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Spectrum and Pattern of Paediatric Dermatoses in a Tertiary Care Section Skin & VD Original Article Spectrum and Pattern of Paediatric Dermatoses in A Tertiary Care Hospital in Faridabad 1 2 Assistant Professor; Senior Resident; 3Junior Resident, Department of 1 2* 3 Dermatology, Venereology and Leprosy, Shanta Passi , Kumar Himanshu , Sneh Lata ESIC Medical College and Hospital, NIT, Faridabad 121001 ABSTRACT DOI:10.21276/iabcr.2019.5.1.13 Background: The prevalence of paediatric skin diseases varies worldwide. Paediatric dermatoses require a separate view from adult dermatoses as there are important differences in clinical presentation, treatment and prognosis. Their characterisation is essential for the preparation of Received: 18.02.19 academic, research and health plans. Accepted: 26.02.19 Aim: The study was carried out to find the incidence of skin diseases in children under 15 years of age. *Corresponding Author Methods: All children below 15 years of age attending dermatology outpatient department for first time were evaluated for various skin dermatoses. Skin diseases were classified into groups like infections and infestations, eczematous, non-infective dermatoses and hypersensitivity reactions. Dr. Kumar Himanshu Results: Male children predominated with male female ratio 1.3:1. Infections and infestations were ESICMCH, Faridabad, Haryana the most common (41.8%) cause of skin dermatoses followed by dermatitis (20.7%), non-infective & autoimmune dermatoses (13.4%) and hypersensitivity reactions seen in 10.8% patients. Miliaria and Copyright: © the author(s) and publisher. other physical dermatoses contributed to about 6% of the total cases. IABCR is an official publication of Ibn Sina Academy of Medieval Medicine & Sciences, Conclusion: Majority of paediatric dermatoses can be grouped into 8 categories. Significant registered in 2001 under Indian Trusts Act, 1882. proportion of dermatoses are infectious and eczematous types. Infections are more prevalent in low socio-economic strata and with proper education and creating awareness they can be minimised to This is an open access article distributed in accordance with the Creative a significant extent. Commons Attribution Non Commercial (CC BY- NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original Keywords: Paediatric dermatoses, Infection, Infestations, Dermatitis work is properly cited and the use is non- commercial INTRODUCTION_____________________ Skin diseases in children are encountered frequently and are rise to differential prevalence of dermatoses among infants, either transitory or chronic and recurrent. Monitoring the toddlers, children and adolescents. So measurement of epidemiology of skin diseases in children helps in effectively impact of paediatric dermatoses is an important component planning relevant educational programmes and preventive of primary health care practice and helps in planning future measures. healthcare, health education, clinical research and allocation The prevalence of paediatric skin diseases varies worldwide. of more resources for care of children. At least 30% of patients visiting paediatric OPD and 30% of dermatology OPD consults constitutes children. Paediatric METHODS__________________________ dermatoses vary from adult dermatoses in terms of clinical A prospective study was performed on all children below 15 presentation, treatment and prognosis, thereby generating years of age with complaints of skin diseases attending special interest in this sub-speciality. Socio-economic status, Dermatology OPD at ESIC Medical College & Hospital from external environment and dietary habits are few of the many January 2018 to December 2018. Children referred from factors that are more influential in dermatoses in children other outpatient departments having skin complaints were than adults. Different degree of exposure to external factors also included. All patients presenting for the first time in and different level of functional development of skin may give Access this article online How to cite this article: Passi S, Himanshu K, Lata S. Spectrum and Pattern of Website: Quick Response code Paediatric Dermatoses in A Tertiary Care Hospital in Faridabad. Int Arch BioMed www.iabcr.org Clin Res. 2019;5(1):46-49. Source of Support: Nil, Conflict of Interest: None DOI: 10.21276/iabcr.2019.5.1.13 International Archives of BioMedical And Clinical Research Vol 5 | Issue 1 | January – March 2019 46 www.iabcr.org Passi S, et al.: Paediatric dermatoses dermatology OPD were recorded and follow up visit for the Table 1: Frequency of Various Dermatoses Seen In Children TOTAL same complaint was not included in the data. To compare PERCENTAGE OF DISEASE NUMBER OF CASES the pattern of dermatoses in different age groups within the CASES 1. Infections and infestations paediatric population, the patients were grouped into four A. Bacterial Infections 233 10.1% categories based on their age Infants (less than 1 year age), B. Fungal infections 292 12.6% C. Viral infections 113 4.9% Pre-school children (1-5 years age), school children (6-10 D. Cutaneous Tuberculosis 7 0.3% years age) and adolescents (11-15 years age). The data was E. Leprosy 3 0.1% F. Scabies 301 13% analysed for freQuency of cutaneous diseases in children and G. Pediculosis 12 0.5% TOTAL 961 41.8% pattern in different age groups. Diagnosis was made mainly 2. Dermatitis on the basis of clinical examination and relevant A. Seborrheic dermatitis 171 7.4% B. Pityriasis alba 138 6% investigations were done to confirm the diagnosis. The cases C. Atopic dermatitis 63 2.7% have been summarised according to the frequency in Table D. Contact dermatitis 19 0.82% E. Nappy dermatitis 11 0.48% 1. F. Perioral dermatitis 3 0.12% G. Juv plantar dermatoses 26 1.2% H. Pompholyx 8 0.3% I. Discoid eczema 34 1.47% RESULTS___________________________ J. Lichen simplex chronicus 4 0.17% TOTAL 477 20.7% 2284 children up to the age of 15 years if both sexes 3. Non-Infectious Dermatoses & Autoimmune Dermatoses attending OPD of Dermatology in ESICMCH, Faridabad were A. Vitiligo 61 2.65% included in the study. There was predominance of males with B. Alopecia areata 29 1.24% C. Psoriasis 20 0.87% 1297 males and 987 females with a male to female ratio of D. Lichen planus 15 0.65% 1.3:1. The youngest patient was 7 days old while the oldest E. Nutritional deficiency 18 0.78% F. Acne 138 6% patient was 14 years and 10 months of age. The largest G. Lichen striatus et atrophic 9 0.39% group was that of adolescents (11-15 years age) with 858 H. Lichen nitidus 4 0.17% I. Pityriasis rosea 14 0.6% patients (37.9%), followed by children of age 1-5 years with TOTAL 308 13.4% 4. Birthmarks and other Genodermatoses 740 patients (32.2%), while there were 454 patients (20%) of A. Haemangiomas 5 0.22% age group (6-10 years) and infants comprised 232 patients B. Naevi 7 0.3% C. Icthyosis (10%). 11 0.48% D. Neurofibromatosis 2 0.12% E. Tuberous sclerosis 1 0.01% TOTAL 26 1.1% DISTRIBUTION OF DISEASE 5. Miscellaneous dermatoses 25 1.08% Infection and infestation were the most common category A. Postinflammatory pigmentary changes B. Physiologic changes representing 41.8% of dermatoses. Among infections and 17 0.74% C. Vasculitis 6 0.24% D. Xerosis infestations, scabies was the commonest constituting 43 1.9% E. Keloids 15 0.65% 31.25% (301 patients) of this category. Second most F. Keratosis pilaris 17 0.74% TOTAL common infection was fungal infections (30% - 292 patients). 123 5.34% Most common fungal infection encountered was Tinea Cruris 6. Hypersensitivity/Drug reaction A. Urticaria/Angioedema 122 5.3% followed by Tinea Capitis. Bacterial infections composed B. Papular urticaria 102 4.4% C. Pedrous dermatitis 17 0.74% 24% of infections (233 patients) periporitis and secondary D. Drug reactions 6 0.24% pyodermas being the commonest. Viral infections constitute TOTAL 247 10.8% 7. Physical factor induced 11.7% of total infections with Molluscum Contagiosum being A. Miliaria 4.3% B. Corns and calluses 0.22% the commonest viral infection (43 patients) followed by Warts 99 C. Cold injury 0.1% 5 (24 patients) and viral exanthema (23 patients) and Herpes D. Polymorphic light eruptions 5.22% 3 TOTAL 5 Simplex and herpes zoster comprised of 15 and 8 patients 4.9% Other dermatoses included mucocele, pyogenic respectively. 7 patients of cutaneous tuberculosis of which 3 112 granuloma, Trichoepithelioma, pityriasis had lupus vulgaris, 2 had scrofuloderma and 2 had lichen lichenoides chronica and Canites scrofulosorum. The second most common category was of Dermatitis Dermatoses caused by physical factors constituted 4.9% of (26.7% of patients). Seborrheic dermatitis and seborrheic dermatoses, with miliaria rubra being the commonest seen in capitis constituted biggest group (171 patients – 35.8%). 99 (88%) patients. Nutritional deficiencies associated Pityriasis alba and atopic dermatitis were seen in 138 (29%) dermatoses were seen in 1% of the patients and included patients and 63 (13%) patients respectively. phrynoderma, acrodermatitis enteropathica and angular Hypersensitivity reactions and related disorders constituted cheilitis. 247 patients. 122 patients had Urticaria. 102 patients were Birthmarks and genodermatoses contributed to 1.1% of the diagnosed as having popular urticaria and 17 patients having total cases in which Icthyosis was the commonest seen in 11 pedrous dermatitis. Drug reactions were seen in only 6 patients followed by melanocytic naevi (7 patients) and patients.
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