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Article ; Online: Dermatologic complications in pediatric patients after hematopoietic stem cell transplantation for sickle cell disease.

Dignum, Tessa / Burroughs, Lauri / Mallhi, Kanwaldeep / Brandling-Bennett, Heather A

2023 Volume 41, Issue 1, Page(s) 61–65

Abstract: Dermatologic complications are common following allogeneic hematopoietic stem cell transplantation, but dermatologic complications among pediatric patients undergoing hematopoietic stem cell transplantation for the treatment of sickle cell disease have ... ...

Abstract	Dermatologic complications are common following allogeneic hematopoietic stem cell transplantation, but dermatologic complications among pediatric patients undergoing hematopoietic stem cell transplantation for the treatment of sickle cell disease have been poorly characterized. In this case series of 17 patients (<21 years old) with sickle cell disease who underwent hematopoietic stem cell transplantation, 16 (94.1%) experienced one or more dermatologic complications after transplant, with the most common complications including acute or chronic mucocutaneous graft-versus-host disease (GVHD) (34.1% of complications), skin eruptions of unknown origin (15.9% of complications), infections (15.9% of complications), and chemotherapy-related pigmentary changes (11.4% of complications). Patients who developed acute or chronic skin GVHD were significantly older at the time of hematopoietic stem cell transplantation. These findings highlight the need to closely monitor for dermatologic complications in pediatric patients who undergo hematopoietic stem cell transplantation for sickle cell disease and underscore the importance of involving dermatology early on when skin complications occur, although further research with a larger multicenter study could help clarify the risk for dermatologic complications and help identify potential ways to mitigate this risk.
MeSH term(s)	Child ; Humans ; Anemia, Sickle Cell/therapy ; Graft vs Host Disease/etiology ; Hematopoietic Stem Cell Transplantation/adverse effects ; Adolescent
Language	English
Publishing date	2023-11-15
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.15471
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Article ; Online: Presenting characteristics and progression of pediatric-onset morphea: Interim analysis of a prospective registry.

Ng, Ashley T / Brandling-Bennett, Heather A / Drolet, Beth A / Siegel, Dawn H / Chiu, Yvonne E

Pediatric dermatology

2023 Volume 40, Issue 4, Page(s) 606–609

Abstract: Morphea is a rare fibrosing disorder with a highly variable disease course, which can complicate management. Here, we present a prospective cohort study describing the current treatments used in the management of pediatric-onset morphea and assessing ... ...

Abstract	Morphea is a rare fibrosing disorder with a highly variable disease course, which can complicate management. Here, we present a prospective cohort study describing the current treatments used in the management of pediatric-onset morphea and assessing responses to systemic and topical therapies. Most patients demonstrated inactive disease by 1 year, regardless of treatment, though recurrences were common in our cohort overall (39%). Our results support the need for continuous monitoring of all children with morphea following the completion of treatment, including topical treatment, due to high rates of disease relapse.
MeSH term(s)	Child ; Humans ; Scleroderma, Localized/diagnosis ; Scleroderma, Localized/drug therapy ; Scleroderma, Localized/complications ; Prospective Studies ; Rare Diseases/complications ; Administration, Topical
Language	English
Publishing date	2023-06-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.15350
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Article ; Online: The geographic distribution of the US pediatric dermatologist workforce: A national cross-sectional study.

Ashrafzadeh, Sepideh / Peters, Gregory A / Brandling-Bennett, Heather A / Huang, Jennifer T

Pediatric dermatology

2020 Volume 37, Issue 6, Page(s) 1098–1105

Abstract: Background /objectives: Although 82% of pediatricians report that their patients have difficulty accessing pediatric dermatologists, the regions with greatest need for the specialty are not well-defined. We aimed to determine the geographic distribution ...

Abstract	Background /objectives: Although 82% of pediatricians report that their patients have difficulty accessing pediatric dermatologists, the regions with greatest need for the specialty are not well-defined. We aimed to determine the geographic distribution of pediatric dermatologists relative to the number of children and pediatric generalists. Methods: We performed a cross-sectional study of all US board-certified pediatric dermatologists, generalists (defined as pediatricians and family medicine physicians), and children in 2020. Data were obtained from the Society for Pediatric Dermatology, American Board of Pediatrics, Centers for Medicare and Medicaid, and US Census Bureau. Number of children, pediatric dermatologists, and pediatric generalists were tabulated in each county and state, and the distributions of pediatric dermatologists and generalists relative to the population of children were quantified with the Gini coefficient. Results: Of 317 pediatric dermatologists, 243 (76.7%) were women and 311 (98.1%) worked in a metropolitan county. A pediatric dermatologist was present in 41/50 (82%) states and 142/3228 (4.4%) counties. Not a single pediatric dermatologist was found in 54/92 (58.7%) counties with 100 000-199 999 children, 15/53 (28.3%) counties with 200 000-499 999 children, and 4/13 (30.8%) counties with ≥500 000 children. The Gini coefficient for the state-level distribution of pediatric dermatologists relative to population of children was 0.488 compared to 0.132 for that of pediatric generalists. Conclusion: There is a maldistribution of pediatric dermatologists, resulting in children with unmet dermatologic needs in nine states and 96 heavily populated counties. These results can inform initiatives to recruit pediatric dermatologists and to expand telehealth access to specific high-density areas.
MeSH term(s)	Aged ; Child ; Cross-Sectional Studies ; Dermatologists ; Dermatology ; Female ; Humans ; Male ; Medicare ; Pediatrics ; United States ; Workforce
Language	English
Publishing date	2020-09-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.14369
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Article ; Online: Development and Validation of the Morphea Activity Measure in Patients With Pediatric Morphea.

García-Romero, Maria Teresa / Tollefson, Megha / Pope, Elena / Brandling-Bennett, Heather A / Paller, Amy S / Keimig, Emily / Arkin, Lisa / Wanat, Karolyn A / Humphrey, Stephen R / Werth, Victoria P / Oza, Vikash / Jacobe, Heidi / Fett, Nicole / Cordoro, Kelly M / Medina-Vera, Isabel / Chiu, Yvonne E

JAMA dermatology

2023 Volume 159, Issue 3, Page(s) 299–307

Abstract: Importance: Morphea is an insidious inflammatory disorder of the skin and deeper tissues. Determining disease activity is challenging yet important to medical decision-making and patient outcomes.: Objective: To develop and validate a scoring tool, ... ...

Abstract	Importance: Morphea is an insidious inflammatory disorder of the skin and deeper tissues. Determining disease activity is challenging yet important to medical decision-making and patient outcomes. Objective: To develop and validate a scoring tool, the Morphea Activity Measure (MAM), to evaluate morphea disease activity of any type or severity that is easy to use in clinical and research settings. Design, setting, and participants: This pilot diagnostic study was conducted from September 9, 2019, to March 6, 2020, in 2 phases: development and validation. During the development phase, 14 morphea experts (dermatologists and pediatric dermatologists) used a Delphi consensus method to determine items that would be included in the MAM. The validation phase included 8 investigators who evaluated the tool in collaboration with 14 patients with pediatric morphea (recruited from a referral center [Medical College of Wisconsin]) during a 1-day in-person meeting on March 6, 2020. Main outcomes and measures: During the development phase, online survey items were evaluated by experts in morphea using a Likert scale (score range, 0-10, with 0 indicating not important and 10 indicating very important); agreement was defined as a median score of 7.0 or higher, disagreement as a median score of 3.9 or lower, and no consensus as a median score of 4.0 to 6.9. During the validation phase, reliability (interrater and intrarater agreement using intraclass correlation coefficients), validity (using the content validity index and κ statistics as well as correlations with the modified Localized Scleroderma Severity Index and the Physician Global Assessment of Activity using Spearman ρ coefficients), and viability (using qualitative interviews of investigators who used the MAM tool) were evaluated. Descriptive statistics were used for quantitative variables. Data on race and ethnicity categories were collected but not analyzed because skin color was more relevant for the purposes of this study. Results: Among 14 survey respondents during the development phase, 9 (64.3%) were pediatric dermatologists and 5 (35.7%) were dermatologists. After 2 rounds, a final tool was developed comprising 10 items that experts agreed were indicative of morphea activity (new lesion in the past 3 months, enlarging lesion in the past 3 months, linear lesion developing progressive atrophy in the past 3 months, erythema, violaceous rim or color, warmth to the touch, induration, white-yellow or waxy appearance, shiny white wrinkling, and body surface area). The validation phase was conducted with 14 patients (median age, 14.5 years [range, 8.0-18.0 years]; 8 [57.1%] female), 2 dermatologists, and 6 pediatric dermatologists. Interrater and intrarater agreement for MAM total scores was good, with intraclass correlation coefficients of 0.844 (95% CI, 0.681-0.942) for interrater agreement and 0.856 (95% CI, 0.791-0.901) for intrarater agreement. Correlations between the MAM and the modified Localized Scleroderma Severity Index (Spearman ρ = 0.747; P < .001) and the MAM and the Physician Global Assessment of Activity (Spearman ρ = 0.729; P < .001) were moderately strong. In qualitative interviews, evaluators agreed that the tool was easy to use, measured morphea disease activity at a single time point, and should be responsive to changes in morphea disease activity over multiple time points. Conclusions and relevance: In this study, the MAM was found to be a reliable, valid, and viable tool to measure pediatric morphea activity. Further testing to assess validity in adults and responsiveness to change is needed.
MeSH term(s)	Adult ; Humans ; Child ; Female ; Adolescent ; Male ; Scleroderma, Localized/diagnosis ; Scleroderma, Localized/pathology ; Reproducibility of Results ; Severity of Illness Index ; Skin/pathology ; Physicians
Language	English
Publishing date	2023-02-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2701761-8
ISSN	2168-6084 ; 2168-6068
ISSN (online)	2168-6084
ISSN	2168-6068
DOI	10.1001/jamadermatol.2022.6365
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Article ; Online: Pyogenic granuloma in a 5-month-old treated with topical timolol.

Khorsand, Kate / Maier, Morgan / Brandling-Bennett, Heather A

Pediatric dermatology

2015 Volume 32, Issue 1, Page(s) 150–151

Abstract: A 5-month-old healthy female presented with a pyogenic granuloma on the cheek. The lesion was treated with topical 0.5% gel-forming solution, resulting in regression of the lesion after 1 month of treatment and no recurrence at 8 months. This case ... ...

Abstract	A 5-month-old healthy female presented with a pyogenic granuloma on the cheek. The lesion was treated with topical 0.5% gel-forming solution, resulting in regression of the lesion after 1 month of treatment and no recurrence at 8 months. This case suggests that treatment of pyogenic granulomas with topical timolol may be considered, especially when other treatment modalities are challenging or could result in significant scarring.
MeSH term(s)	Administration, Topical ; Adrenergic beta-Antagonists/therapeutic use ; Female ; Granuloma, Pyogenic/drug therapy ; Humans ; Infant ; Timolol/therapeutic use
Chemical Substances	Adrenergic beta-Antagonists ; Timolol (817W3C6175)
Language	English
Publishing date	2015-01
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.12297
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Article ; Online: Beta-blockers for childhood vascular tumors.

Bayart, Cheryl B / Brandling-Bennett, Heather A

Current opinion in pediatrics

2015 Volume 27, Issue 4, Page(s) 454–459

Abstract: Purpose of review: Since 2008, beta-blockers have become first-line treatment for infantile hemangiomas, the most common tumor of infancy. Their role is also being explored in the treatment of other childhood vascular tumors.: Recent findings: Recent ...

Abstract	Purpose of review: Since 2008, beta-blockers have become first-line treatment for infantile hemangiomas, the most common tumor of infancy. Their role is also being explored in the treatment of other childhood vascular tumors. Recent findings: Recent research has demonstrated that propranolol is a more effective and safer treatment for infantile hemangiomas than previous therapeutic options. It is most effective when initiated during the tumor's proliferative phase. Other oral beta-blockers such as atenolol and nadolol are less studied, but may offer similar efficacy. Topical beta-blockers such as timolol appear to be effective in treating small, superficial infantile hemangiomas. Beta-blockers have shown variable results for the treatment of other vascular tumors of childhood, such as pyogenic granulomas, kaposiform hemangioendotheliomas, and tufted angiomas. Summary: Propranolol has revolutionized the treatment of infantile hemangiomas, and other beta-blockers provide promising alternatives. Unanswered questions remain about the optimal choice of agent, delivery mechanism, dosage, need for pretreatment evaluation or ongoing monitoring, and duration of therapy. The role of beta-blockers in treating other types of vascular tumors requires further study.
MeSH term(s)	Administration, Oral ; Administration, Topical ; Adrenergic beta-Antagonists/administration & dosage ; Atenolol/administration & dosage ; Child, Preschool ; Facial Neoplasms/drug therapy ; Facial Neoplasms/pathology ; Humans ; Infant ; Neoplastic Syndromes, Hereditary ; Neurocutaneous Syndromes/drug therapy ; Neurocutaneous Syndromes/pathology ; Propranolol/administration & dosage ; Skin Neoplasms/drug therapy ; Skin Neoplasms/pathology ; Timolol/administration & dosage ; Treatment Outcome ; Vascular Neoplasms/drug therapy ; Vascular Neoplasms/pathology
Chemical Substances	Adrenergic beta-Antagonists ; Atenolol (50VV3VW0TI) ; Timolol (817W3C6175) ; Propranolol (9Y8NXQ24VQ)
Language	English
Publishing date	2015-08
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0000000000000238
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Article ; Online: Deficiencies in Dermatologic Training in Pediatric Residency: Perspective of Pediatric Residency Program Directors.

Khorsand, Kate / Brandling-Bennett, Heather A

Pediatric dermatology

2015 Volume 32, Issue 6, Page(s) 819–824

Abstract: Background/objectives: Children with skin-related problems commonly present to general pediatricians, and dermatology is among the top specialty areas that pediatricians have identified as having inadequate training to support their practice. This study ...

Abstract	Background/objectives: Children with skin-related problems commonly present to general pediatricians, and dermatology is among the top specialty areas that pediatricians have identified as having inadequate training to support their practice. This study was designed to document current opportunities for dermatologic training during pediatric residency and provides suggestions for improvement. Methods: Pediatric residency program directors were contacted to participate in an online survey focusing on dermatologic training during pediatric residency. The survey was sent to 199 programs, from which 78 responses were received (response rate 39.2%). Required or elective rotations, other educational opportunities, and adequacy of dermatology training during pediatric residency were assessed and compared between institutions with zero, one, or two or more affiliated pediatric dermatologists. Results: Eighty-four percent of pediatric residency programs offer clinical training in dermatology. This training is required in only 19% of programs and is elective in 73%. Fewer than one-quarter of eligible residents participate in the elective option. Didactic dermatology lectures are available at all of the programs. Overall, only 6% of residency program directors felt that their graduating residents received very adequate training in dermatology and 26% felt their residents received inadequate training. Conclusions: Exposure to dermatology clinics was perceived to be the most desirable training modality for pediatric residents, but a minority of residents receive this exposure. Many pediatric residency program directors felt that residents receive inadequate dermatology training, which indicates a need to address educational deficiencies. Supporting a pediatric dermatologist on staff and requiring a rotation in pediatric dermatology could improve dermatologic curricula for pediatric residents.
MeSH term(s)	Adult ; Clinical Competence ; Curriculum ; Dermatology/education ; Education, Medical, Graduate/organization & administration ; Faculty, Medical/organization & administration ; Female ; Humans ; Internship and Residency/organization & administration ; Male ; Needs Assessment ; Pediatrics/education ; Physician Executives/organization & administration ; Program Evaluation ; Surveys and Questionnaires ; United States
Language	English
Publishing date	2015-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.12662
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Article ; Online: Cutaneous reactions to pediatric cancer treatment part II: Targeted therapy.

Carlberg, Valerie M / Davies, Olivia M T / Brandling-Bennett, Heather A / Leary, Sarah E S / Huang, Jennifer T / Coughlin, Carrie C / Gupta, Deepti

Pediatric dermatology

2020 Volume 38, Issue 1, Page(s) 18–30

Abstract: Cancer remains a leading cause of morbidity and mortality among children. Targeted therapies may improve survivorship; however, unique side-effect profiles have also emerged with these novel therapies. Changes in hair, skin, and nails-termed dermatologic ...

Abstract	Cancer remains a leading cause of morbidity and mortality among children. Targeted therapies may improve survivorship; however, unique side-effect profiles have also emerged with these novel therapies. Changes in hair, skin, and nails-termed dermatologic adverse events (AEs)-are among the most common sequelae and may result in interruption or discontinuation of therapy. Though dermatologic AEs have been detailed in adults, these findings are not well described in the pediatric population. We reviewed the literature to characterize dermatologic AEs to anticancer targeted therapies available as of July 2020 and summarized the spectrum of clinical findings as well as treatment recommendations for children. Dermatologic AEs are among the most common AEs reported in pediatric patients receiving targeted therapy, but morphologic and histologic descriptions are often lacking in current publications. Pediatric dermatologists are uniquely poised to recognize specific morphology of dermatologic AEs and make recommendations for prevention and treatment that may improve quality of life and enable ongoing cancer therapy.
MeSH term(s)	Antineoplastic Agents/adverse effects ; Child ; Humans ; Molecular Targeted Therapy/adverse effects ; Neoplasms/drug therapy ; Quality of Life ; Skin
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2020-12-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.14495
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Article ; Online: Propranolol for infantile haemangiomas: review of report of a consensus conference.

Biesbroeck, Lauren / Brandling-Bennett, Heather A

Archives of disease in childhood. Education and practice edition

2014 Volume 99, Issue 3, Page(s) 95–97

MeSH term(s)	Congresses as Topic ; Hemangioma/complications ; Hemangioma/drug therapy ; Hemangioma/pathology ; Humans ; Infant ; Patient Selection ; Propranolol/therapeutic use ; Vasodilator Agents/therapeutic use
Chemical Substances	Vasodilator Agents ; Propranolol (9Y8NXQ24VQ)
Language	English
Publishing date	2014-06
Publishing country	England
Document type	Consensus Development Conference ; Journal Article ; Practice Guideline
ZDB-ID	2148818-6
ISSN	1743-0593 ; 1743-0585
ISSN (online)	1743-0593
ISSN	1743-0585
DOI	10.1136/archdischild-2013-305027
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Article ; Online: Lichenoid Drug Eruption with Prominent Nail Changes Due to Leflunomide in a 12-Year-Old Child.

May, Caitlin / Fleckman, Philip / Brandling-Bennett, Heather A / Cole, Bonnie / Sidbury, Robert

Pediatric dermatology

2017 Volume 34, Issue 4, Page(s) e225–e226

Abstract: We present the case of a 12-year-old-girl who developed lichenoid dermatitis approximately 1 year after starting leflunomide for juvenile idiopathic arthritis. The eruption resolved promptly with discontinuation of the suspected culprit agent, supportive ...

Abstract	We present the case of a 12-year-old-girl who developed lichenoid dermatitis approximately 1 year after starting leflunomide for juvenile idiopathic arthritis. The eruption resolved promptly with discontinuation of the suspected culprit agent, supportive of a lichenoid drug eruption, but she subsequently developed markedly dystrophic nails with lichen planus-like features. A biopsy of her cutaneous findings at the time of initial presentation demonstrated lichenoid dermatitis, and a nail matrix biopsy was deferred given clinical correlation. Prominent nail changes in lichenoid drug eruptions, particularly in children, are rare but should be considered in children with new-onset nail dystrophy.
Language	English
Publishing date	2017-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.13168
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