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Winter 2020, Vol. 28 No. 4

Hong Kong J. Dermatol. Venereol. (2020) 28, 169


Reports on Scientific Meetings

The Annual Scientific Meeting by Hong Kong Society of Dermatology and Venereology 2020

Reported by OC Lau 劉安祥

Date:   20 September, 2020
Venue:   Live Webinar
Organiser:   Hong Kong Society of Dermatology and Venereology

A paradigm shift in the management of atopic dermatitis in paediatric population

Speaker: CK Yeung
Hong Kong Society of Dermatology and Venereology, Hong Kong

The atopic dermatitis (AD) is characterised by chronic relapsing itchy lesions typically on face, acral and flexural area in children. The prevalence is estimated to be 15-20% in children and 2-5% in adults. Despite its high prevalence, the impact on quality of life (QOL) is often underestimated.

Management goals of AD include education, avoidance of trigger factors, optimization of skin barrier function, clearance of skin inflammation with interruption of itch-scratch-cycle and to improved QOL by minimizing flares through early treatment. Topical treatments are the first line treatment recommended,but when they fail to have achieve stable long term control, unable to show adequate clinical improvement or there are unacceptable treatment-related adverse events, systemic therapy should be considered. However, all immunosuppressive agents such as azathioprine, cyclosporin A, methotrexate, mycophenolate mofetil are off-label use in paediatric patients and they are limited by the potential toxicities.

Dupilumab is a new emerging targeted therapy. It is a fully human monoclonal antibody directed against IL-4 and IL-13 receptors. Study in adolescents (12-17 years) showed dupilumab has clinically meaningful improvement in AD signs, symptoms and QOL in moderate-to-severe adolescents. The safety profile is acceptable with higher rate of conjunctivitis and injection-site reactions in dupilumab group. Both placebo-corrected efficacy and safety of dupilumab in adolescent are similar to those in adults.

Learning points:
Dupilumab provide significant clinical benefit for young patients whose disease inadequately managed by existing options.