Division of Pediatric Dermatology

The Saint Louis University Division of Pediatric Dermatology is a nationally recognized center of expertise, providing tertiary medical, surgical and investigative dermatology services for children with all forms of skin disease.

Pediatric Dermatology Training

In addition to a busy clinical service, the division provides lectures and didactic training for dermatology and pediatrics residents, medical students, allied health students from Saint Louis University and other collaborating institutions, as well as CGCMC clinical staff.

Elaine Siegfried, M.D., has been an active mentor for medical students and dermatology residents, supervising several student and dermatology resident research projects. Dr. Siegfried is also a frequently invited speaker and appointed member of multiple national organizations and working groups.

Since 2015, Dr. Siegfried has focused significant time and energy to leading a national multi specialty effort in collaboration with the FDA Division of Dermatology and Dental Products to create a draft guidance document for the industry to help standardize and optimize new drug clinical trials protocols for atopic dermatitis in pediatric patients.

Staff and Facilities

The members of the division include one full-time physician, a physician assistant, two full-time RNs and an administrative assistant. Remote dermatology consultation is available seven days per week, 24 hours per day via the Access Line and direct phone consultation. To date, this system has addressed more than 400 requests (>40/month).

In-person consultation is provided for the emergency department, inpatient services and hospitalized dermatology patients at SSM Health Cardinal Glennon Children’s Hospital.

Ambulatory patients are seen at SSM Health Cardinal Glennon Children’s Hospital two days per week in addition to several other locations. The division directs industry-sponsored clinical trials utilizing the infrastructure of the Department of Pediatrics Clinical Trials Unit and Department of Dermatology Clinical Trials Unit.

Service Overview

Pediatric dermatology encompasses many diverse diagnoses that may be the largest of any subspecialty. The Dermatology Division in the Department of Pediatrics provides care for children with a range of congenital and acquired skin disease, including:

  • Acne
  • Dermato-oncology
  • Acquired Bullous Disorders
  • Epidermolysis Bullosa
  • Alopecias
  • Genodermatoses
  • Connective Tissue Diseases (lupus, morphea, dermatomyositis
  • Hemangiomas
  • Cellular infiltrates (mastocytosis, lymphocytic and neutrophilic spectrum)
  • Hyperhidrosis
  • Ichthyoses
  • Hypersensitivity Reactions (Erythema multiforme, Stevens-
  • Johnson, Toxic Epidermal necrolysis)
  • Inflammatory Skin Diseases (psoriasis, eczemas, overlap)
  • Skin infections (Tinea, Candidiasis, HSV, molluscipox, verruca vulgaris)
  • Neonatal Skin Disease/complications (incl Collodion and Harlequin Ichthyosis)
  • Urticaria
  • Nail Disease
  • Vascular Malformations
  • Vitiligo

Research

Multicenter Collaboration
  • PeDRA: The TREatment of severe Atopic dermatitis in children Taskforce (TREAT) U.S. and Canada Survey
  • PeDRA: Retrospective review of systemic therapy for atopic dermatitis in children
  • SUNY Downstate/Yale: Management of harlequin ichthyosis: consensus opinion (submitted for publication)
  • UT-Houston: Infantile hemangiomas: analysis of untreated lesions to establish early systemic treatment criteria, presented at the American Academy of Dermatology annual meeting, Washington DC, March 2016
  • UCSD: Pediatric psoriasis disease and treatment: effects on concomitant  NAFLD
  • International Psoriasis Council: Retrospective Chart Review of Systemic Treatments in Pediatric Psoriasis: An International Multicenter Study
Research and Grants

Active Industry Sponsored Clinical Trials

  • Phase 2, An Open-Label 5 year Extension Study to Evaluate the Safety of Etanercept in Pediatric Subjects with Plaque Psoriasis, Principal Investigator, Sponsor:  Amgen
  • A Multicenter, Randomized, Double-Blind, Vehicle-Controlled Study of the Safety and Efficacy of AN2728 Topical Ointment, 2% in Children, Adolescents, and Adults (Ages 2 Years and Older) With Atopic Dermatitis, Sponsor:  Anacor
  • A Multicenter, Randomized, Double-Blind, Phase 3 Study of the Safety, Efficacy, Systemic Exposure, and Pharmacodynamics of Calcipotriene Foam, 0.005%, Versus Vehicle Foam in Pediatric Subjects (Ages 2 to 11 Years) with Plaque Psoriasis (Site initiation 9/29/15), Sponsor:  GSK-Stiefel
  • A Randomized, Double-Blind, Placebo-Controlled Study To Investigate The Efficacy and Safety Of Dupilumab Monotherapy In Patients 12 to 18 Years Of Age, With Moderate-To-Severe Atopic Dermatitis, Sponsor: Regeneron Pharmaceuticals

SLU Medical Student/Resident Collaboration

  • Darji K M4: INF gamma for chronic/recurrent eczema herpeticum
  • Bryan Z M4: Vitamin D deficiency and atopic dermatitis: consider disease, race, and body mass
  • Janssen M M3: Occult celiac disease presenting with immunonegative dermatitis in childhood
  • Jackson S M4: Paradoxic inflammatory skin disease
  • Kurtz A Derm Research Fellow: Dosing errors in propranolol administration for the treatment of infantile hemangioma.
  • Dilworth D R2: Impact of prior authorization on office flow and patient access to medication
  • Varade R R3: Harlequin ichthyosis
  • Simonetta C R3: A case of multiple palisaded encapsulated neuromas in a pediatric patient with dysmorphic features
  • Sutton A R3: Neonatal lupus erythematosus presenting with widespread atrophic scarring
  • Varade R R3: The impact of quantifiable parameters on treatment adherence for children with chronic inflammatory skin disease

SLU Graduate/Faculty Collaboration

  • Schneider C PhD candidate: Parent-child interactional factors affecting medical adherence in children with atopic dermatitis
  • Chaudhry S Asst. Prof Derm: Pediatric dermatology no-show rates: impact of insurance type and scheduling policy
  • Frisch S Private Dermatologist: Immune function in children with severe inflammatory skin disease: A retrospective analysis
  • Morrison L Prof. Micro: Herpes simplex virus detection in atopic children with suspected eczema herpeticum, and trial of topical treatment with ciclopirox olamine

Multicenter Collaboration

  • PeDRA: The TREatment of severe Atopic dermatitis in children Taskforce (TREAT) U.S. and Canada Survey
  • PeDRA: Retrospective review of systemic therapy for atopic dermatitis in children
  • SUNY Downstate/Yale: Management of harlequin ichthyosis: consensus opinion
  • UT-Houston: Infantile hemangiomas: analysis of untreated lesions to establish early systemic treatment criteria
  • UCSD: Pediatric psoriasis disease and treatment: Effects on Concomitant NAFLD
  • International Psoriasis Council: Retrospective Chart Review of Systemic Treatments in Pediatric Psoriasis: An International Multicenter Study

Extramural Collaborative Efforts

  • Evaluation of Phenotypic and Genetic Properties in Male Subjects Affected By X-linked Hypohidrotic Ectodermal Dysplasia (XLHED): Intrafamilial Variation and Assessment of Skin Properties (NFED, University of Colorado via ICTS)
  • Systemic Therapies for Pediatric Atopic Dermatitis and Systemic Therapies for Pediatric Psoriasis (via PeDRA - Pediatric Dermatology Research Alliance - an independent multicenter consortium of clinical investigators)
  • Protocol Guidance for New Therapeutic Agents for Atopic Dermatitis in Children (via PeDRA; R-13 and WUSTL ICTS grants submitted)
Publications
  •  Bryan ZT, Missall TA, Stieren S, Siegfried E, Burkemper NM. Clinicopathologic evaluation of cardiofaciocutaneous syndrome: overcoming the challenges of diagnosing a rare genodermatosis. Pediatr Dermatol. 2015. 32(1):e23-8.
  • Luger T, Boguniewicz M, Carr W, Cork M, Deleuran M, Eichenfield L, Eigenmann P, Fölster-Holst R, Gelmetti C, Gollnick H, Hamelmann E, Hebert AA, Muraro A, Oranje AP, Paller AS, Paul C, Puig L, Ring J, Siegfried EC, Spergel JM, Stingl G, Taieb A, Torrelo A, Werfel T, Wahn U. Pimecrolimus in atopic dermatitis: consensus on safety and the need to allow use in infants. Pediatr Allergy Immunol. 2015. 26(4):306-15.
  • Siegfried EC, Jaworski JC, Kaiser JD, Hebert AA. Systematic review of published trials: long-term safety of topical corticosteroids and topical calcineurin inhibitors in pediatric patients with atopic dermatitis. BMC Pediatr. 2016 Jun 7;16:75.
  • Beal BT, Prodanovic E, Kuo JE, Armbrecht ES, Peter JR, Siegfried EC. Impact of a Pediatric Dermatology Service on Emergency Department Utilization for Children with Dermatitis. Pediatr Dermatol. 2016 ;33(1):69-74.
  • Siegfried EC, Hebert AA. Diagnosis of Atopic Dermatitis: Mimics, Overlaps, and Complications. J Clin Med. 2015. 6;4(5):884-917.
  • Paller AS, Siegfried EC, Pariser DM, Rice KC, Trivedi M, Iles J, Collier DH, Kricorian G, Langley RG. Long-term safety and efficacy of etanercept in children and adolescents with plaque psoriasis. J Am Acad Dermatol. 2016 Feb;74(2):280-7.e1-3.
Abstracts
  • Kavita Darji, M4; Stephanie Frisch, MD; Elaine Siegfried, MD.  A Retrospective Review of Interferon Gamma for Children with Severe Atopic Dermatitis and Recurrent Eczema Herpeticum.  Society for Pediatric Dermatology Annual Meeting, Jul 2015, Minneapolis, MN and MO ACP Annual Meeting, Sep 2015
  • Varade R MD R3: The impact of quantifiable parameters on treatment adherence for children with chronic inflammatory skin disease, Annual Saint Louis University Dermatology Research Symposium, June 2016
  • Kurtz A Derm Research Fellow: Dosing errors in propranolol administration for the treatment of infantile hemangioma. Annual Saint Louis University Dermatology Research Symposium, June 2016 and Society for Pediatric Dermatology Annual Meeting, Jul 2016, Minneapolis, MN.
  • Dilworth D MD R2: Impact of prior authorization on office flow and patient access to medication,  Annual Saint Louis University Dermatology Research Symposium, June 2016
  • Varade R MD R3: Harlequin ichthyosis. American Academy of Dermatology Annual Meeting, Washington, DC, March 2016
  • Simonetta C MD R3: A case of multiple palisaded encapsulated neuromas in a pediatric patient with dysmorphic features.  Annual meeting of the Missouri Derm Society,  September  2015
  • Sutton A MD R3: Neonatal lupus erythematosus presenting with widespread atrophic scarring. Annual meeting of the Missouri Derm Society,  September  2015