What are common pediatric dermatological problems?

From the Guidelines

Common pediatric dermatologic problems include atopic dermatitis (eczema), diaper rash, impetigo, molluscum contagiosum, warts, tinea infections, acne, and scabies. Atopic dermatitis presents as dry, itchy, red patches typically on the face, neck, and flexural areas of extremities, treated with moisturizers and topical corticosteroids like hydrocortisone 1% for mild cases or triamcinolone 0.1% for moderate cases, as recommended by guidelines of care for the management of atopic dermatitis 1. Some key points to consider in the management of these conditions include:

• Diaper rash appears as red, irritated skin in the diaper area and responds to frequent diaper changes, barrier creams with zinc oxide, and brief exposure to air.
• Impetigo shows as honey-colored crusted lesions or fluid-filled blisters, requiring mupirocin ointment applied three times daily for 5-7 days or oral antibiotics for widespread cases.
• Molluscum contagiosum manifests as small, flesh-colored papules with central umbilication that often resolve spontaneously but can be treated with cantharidin, cryotherapy, or curettage if persistent.
• Warts appear as rough, skin-colored growths caused by HPV, treated with salicylic acid preparations, cryotherapy, or duct tape occlusion.
• Tinea infections (ringworm) present as circular, scaly patches with central clearing, treated with topical antifungals like clotrimazole or terbinafine twice daily for 2-4 weeks.
• Adolescent acne involves comedones, papules, and pustules on the face, chest, and back, managed with benzoyl peroxide washes, topical retinoids like adapalene 0.1%, and topical antibiotics such as clindamycin 1%, as per the guidelines of care for the management of acne vulgaris 1.
• Scabies causes intense itching and linear burrows, particularly between fingers and on wrists, treated with permethrin 5% cream applied from neck down, left on for 8-14 hours, then repeated in one week. It is also important to note that visual identification is crucial for accurate diagnosis and treatment of these conditions, although pictures cannot be included in this text-based response. Recent guidelines, such as the Taiwan guidelines for the diagnosis and management of pediatric atopic dermatitis, provide a concise overview of the epidemiology, clinical characteristics, diagnosis, mechanisms, treatments, and education for atopic dermatitis 1. However, the most recent and highest quality study, the guidelines of care for the management of acne vulgaris 1, should be prioritized when making treatment decisions.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Common Pediatric Dermatologic Problems

• Atopic dermatitis (AD) is a chronic, recurring, inflammatory skin condition characterized by xerosis, pruritus, and rash 2
• Seborrheic dermatitis (SD) is a common, chronic, relapsing, inflammatory condition that involves sebaceous skin areas, often presenting with greasy, yellow scales on the scalp or face 2
• Acne vulgaris is an inflammatory disease of the pilosebaceous unit of the skin that primarily involves the face and trunk, affecting approximately 9% of the population worldwide 3
• Psoriasis, poison ivy, and eczema are comprised of scaling patches and plaques, with therapy typically consisting of topical emollients and corticosteroids 4
• Vascular anomalies, such as port wine stains and hemangiomas, are common in the pediatric population, with port wine stains potentially treated with pulsed dye laser and hemangiomas often spontaneously regressing by age ten 4
• Infectious etiologic agents of skin disease, including bacteria, fungi, and viruses, can present as a rash or ulcer, with treatment varying depending on the specific infection 4

Treatment Options

• Topical corticosteroids are the first-line treatment for atopic dermatitis flare-ups, with topical calcineurin inhibitors and ultraviolet phototherapy also effective for moderate to severe cases 2, 5
• Emollient use, topical corticosteroids, and calcineurin inhibitors can help prevent atopic dermatitis flare-ups 2
• Topical ketoconazole shampoo, gel, or lotion is safe and effective for treating seborrheic dermatitis in infants and children 2
• Topical retinoids, benzoyl peroxide, azelaic acid, or combinations of topicals are first-line treatments for acne vulgaris, with oral antibiotics, hormonal therapies, or isotretinoin recommended for more severe disease 3
• Antihistamines are not recommended for the general use in the management of atopic dermatitis, although sedating antihistamines may be useful for short-term relief of insomnia secondary to itch 6

Images of Each Condition

Note: Unfortunately, images of each condition cannot be provided in this text-based format. However, it is recommended to consult a dermatology textbook or online resource for visual aids to help diagnose and manage common pediatric dermatologic problems.