In what many audience members called their favorite session of the day, Elizabeth Swanson, MD, reviewed the latest updates in treatments for common pediatric conditions. Starting with atopic dermatitis, Dr Swanson reviewed the indications for recently approved nonsteroidal topical therapies such as tapinarof 1% cream and roflumilast 0.15% cream. Dupilumab is approved for patients as young as 6 months of age with moderate-to-severe atopic dermatitis, and Dr Swanson discussed what to do with vaccines for these patients on dupilumab. Non-live vaccines are safe and have been shown to be effective in patients who receive them while taking dupilumab, and no dose modification is needed. The measles, mumps, and rubella vaccine and varicella vaccine are live vaccines commonly given at age 1-2 years and 4-5 years. Dr Swanson recommends waiting four weeks after dupilumab to give a live vaccine and restarting four weeks after the vaccine.  

Moving on to hidradenitis suppurativa (HS), Dr Swanson reviewed the HS treatment landscape. Adalimumab is the only biologic approved for adolescent patients aged 12 years and older with HS, and Dr Swanson advocated for more treatment options for younger patients as HS now appears to be starting at younger ages. For alopecia areata, ritlecitinib 50-mg daily is the only oral JAK inhibitor approved in the adolescent population. Dr Swanson presented multiple cases of treatment success with JAK inhibitors in pediatric and adolescent alopecia areata. Ruxolitinib 1.5% cream is approved for nonsegmental vitiligo in patients 12 years of age and older and can be applied on up to 10% body-surface area. Dr Swanson recommended combining this treatment with oral polypodium leucotomos. While the polypodium capsules can be large, Dr Swanson gave a tip on opening the capsule and mixing the powder in juice for pediatric patients. To conclude, Dr Swanson presented a case of pediatric generalized pustular psoriasis and reminded the audience that spesolimab, an IL-36 receptor inhibitor, is approved for GPP in patients 12 years of age and older.