What are common pediatric dermatological problems?

From the Guidelines

Common pediatric dermatologic problems include atopic dermatitis (eczema), diaper dermatitis, acne, warts, molluscum contagiosum, impetigo, and tinea infections, with atopic dermatitis being a chronic relapsing inflammatory skin disease commonly seen in children, as noted in the Taiwan guidelines for the diagnosis and management of pediatric atopic dermatitis 1.

Key Conditions and Treatments

• Atopic dermatitis typically requires daily moisturizing with fragrance-free emollients and topical corticosteroids like hydrocortisone 1% for mild cases or triamcinolone 0.1% for moderate cases, applied twice daily for 7-14 days.
• Diaper dermatitis responds well to barrier creams containing zinc oxide applied at each diaper change, with antifungal creams like nystatin added if Candida is suspected.
• Acne in adolescents can be treated with benzoyl peroxide 2.5-5% wash daily and topical retinoids like adapalene 0.1% gel at night, as recommended by the guidelines of care for the management of acne vulgaris 1.
• Warts often resolve spontaneously but can be treated with salicylic acid preparations or cryotherapy for persistent cases.
• Molluscum contagiosum typically self-resolves within 6-18 months but can be treated with gentle curettage or cantharidin if causing distress.
• Impetigo requires topical mupirocin ointment applied three times daily for 5-7 days, or oral antibiotics like cephalexin (25-50 mg/kg/day divided three times daily) for widespread cases.
• Tinea infections respond to topical antifungals like clotrimazole or terbinafine applied twice daily for 2-4 weeks.

Importance of Early Intervention

Early intervention is crucial as many conditions can worsen without proper treatment. Parents should be educated about proper skin care routines, avoiding triggers, and recognizing signs of secondary infection requiring medical attention. The management of these conditions should be guided by the most recent and highest quality evidence, such as the guidelines provided by the Taiwan Academy of Pediatric Allergy, Asthma and Immunology 1 and the American Academy of Dermatology 1.

From the FDA Drug Label

Directions Adults and children 12 years of age and older: use once daily clean the skin gently and pat dry before applying the product cover the entire affected area with a thin layer. For example, if your acne in on the face, apply the product to the entire face. Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily Purpose Acne treatment

Common pediatric dermatologic problems include:

• Acne in children 12 years of age and older 2
• Itching of skin irritation, inflammation, and rashes in children 2 years of age and older 3 Note that for children under 12 years of age (for adapalene) or under 2 years of age (for hydrocortisone), a doctor should be consulted. 2 3

From the Research

Common Pediatric Dermatologic Problems

• Skin lesions, such as vitiligo, acrochordons, dermatofibromas, keloids, milia, neurofibromas, and pyogenic granulomas, are common in the pediatric population 4
• Conditions characterized by scaling patches and plaques, including psoriasis, atopic dermatitis, poison ivy, and eczema, are also prevalent 4
• Acne vulgaris is the most common skin disease in the pediatric and adolescent population, and can be psychologically debilitating 4
• Vascular anomalies, such as port wine stains and hemangiomas, are also common 4

Infectious Dermatologic Conditions

• Bacterial infections, including impetigo, erythema chronicum migrans, folliculitis, and cellulitis, can present as skin lesions or rashes 4
• Fungal infections, such as tinea, can be treated with topical antifungals, while viral infections, including warts, varicella, molluscum contagiosum, and herpes, require various treatments 4
• Scabies and lice are infectious agents that can be treated with permethrin and pyrethrin solutions 4

Atopic Dermatitis

• Atopic dermatitis (AD) is a chronic, recurring, inflammatory skin condition characterized by xerosis, pruritus, and rash 5, 6, 7
• Treatment of AD typically involves topical corticosteroids, emollients, and calcineurin inhibitors, as well as phototherapy for refractory cases 5, 6, 7
• Antibiotic therapy may be necessary to treat secondary skin infections in patients with AD 8

Other Dermatologic Conditions

• Seborrheic dermatitis is a common, chronic, relapsing, inflammatory condition that involves sebaceous skin areas, and can be treated with topical ketoconazole shampoo, gel, or lotion 5
• Psoriasis, poison ivy, and eczema are conditions characterized by scaling patches and plaques, and can be treated with topical emollients and corticosteroids 4