Background: A needs assessment for patients with hidradenitis suppurativa (HS) will support advancements in multidisciplinary care, treatment, research, advocacy, and philanthropy.

Our findings illustrate the emotional impact of atopic dermatitis and the frustration with the lack of potential cure. 'Corticosteroid phobia' was universal among parents in our cohort and is a fear generated by doctors, pharmacists, close acquaintances and information from the internet. Participants expressed high levels of parental guilt linked to a desire for an eradicable 'cause' for atopic dermatitis, despite intellectually understanding this is a genetically determined condition. Parents were willing to change attitudes with accurate information from perceived reliable sources, positive hospitalization experiences and a relationship with a trusted dermatologist. Parents' suggestions to improve confidence included the provision of readily available information and better access to doctor- and nurse-led paediatric dermatology services.

Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession.

Atopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self-esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short-term hypothalamic-pituitary-adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children.

Atopic dermatitis (AD) is a chronic relapsing inflammatory disease of the skin and is the most common paediatric dermatological condition. While no cure is available, it can be treated effectively if adherence to a therapeutic plan is maintained. Poor adherence to treatment is common in AD and can lead to treatment failure, which has significant impacts on the patient, family and society. A comprehensive literature search was conducted to identify factors that contribute to poor treatment adherence in childhood AD and to identify possible strategies to remedy these. Identified factors leading to poor treatment adherence include: complexity of treatment regimen, lack of knowledge, impaired quality of life, dissatisfaction with treatment strategies, infrequent follow up, corticosteroid phobia and the use of complementary and alternative medicine. Effective strategies to increase treatment adherence include: caregiver education and utilisation of education adjuncts, optimisation of the patient/caregiver-clinician relationship, early and frequent follow up and improvement of patient and caregiver quality of life.

When vulvar lichen sclerosus occurs in prepubertal children it is widely believed that it is likely to remit at puberty. However when it occurs in adult women it is accepted that remission is unlikely and that in addition untreated or inadequately treated disease may be complicated by significant disturbance of vulvar architecture and less commonly squamous cell carcinoma. Our database reveals 18 girls who developed lichen sclerosus prior to puberty who are now adolescents or young adults. Twelve have remained under surveillance and the other six patients have been lost to follow-up. We report a prospective series of these 12 patients. Three patients have achieved complete remission sustained for three or more years, all prior to menarche. Nine patients, or 75% of the cohort, who still had active lichen sclerosus at puberty continue to require maintenance therapy after menarche. Of the 12, six have had significant disturbance of vulvar architecture. The concept that prepubertal lichen sclerosus resolves at puberty would appear not to be true in the majority of patients. Even when diagnosed early and treated effectively, childhood onset lichen sclerosus may be complicated by distortion of vulvar architecture.

suggests that psoriasis poses a cardiometabolic risk in children, as in adults. The best way to screen for this has not yet been established. Waist-to-height ratio (WtHR) can easily identify children with increased central adiposity and is a simpler alternative to body mass index (BMI) that does not require growth charts or percentiles. Having a WtHR of 0.5 or greater is associated with future cardiovascular risk. OBJECTIVE To determine whether children with psoriasis are more likely to have increased WtHR, obesity, and metabolic syndrome relative to children without psoriasis. DESIGN, SETTING, AND PARTICIPANTS This multicenter cross-sectional prospective case-control study was conducted from February 7, 2014, to July 15, 2015, in a tertiary referral center pediatric dermatology clinic and in 2 private consultant rooms of specialist dermatologists, all located in Sydney and Gosford, New South Wales, Australia. Participants were children (110 girls and 98 boys) aged from 5 to 16 years, 135 children with psoriasis and 73 controls with noninflammatory skin conditions. MAIN OUTCOMES AND MEASURES Increased central adiposity indicated by WtHR of 0.5 or higher, metabolic syndrome, and increased BMI. RESULTS Of the 208 children evaluated (110 girls and 98 boys) aged from 5 to 16 years (mean age, 8.9 years), 135 had psoriasis and 73 were controls with noninflammatory skin conditions. Children with psoriasis were more likely to have increased central adiposity, with WtHR of 0.5 or greater (29% [n = 39] vs 11% [n = 8]; P = .002). Four of 53 children older than 10 years with psoriasis were found to have metabolic syndrome compared with none of 29 in the control group (8% vs 0%; P = .29). Three of 15 children with moderate to severe psoriasis had metabolic syndrome compared with 1 of 38 children with mild psoriasis (20% vs 3%; P = .06). Children with moderate to severe psoriasis had a higher mean WtHR than children with mild psoriasis (0.48 vs 0.46; P = .04). Overweight and obesity according to BMI did not vary significantly between children with psoriasis and controls (17% [n = 23] vs 16% [n = 12]; P = .91). CONCLUSIONS AND RELEVANCE In this Australian cohort of children with psoriasis, elevated WtHR was significantly more common in patients with psoriasis than in controls, while proportions of participants with metabolic syndrome or BMI-determined obesity were not significantly different between the 2 groups.

Summary Background Hidradenitis suppurativa (HS) is a debilitating and distressing chronic inflammatory skin disease. There is also evolving evidence supporting the association between HS and cardiovascular risk factors, including smoking, obesity, hyperlipidaemia and metabolic syndrome. Notably, these are clinical features and risk factors that are closely associated with type 2 diabetes mellitus (DM). Aims We performed a pooled adjusted meta‐analysis of comparative studies to investigate the relationship between HS and DM. Methods A systematic review and meta‐analysis was performed according to recommended Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. OR was used as the summary effect size. Results From pooled analysis of unadjusted data from 12 studies, we found a significantly higher proportion of DM in HS cases compared with non‐HS healthy controls (16.1% vs. 15.7%; OR = 2.17; 95% CI 1.85–2.55; P < 0.001). Adjusted effect sizes from five studies were also pooled. A significantly higher proportion of DM was found for HS compared with healthy controls, although the effect size was attenuated compared with unadjusted analyses (OR 1.69; 95% CI 1.50–1.91; P < 0.001). Conclusions To our knowledge, our systematic review and meta‐analysis is the first to pool adjusted effect sizes. We found that HS was associated with a 1.69‐fold increased odds of diabetes; however, the absolute risk difference was small (16.1% vs. 15.7%) and is probably not clinically relevant. Treating clinicians should be aware of this association, but there may not be an urgent need to perform screening for impaired glucose tolerance or diabetes.