Skip to main content
SpringerLink
Log in
Book cover

Biologic and Systemic Agents in Dermatology pp 273–280Cite as

Oral Systemic Agents in Pediatric Dermatology

  • Chapter
  • First Online:

  • 1479 Accesses

Abstract

Oral systemic agents are used in pediatric dermatology for a broad range of conditions, including inflammatory disorders, vascular tumors and malformations, connective tissue diseases, and immunobullous diseases, among others. Their utilization may be indicated after failure of standard non-systemic therapies or in the setting of certain indicators of greater disease impact or severity. The choice of agent, determination of optimal dosing and duration, and decision of monitoring parameters often rely heavily on well-informed clinical judgement that reconciles broader, literature-based strategies with individual patient considerations and provider experience. This chapter focuses on the use of oral agents for the treatment of recalcitrant atopic dermatitis, severe psoriasis, and impacting infantile hemangiomas.

This is a preview of subscription content, log in via an institution.

References

  1. Daley-Yates PT, Richards DH. Relationship between systemic corticosteroid exposure and growth velocity: development and validation of a pharmacokinetic/pharmacodynamic model. Clin Ther. 2004;26(11):1905–19.

    Article  CAS  PubMed  Google Scholar 

  2. Bair B, Dodd J, Heidelberg K, Krach K. Cataracts in atopic dermatitis: a case presentation and review of the literature. Arch Dermatol Am Med Assoc. 2011;147(5):585–8.

    Article  Google Scholar 

  3. Totri CR, Eichenfield LF, Logan K, Proudfoot L, Schmitt J, Lara-Corrales I, et al. Prescribing practices for systemic agents in the treatment of severe pediatric atopic dermatitis in the US and Canada: the PeDRA TREAT survey. J Am Acad Dermatol. 2017;76(2):281–5.

    Article  PubMed  Google Scholar 

  4. Zurbriggen B, Wüthrich B, Cachelin AB, Wili PB, Kägi MK. Comparison of two formulations of Cyclosporin A in the treatment of severe atopic dermatitis. Dermatology (Basel). 1999;198(1):56–60.

    Article  CAS  Google Scholar 

  5. Dadlani C, Orlow SJ. Treatment of children and adolescents with methotrexate, cyclosporine, and etanercept: review of the dermatologic and rheumatologic literature. J Am Acad Dermatol. 2005;52(2):316–40.

    Article  PubMed  Google Scholar 

  6. van Roon EN, van de Laar MAFJ. Methotrexate bioavailability. Clin Exp Rheumatol. 2010;28(5 Suppl 61):S27–32.

    PubMed  Google Scholar 

  7. Mazaud C, Fardet L. Relative risk of and determinants for adverse events of methotrexate prescribed at a low dose: a systematic review and meta-analysis of randomized. Placebo-Controlled Trials Br J Dermatol. 2017;9

    Google Scholar 

  8. Kalb RE, Strober B, Weinstein G, Lebwohl M. Methotrexate and psoriasis: 2009 National Psoriasis Foundation Consensus Conference. 2009. pp. 824–37.

    Google Scholar 

  9. Schmitt J, Abraham S, Trautmann F, Stephan V, Fölster-Holst R, Homey B, et al. Usage and effectiveness of systemic treatments in adults with severe atopic eczema: first results of the German Atopic eczema registry TREAT Germany. J Dtsch Dermatol Ges. 2017;15(1):49–59.

    Google Scholar 

  10. Sidbury R, Davis DM, Cohen DE, Cordoro KM, Berger TG, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71:327–49.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Caufield M, Tom WL. Oral azathioprine for recalcitrant pediatric atopic dermatitis: clinical response and thiopurine monitoring. J Am Acad Dermatol. 2013;68(1):29–35.

    Article  CAS  PubMed  Google Scholar 

  12. Fuggle NR, Bragoli W, Mahto A, Glover M, Martinez AE, Kinsler VA. The adverse effect profile of oral azathioprine in pediatric atopic dermatitis, and recommendations for monitoring. J Am Acad Dermatol. 2015;72(1):108–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Haeck IM, Knol MJ, Berge Ten O, van Velsen SGA, de Bruin-Weller MS, Bruijnzeel-Koomen CAFM. Enteric-coated mycophenolate sodium versus cyclosporin a as long-term treatment in adult patients with severe atopic dermatitis: a randomized controlled trial. J Am Acad Dermatol. 2011;64(6):1074–84.

    Article  CAS  PubMed  Google Scholar 

  14. El-Khalawany MA, Hassan H, Shaaban D, Ghonaim N, Eassa B. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. Eur J Pediatr. 2013;172(3):351–6.

    Article  CAS  PubMed  Google Scholar 

  15. Gerbens LAA, Boyce AE, Wall D, Barbarot S, de Booij RJ, Deleuran M, et al. TREatment of ATopic eczema (TREAT) registry taskforce: protocol for an international Delphi exercise to identify a core set of domains and domain items for national atopic eczema registries. Trials BioMed Central. 2017;18(1):87.

    Google Scholar 

  16. van Geel MJ, Oostveen AM, Hoppenreijs EPAH, Hendriks JCM, van de Kerkhof PCM, de Jong EMGJ, et al. Methotrexate in pediatric plaque-type psoriasis: long-term daily clinical practice results from the child-CAPTURE registry. J Dermatolog Treat. 2015;26(5):406–12.

    Article  PubMed  Google Scholar 

  17. Oostveen AM, de Jager MEA, van de Kerkhof PCM, Donders ART, de Jong EMGJ, Seyger MMB. The influence of treatments in daily clinical practice on the Children’s dermatology life quality index in juvenile psoriasis: a longitudinal study from the child-CAPTURE patient registry. Br J Dermatol. 2012;167(1):145–9.

    Article  CAS  PubMed  Google Scholar 

  18. Klufas DM, Wald JM, Strober BE. Treatment of moderate to severe pediatric psoriasis: a retrospective case series. Pediatr Dermatol. 2016;33(2):142–9.

    Article  PubMed  Google Scholar 

  19. Sanclemente G, Murphy R, Contreras J, García H, Bonfill CX. Anti-TNF agents for paediatric psoriasis. Cochrane database syst rev. 2015;(11):CD010017.

    Google Scholar 

  20. Bulbul Baskan E, Yazici S, Tunali S, Saricaoglu H. Clinical experience with systemic cyclosporine a treatment in severe childhood psoriasis. J Dermatol Treat. 2016;27(4):328–31.

    Article  CAS  Google Scholar 

  21. Perrett CM, Ilchyshyn A, Berth-Jones J. Cyclosporin in childhood psoriasis. J Dermatol Treat. 2003;14(2):113–8.

    Article  CAS  Google Scholar 

  22. Marqueling AL, Cordoro KM. Systemic treatments for severe pediatric psoriasis: a practical approach. Dermatol Clin. 2013;31(2):267–88.

    Article  CAS  PubMed  Google Scholar 

  23. Di Lernia V, Stingeni L, Boccaletti V, Calzavara Pinton PG, Guarneri C, Belloni Fortina A, et al. Effectiveness and safety of cyclosporine in pediatric plaque psoriasis: a multicentric retrospective analysis. J Dermatol Treat. 2016;27(5):395–8.

    Article  Google Scholar 

  24. Di Lernia V, Bonamonte D, Lasagni C, Belloni Fortina A, Cambiaghi S, Corazza M, et al. Effectiveness and safety of Acitretin in children with plaque psoriasis: a multicenter retrospective analysis. Pediatr Dermatol. 2016;33(5):530–5.

    Article  PubMed  Google Scholar 

  25. Léauté-Labrèze C, Voisard J-J, Moore N. Oral propranolol for infantile hemangioma. N Engl J Med. 2015;373(3):284–5.

    Article  PubMed  Google Scholar 

  26. Mei-Zahav M, Blau H, Hoshen M, Zvulunov A, Mussaffi H, Prais D, et al. Propranolol treatment for infantile hemangioma does not increase risk of childhood wheezing. Pediatr Pulmonol. 2017;25:168.

    Google Scholar 

  27. Drolet BA, Frommelt PC, Chamlin SL, Haggstrom A, Bauman NM, Chiu YE, et al. Initiation and use of propranolol for infantile hemangioma: report of a consensus conference. Pediatrics. 2013;131(1):128–40.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Garzon MC, Epstein LG, Heyer GL, Frommelt PC, Orbach DB, Baylis AL, et al. PHACE syndrome: consensus-derived diagnosis and care recommendations. J Pediatr. 2016;178:24–33.e2

    Article  PubMed  Google Scholar 

  29. Bernabeu-Wittel J, Narváez-Moreno B, de la Torre-García JM, Fernández-Pineda I, Domínguez-Cruz JJ, Coserría-Sánchez F, et al. Oral Nadolol for children with infantile hemangiomas and sleep disturbances with oral propranolol. Pediatr Dermatol. 2015;32(6):853–7.

    Article  PubMed  Google Scholar 

  30. Randhawa HK, Sibbald C, Garcia Romero MT, Pope E. Oral Nadolol for the treatment of infantile hemangiomas: a single-institution retrospective cohort study. Pediatr Dermatol. 2015;32(5):690–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric and Adolescent Dermatology, University of California, San Diego/Rady Children’s Hospital, 8010 Frost Street, Suite 602, San Diego, CA, 92123, USA

    Nancy Cheng MD & Wynnis L. Tom MD

Authors
  1. Nancy Cheng MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wynnis L. Tom MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wynnis L. Tom MD .

Editor information

Editors and Affiliations

  1. Division of Dermatology, David Geffen School of Medicine a UCLA, Los Angeles, California, USA

    Paul S. Yamauchi

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Cheng, N., Tom, W.L. (2018). Oral Systemic Agents in Pediatric Dermatology. In: Yamauchi, P. (eds) Biologic and Systemic Agents in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-66884-0_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-66884-0_28

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66883-3

  • Online ISBN: 978-3-319-66884-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation