News in brief: Sunburns warranting admission aren’t child’s play; Dupilumab promising in kids with AD; Compression enhances BCC therapy

Skin cancers

12 May 2021

Parents, schools, sports need to step up as young people dominate severe sunburns

Sunburn severe enough to warrant admission to specialist burns services is rare but entirely preventable and concerning.

A review of the Burns Registry of Australia and New Zealand (BRANZ) found 167 cases (0.6%) of severe sunburn amidst 29,382 patients between 2010 and 2019.

Most patients (59%) sustained superficial burns, 29% had mid-dermal burns, 12% had deep dermal burns and 4% sustained full-thickness burns.

Almost 1 in 5 patients with severe sunburn (9%) underwent a burn wound management surgical procedure and 4% required ICU admission.

More than half (62%) of patients were under 25 years of age with numbers fairly evenly across age groups 0-1 year, 1-4 years, 5-14 years and 15-24 years.

Most severe sunburns (64%) occurred while young people participated in a leisure or sporting activity. An additional 12% sustained sunburns while resting or sleeping outside.

JAMA Dermatology

Younger children with AD also benefit from dupilumab

Dupilumab, recently PBS listed for adolescents from age 12 and adults with severe atopic dermatitis, is also looking promising in a younger age group.

Results from the phase 3 LIBERTY AD PEDS trial showed dupilumab in addition to medium‐potency topical corticosteroids led to significant improvement in signs and symptoms in children aged ≥ 6 to < 12 years.

Children randomised to the monoclonal antibody were more likely to achieve Investigator’s Global Assessment (IGA) scores of 0/1 (clear/almost clear) and EASI‐75 than controls on topical corticosteroids alone.

Duplimab also led to significant improvement in itch and CDLQI quality‐of‐life assessment compared with placebo.

Injection‐site reaction and conjunctivitis were more common with dupilumab than with placebo but serious adverse events and treatment discontinuations due to AEs were rare.

The results were presented recently at the ACD ASM.

Compression prevents recurrence of BCCs after PDT

The use of compression in photodynamic activation of BCC may prevent recurrences, an Australian study suggests.

Dr Robert Stephens and colleagues at North West Sydney Dermatology & Laser used a “compression protocol” when treating 32 BCCs with topical (MAL)‐PDT using 630 nm red light and intense pulsed light delivered with enough mechanical pressure in order to blanch the skin.

During follow up of between three and 24 months there was no evidence of recurrence in all but one of the BCCs, according to results they presented at the Australasian College of Dermatology (ACD) virtual meeting in April 2021.

Dr Roberts said the treated BCC were up to a thickness of 1.36 mm, of which 18 were nodular, 13 were superficial and one was morphoeic. Four tumours were recurrent lesions. 20/32 tumours were located on the face including 16 tumours within the “H‐zone”.







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