Table of Content


Autumn 2020, Vol. 28 No. 3

Hong Kong J. Dermatol. Venereol. (2020) 28, 127

Reports on Scientific Meetings

HKSDV & HKSPD Scientific Live Webinar

Reported by KW Chan 陳錦華

Date:   4 August, 2020
Venue:   Webinar
Organiser:   Hong Kong Society of Dermatology and Venereology & Hong Kong Society for Paediatric Dermatology

Targeted therapies: Changing the treatment paradigm in adolescent/ pediatric atopic dermatitis

Speaker: GJA Mark
KK Women's and Children's Hospital, Singapore

Atopic Dermatitis (AD) is common skin condition in children and adolescents. In Singapore, 20.6% of children and adolescents (less than 18 years old) suffered from AD in 2017. Severe psychosocial dysfunction in patients and patients' families result in poorly controlled AD. Most patients improve with traditional treatments including moisturisers, topical corticosteroids and topical calcineurin inhibitors. A minority of them may need second and third-line treatments, including phototherapy and systemic immunomodulators. Biologics are emerging target therapies for AD. Dupilumab is a human IgG monoclonal antibody targeting the common IL-4 receptor, resulting in inhibition of both IL-4 and IL-13 signalling. It has a direct effect on AD disease mechanisms. Studies and early clinical use showed good results, in terms of improvement on signs and symptoms of AD and quality of life. However, cost, unknown long-term efficacy and side effects may limit its use, especially in children. The use of dupilumab may be considered for patients with severe AD, poor quality of life and other co-morbidities, especially if second and third-line treatments have failed or are contraindicated. It is important to have an in-depth discussion with patients and caregivers regarding benefits and costs of biologics treatment and monitoring of short and long-term complications.

Learning points:
Studies on the use of biologics have shown good results but its use, especially in children, may be limited because of cost, unknown long-term efficacy and side effects.