Albert Yan, MD: Detecting Pediatric Skin Disease with the Microbiome, Technology

Adoption of sequencing and advances in systemic evaluation capability have made endless opportunities for better diagnostics in fields including dermatology.

In an interview with HCPLive during the Maui Derm 2023 NP + PA Summer Conference in Colorado Springs this week, Albert Yan, MD, chief of pediatric dermatology at the Children’s Hospital of Philadelphia (CHOP), discussed a pair of recent benchmarks in technology-driven diagnostics that his team and/or colleagues had been involved with.

The first findings, from Yan’s team at CHOP, showed preadolescent patients with acne start to narrow down the microbial flora on their skin—overgrowth of certain bacterium is a key correlation with acne presence.¹

“And as you effectively treat those patients with topical agents like benzoyl peroxide, topical retinoids, it starts to rebalance things and you start to see a more diverse microbial environment that reflects a return to the more normal state in patients,” Yan explained.

The findings support the concept of the microbiome as both a useful marker for disease severity, as well as a potential driver of the disease itself—and therefore a target for intervention—in dermatology.

“I think the microbiome is a really interesting area of research for a number of different dermatologic diseases, because it can play a role in the pathogenesis of numerous different skin disorders: acne, atopic dermatitis, etc,” Yan said.

The second findings, from Yan’s colleagues at CHOP, regarded the use of more sophisticated genomic profiling for complex vascular anomalies to help isolate relevant cells and eventually identify gene abnormalities in patients.²

“In doing so…they were able to come up with novel diagnoses for some of these cases that triggered a change in the treatment plan for those patients, and that led to significant improvement in the management of those particularly complex disorders,” Yan said. “So I think that’s exciting, and that along with the advances in artificial intelligence bode really well for clinicians in what we do.”

References

1. ^{Coughlin CC, Swink SM, Horwinski J, et al. The preadolescent acne microbiome: A prospective, randomized, pilot study investigating characterization and effects of acne therapy. Pediatr Dermatol. 2017;34(6):661-664. doi:10.1111/pde.13261}
2. ^{Li, Sheppard et al, “Genomic profiling informs diagnoses and treatment in vascular anomalies.” Nature Medicine. Online June 1, 2023. DOI: 10.1038/s41591-023-02364-x.}