the largest retailers in the United States. Each potential allergen is discussed, and epidemiologic studies of rates of sensitization to potential allergens in children are also reported. CONCLUSIONS: Botanical extracts, including members of the Compositae family, were the most commonly represented potential allergen in both diaper wipes and topical preparations. Other potential allergens identified with high frequency include α-tocopherol, fragrances, propylene glycol, parabens, iodopropynyl butylcarbamate, and lanolin. Frequent culprits such as formaldehyde releasers and methylchloroisothiazolinone/methylisothiazolinone were not prevalent in our analyzed products.