Filling the gaps in pediatric dermatology

Loretta Fiorillo works to transform treatment options for children with psoriasis.

Alexis Millar - 5 January 2018

For eight-year-old Jillian Karst, life is filled with friends' birthday parties and fun days at school. It's a normal life for a little girl from southern Saskatchewan, but it's a big change from where she was only a few short months ago.

Jillian has severe psoriasis, which covered her face, scalp and body in very large and painful red, scaly patches. Jillian found it difficult to attend school or see friends, but that quickly changed thanks to the chance to participate in a clinical research trial at the University of Alberta.

"Now it's a night and day difference," said Shirley Karst, Jillian's mom. "She's a social butterfly!"

Strides to improve children's health achieved through clinical research

Currently, there are no systemic drugs licensed for psoriasis in children. When a new medication was identified that had been approved for adult psoriasis and administered orally, Loretta Fiorillo, member of the Women and Children's Health Research Institute (WCHRI) at the University of Alberta and divisional director of pediatric dermatology in the Department of Pediatrics, knew she wanted to study it for her pediatric patients.

"I see patients all the time with psoriasis. Psoriasis in children can be very detrimental to their self-image, since it is located in such obvious places," explained Fiorillo. "Having red, scaly patches on their faces really affects their daily lives, experiences with peers, confidence and school performance."

The Karst family learned about Fiorillo's first clinical trial for children with psoriasis from their dermatologist in Saskatchewan. Within weeks, the family made the trek to Edmonton to meet with Fiorillo and her WCHRI research coordinator, Heather Rylance.

Today, Jillian has only a single visible patch of psoriasis on her arm and is a bright and bubbly young girl. "It's been a life-changing experience for Jillian," said Karst. "I would do all of this again in a heartbeat."

The team is pleased with the progress, especially in Jillian's case. Fiorillo hopes that this medication will be approved to treat pediatric psoriasis. "The results seem very promising."

The study has also garnered attention-recently winning the Clinical Research Site Award from INC Research in recognition of the group's exceptional study enrolment rate, data integrity and overall quality of work.

"I'm very happy because often dermatology is a forgotten specialty," said Fiorillo, emphasizing the award is the result of the collaborative efforts between the Stollery Children's Hospital, staff within the Pediatric Clinical Investigation Unit and her research team, including Rylance.

This was Fiorillo's first clinical trial but it will not be her last-she's looking forward to starting more trials to help children like Jillian, who have limited solutions or medications available.

"I see this study as a stepping stone to more research that will help fill the gap in pediatric dermatology treatments. This experience has opened my eyes to the support available for clinical trials―the idea that if there is an unmet need, I can look at helping to meet that need through support from the Stollery Children's Hospital and WCHRI."

Fiorillo's research was funded by the generous support of the Stollery Children's Hospital Foundation, through WCHRI. This story was first published in WCHRI's 2016/17 Annual Report.