Children’s skin is special. It significantly differs from the skin of an adult. It is thinner and much more easily exposed to negative effects of environmental factors. That is why dermatological problems occur more often in children than in adult patients. Specialists at Pediatric Dermatology Department at Tel Aviv Medical Clinic know about all age-related skin characteristics, which is taken into account when managing young patients with dermatological problems.

Our specialists are proficient in modern techniques for diagnosing and treating skin diseases. Pediatric Dermatology Department employs only highly qualified medical personnel who diagnose and treat skin diseases in children of any complexity. All doctors apply an individual approach to each individual child and his problem, selecting only an effective treatment regimen taking into account patient’s age, the cause of his illness, and contraindications to certain medications or procedures.

Definitely, you should consult a dermatologist if any rash appears on your child’s skin. In addition, consultation may be required if problems arise with nail or hair growth; primary or secondary immunodeficiency in a child; chronic diseases of gastrointestinal tract; frequent allergic reactions on skin; genetic predisposition to certain dermatological diseases.

Doctor examining baby skin on hand with magnifying glass in clinic. Treatment of pigmented nevi in children concept

Departments

Several highly specialized individual clinics operate on the basis of TAMC Pediatric Dermatology Department:

General dermatology – specialists in this profile conduct an initial consultation and examination of a child with a rash. Specialist also prescribes a set of additional examinations, if necessary, and outlines a treatment program for the most common dermatological diseases. In cases where a patient requires specialized care, dermatologist refers the patient to a specific specialist, for example, an oncology dermatologist.
Oncology dermatology – specialists in this profile are engaged in diagnostics and treatment of benign and malignant neoplasms in children (papillomas, nevi, skin hemangiomas, melanoma, basal cell and squamous cell skin cancer).
Clinic for psoriasis treatment – specialist dermatologists in this sphere are engaged in modern and comprehensive treatment of various forms of psoriasis. The effectiveness of treating this skin pathology in Israel is known far beyond its borders, so thousands of children with severe variants of psoriasis come here every year for treatment.
Clinic for atopic dermatitis treatment – specialists in this profile are engaged in comprehensive diagnosis and treatment of allergic and atopic dermatitis; patients can also undergo modern allergy treatment – ASIT therapy on the basis of our department.
Acne Treatment Clinic – specialists in this profile treat acne in teenagers.
Clinic for treatment of genetic diseases with a predominant involvement of skin – dermatologists provide the necessary assistance for diseases such as ichthyosis, epidermolysis bullosa, chronic keratosis – lichen planus pilaris (Devergie’s disease).
Clinic of skin mycoses diagnostics and treatment.

What diseases does Pediatric Dermatology Department treat?

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Diagnostic methods in pediatric dermatology

The presence of any skin rash requires a detailed and modern diagnostics, and not just an examination by a dermatologist. During the diagnostic process, it is necessary to find the cause of pathological malformations on skin in order to eliminate it and prevent relapses.

An indispensable diagnostic method in practice of modern dermatologist is dermatoscopy. This is a way to examine the surface layers of skin using a special instrument – a dermatoscope. Our clinic’s specialists use only the highest quality Israeli, American or German-made devices, which allow them to examine an element on skin in detail under high magnification in various modes, examine its blood supply, and also make high-quality digital images or video recordings of examination process.

Cytological and histological examination remains an important diagnostic method. For a cytological examination, a scraping, smear or impression smear from the surface of an element of rash is sufficient, which doctor examines under a microscope and issues a conclusion about the nature of skin disease; for example, in this way the vast majority of fungal infections of skin and nails can be diagnosed.

In case of tumor-like or oncological neoplasms (various nevi, dermatofibromas, chronic ulcers, etc.), a more detailed examination of biological material sample is required. To do this, a biopsy is performed with the composing and fixation of material samples and subsequent viewing of these blocks by a highly qualified pathologist in order to verify the diagnosis histologically. Thanks to such molecular tests, we are confident in correctness of final diagnosis and ffectiveness of future treatment regimen.

A modern type of biopsy is a punch biopsy. It allows us to establish an accurate diagnosis in a short time with an accuracy of 99% and begin appropriate therapy. Sampling of biological material occurs not with the help of regular needle, but with a specially designed DERMO-PUNCH instrument (a cylinder with a sharp cutting edge) designed for this purpose.

If clinical situation requires, young patients are referred for modern imaging diagnostics of the whole body. This situation arises when diagnosing a malignant skin tumor in order to make sure that there are no metastases in distant organs or to find them if, unfortunately, they have already developed.

The entire range of modern medical imaging techniques is used – CT, MRI with and without contrast, PET-CT, PET-MRI, ultrasound, etc. All the necessary modern diagnostic methods using innovative equipment are performed directly at TAMC.

For etiological diagnostics of allergic skin diseases, various allergic provocative tests and skin tests (prick test, patch test) are used, which make it possible to verify the causative factor of allergic rashes and get rid of the disease once and for all.

Important!

TAMC specialists conduct only comprehensive diagnostic programs to find causative and concomitant diseases, obtain an accurate and true picture of problem, and select the best and effective treatment regimens.

Modern treatment methods in pediatric dermatology

Patients of Pediatric Dermatology Department at TAMC have a unique opportunity to take part in clinical trials of certain innovative drugs or methods for treating severe dermatological diseases. For some children, this is the only chance to continue life and maintain its high quality.

Allergen-specific immune therapy (ASIT) is an effective method for treating allergic skin diseases when it is not possible to get rid of allergen influence. Procedure is based on the long-term introduction of an allergen into the body, which causes an individual reaction, starting with very small quantities, gradually increasing the dose to a high one. Such actions teach the immune system tolerance, that is, not to react very actively to allergen. Over time, allergic reactions stop. This is a long process (from 6 months, and sometimes longer). All this time, our doctors are in contact with their patients, selecting the required dose of allergen.

If dermatologist diagnoses a patient with benign skin malformations, exclusively minimally invasive techniques are used to remove them, which are not accompanied by pain during removal and subsequent cosmetic defects (the wound heals without scar formation). Such techniques include laser vaporization, cryodestruction with liquid nitrogen, radio wave coagulation, electrocoagulation. All our specialists master the techniques of these interventions and effectively apply them in practice.

PUVA therapy is actively used to treat young patients with severe types of psoriasis. This is a combined phototherapy technique in which the child is given photoactive drugs (psoralens) and then irradiated with ultraviolet light. Psoralens increase the sensitivity of skin with a rash, due to which it actively absorbs ultraviolet light, which has a restorative effect on skin cells and promotes remission of the disease.

Spinal surgery. Group of surgeons in operating room with surgery equipment. Laminectomy. Modern medical background

TAMC uses the latest methods for treating melanoma in children – the use of drugs based on T-vec. This is a medicine based on live viruses of the T-vec group. They are injected directly into melanoma, due to which the tumor is destroyed from the inside by patient’s immune system.

Mohs micrographic surgery is currently the best treatment option for skin cancer. This intervention makes it possible to achieve the maximum percentage of cure for basal cell carcinoma, squamous cell carcinoma, and melanoma. The essence of the method is stage-by-stage excision of tumor with mandatory histological control of each manipulation. In clinics in America, Israel and other countries with a highly developed level of medicine, Mohs surgery is accepted as a model of micrographic intervention and is successfully used for complete treatment of skin cancer.

Of all the treatments for skin cancer, radiation therapy provides the best results. This primarily concerns facial skin tumors. Considering that there are basal cell cancers on facial skin, radiation therapy provides a high percentage of treatment with a good cosmetic effect. Radiation therapy for skin cancer has the following advantages over surgical treatment: it is a bloodless, painless method of treatment and provides a good cosmetic effect. At TAMC, only modern and safe linear accelerators for external beam radiation therapy and safe contact irradiation techniques, such as brachytherapy, are used to treat children.

Chemotherapy can also be used in complex treatment of skin malignant neoplasms. Unfortunately, a pathology such as melanoma is resistant to classical chemotherapy drugs. Therefore, in such cases, treatment is supplemented with modern methods of drug treatment – targeted drugs, drugs with immunobiological action.

Antibodies to programmed death receptor 1 (PD-1) (pembrolizumab and nivolumab) are used among immunobiological drugs for skin cancer. Ipilimumab (cytotoxic T-lymphocyte-associated antigen 4 – CTLA-4 monoclonal antibody) is another form of immunotherapy that may also prolong the survival of melanoma patients. A combination of a PD-1 and CTLA-4 inhibitor (nivolumab/ipilimumab) is preferred, but a combination of a PD-1 and LAG-3 inhibitor (nivolumab/relatlimab) is also available.

Molecularly targeted therapies include application of vemurafenib, dabrafenib and encorafenib, which work by inhibiting the activity of BRAF (protein kinase) gene, resulting in slowing or stopping the proliferation of tumor cells. These drugs prolong the survival of patients with metastatic disease.

The addition of mitogen-activated protein kinase (MEK) inhibitor enzymes MEK1 and MEK2 (trametinib, cobimetinib, and binimetinib) further prolongs survival in this group of patients. Combination BRAF and MEK inhibitors (eg, dabrafenib/trametinib, encorafenib/binimetinib, vemurafenib/cobimetinib) are available for patients who are not candidates for immunotherapy.

TIL therapy for melanoma is an innovative modern treatment method. Method is based on application of tumor-infiltrating lymphocytes (TIL). Even patients with distant metastases of melanoma after a course of TIL treatment show a positive response to therapy.

Thus, in Pediatric Dermatology department of TAMC, children of any age can receive all necessary and modern medical care in fight against various skin diseases. The entire treatment and diagnostic process takes place in physically and psychologically comfortable conditions; if necessary, other specialists are involved – oncologists, rehabilitation specialists, plastic surgeons, psychologists.