What are the common dermatological conditions in pediatric patients?

From the Guidelines

Common dermatological conditions in children include atopic dermatitis, diaper rash, impetigo, molluscum contagiosum, and tinea infections, with atopic dermatitis being a chronic relapsing inflammatory skin disease that affects up to 20% of children, as stated in the Taiwan guidelines for the diagnosis and management of pediatric atopic dermatitis 1.

Key Conditions and Their Management

• Atopic dermatitis (eczema) is managed with regular moisturizing, topical corticosteroids like hydrocortisone 1% for mild cases or triamcinolone 0.1% for moderate cases, applied twice daily for 7-14 days, as per the guidelines of care for the management of atopic dermatitis 1.
• Diaper rash requires frequent diaper changes, gentle cleansing, and zinc oxide barrier creams with each change.
• Impetigo, a bacterial skin infection, is treated with topical mupirocin 2% ointment applied three times daily for 5-7 days, or oral antibiotics like cephalexin (25-50 mg/kg/day divided three times daily for 7 days) for widespread cases.
• Molluscum contagiosum, a viral infection causing small flesh-colored bumps, often resolves spontaneously but can be treated with gentle curettage or cantharidin application by a dermatologist.
• Tinea infections (ringworm) respond to topical antifungals like clotrimazole or miconazole applied twice daily for 2-4 weeks.

Prevention Strategies

Prevention strategies include:

• Regular bathing with mild soap
• Moisturizing
• Avoiding known irritants
• Maintaining good hygiene practices These strategies can help reduce the incidence and severity of common dermatological conditions in children, as supported by the joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis in pediatric patients 1.

Consideration of Other Conditions

Other conditions like cutaneous mastocytosis, which can present with symptoms such as flushing, pruritus, and diarrhea, should also be considered in the differential diagnosis, as discussed in the diagnosis and treatment of cutaneous mastocytosis in children 1. However, the primary focus should be on the most common conditions and their evidence-based management, prioritizing the well-being and quality of life of pediatric patients, as emphasized in the Taiwan guidelines for the diagnosis and management of pediatric atopic dermatitis 1.

From the Research

Common Dermatological Conditions in Pediatric Patients

• Atopic dermatitis (AD) is a chronic, recurring, inflammatory skin condition characterized by xerosis, pruritus, and rash 2, 3, 4, 5
• Seborrheic dermatitis (SD) is a common, chronic, relapsing, inflammatory condition that involves sebaceous skin areas, with infection with Malassezia species and the inflammatory response to it being the probable etiologies 3
• Skin infections, including:
  • Viral infections: warts, molluscum contagiosum, hand-foot-and-mouth disease, and herpes simplex 6
  • Bacterial infections: impetigo, cellulitis, and abscess 6
  • Fungal infections: oral and genital candidiasis, tinea capitis, and tinea corporis 6
  • Parasitic infections: scabies 6

Treatment Options

• Topical corticosteroids are the first-line treatment for AD flare-ups 2, 3, 5
• Topical calcineurin inhibitors are second-line treatments for AD 2, 3
• Emollient use, topical corticosteroids and calcineurin inhibitors, and bleach baths can help prevent AD flare-ups 3
• Phototherapy may be utilized in children, particularly in adolescents >12 years, if they have access to treatment 2, 4
• Systemic medical therapies, including traditional immunosuppressants, biologics, and small molecule inhibitors, may be used for severe AD 4