Board Review: Pediatric Skin Conditions Quick Review

Overview / Definition Pediatric skin conditions encompass a wide range of dermatologic disorders that affect infants, children, and adolescents. These conditions can vary greatly in their presentation, etiology, and management compared to adult dermatology. Common pediatric skin issues include eczema, impetigo, and acne, among others. Epidemiology Pediatric skin disorders are highly prevalent in the population. Studies indicate that: Approximately 20% to 30% of children have some form of skin disease. Conditions such as atopic dermatitis and acne are particularly common, with atopic dermatitis affecting up to 10-20% of children. Infections like impetigo are more frequent in children aged 2 to 6 years. Pathophysiology / Mechanism The pathophysiology of pediatric skin conditions varies by disorder but often involves a combination of genetic, environmental, and immunologic factors: Atopic Dermatitis: Involves a dysregulation of the immune system and skin barrier function. Acne: Results from hormonal changes leading to increased sebum production and follicular occlusion. Infections: Often caused by bacteria (e.g., Staphylococcus aureus in impetigo) and viruses (e.g., varicella-zoster virus in chickenpox). Clinical Presentation Pediatric skin conditions can present with a variety of signs and symptoms, which may include: Atopic Dermatitis: Erythematous, itchy patches, commonly found on flexural areas. Impetigo: Honey-colored crusted lesions, often around the nose and mouth. Acne: Comedones, papules, pustules, and occasionally cysts, primarily on the face, back, and shoulders. Diagnosis / Workup The diagnosis of pediatric skin conditions typically involves a thorough history and physical examination. Key points include: Consider the child's age, family history, and any associated symptoms. Perform a skin examination to assess the pattern, distribution, and characteristics of lesions. Laboratory tests (e.g., skin cultures, allergy testing) may be needed in certain cases. T