Topical calcineurin inhibitors for pediatric periorificial dermatitis - 29/02/20

Doi : 10.1016/j.jaad.2020.01.064

Ayelet Ollech, MD ^a,^⁎ , Rame Yousif, BS ^b, Lacey Kruse, MD ^a,^b,^c, Annette Wagner, MD ^a,^b,^c, Brandi Kenner-Bell, MD ^a,^b,^c, Sarah Chamlin, MD ^a,^b,^c, Duri Yun, MD ^a,^b,^c, Lisa Shen, MD ^d, Karina Vivar, MD ^a,^b,^c, Megan Reynolds, APN ^a, Amy S. Paller, MD ^a,^b,^c, Anthony J. Mancini, MD ^a,^b,^c
^a Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
^b Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
^c Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
^d Department of Dermatology, School of Medicine, Boston University, Boston, Massachusetts

^∗Correspondence to: Ayelet Ollech, MD, Pediatric Dermatology Unit, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.Pediatric Dermatology UnitSheba Medical CenterSackler School of MedicineTel Aviv UniversityTel AvivIsrael

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Saturday 29 February 2020

Abstract

Background

Data regarding the treatment of periorificial dermatitis with topical calcineurin inhibitors (TCI) in the pediatric population are limited.

Objective

To assess the clinical utility of TCI in pediatric patients with periorificial dermatitis.

Methods

A retrospective medical record review of all pediatric patients with periorificial dermatitis treated with TCIs was performed. Follow-up via telephone was performed to capture missing data.

Results

A total of 132 patients met the inclusion criteria. The median age at diagnosis was 4.2 years (interquartile range, 2.3-8.2). The median follow-up was 5.2 months (interquartile range, 2.1-11.7). Seventy-two patients had evaluable follow-up data. Of these, 48 (67%) patients were treated with TCI alone, 12 (16.7%) were treated with a combination of TCI and topical metronidazole, and 9 (12.5%) were treated with a combination of TCI and a systemic antibiotic. Complete response was noted in 68.8% of patients treated with TCI alone, in 75% of patients treated with TCI and metronidazole, and in 77.8% of patients treated with TCI and a systemic antibiotic. Adverse events were rare and mild in severity.

Conclusion

Topical calcineurin inhibitors are an effective therapeutic option for pediatric patients with periorificial dermatitis and were well tolerated in this cohort.

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Key words : azithromycin, erythromycin, minocycline, pediatric dermatology, perioral dermatitis, periorificial dermatitis, pimecrolimus, tacrolimus, topical calcineurin inhibitor, topical metronidazole

Abbreviations used : CR, IQR, POD, TCI

Esquema

Methods

Patients and disease characteristics

Disease presentation and characteristics

	Funding sources: None.
	Conflicts of interest: None disclosed.
	IRB approval status: Reviewed and approved by Western IRB (approval no. 20182296).
	Reprints not available from the authors.