International Journal of Research in Dermatology Medasani V et al. Int J Res Dermatol. 2018 Aug;4(3):368-375 http://www.ijord.com DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20183160 Original Research Article Prevalence of paediatric dermatoses among patients attending Dermatology outpatient department in a tertiary care hospital in Puducherry Varsha Medasani, Paquirissamy Oudeacoumar*, Rao Chitralekhya, Saurabh Krishna Misra Department of DVL, AVMC&H, Pondicherry, Puducherry, India Received: 04 April 2018 Revised: 30 May 2018 Accepted: 01 June 2018 *Correspondence: Dr. Paquirissamy Oudeacoumar, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Skin diseases are a major health problem in the paediatric age group and are associated with significant morbidity. Dermatoses in children are more influenced by socioeconomic status, dietary habits, climatic exposure and external environment as compared to adults. The present study was undertaken to know the prevalence of paediatric dermatoses among patients attending Dermatology outpatient department in a tertiary care hospital in Puducherry. Methods: All newly diagnosed, untreated male and female paediatric patients (from neonates to adolescents ≤19 years of age) attending Dermatology OPD, from October 2015 to September 2017 were evaluated to study the prevalence and patterns of paediatric dermatoses. The skin disorders were classified into groups like infections, infestations, eczemas, acne, hypersensitivity disorders, sweat gland disorders, pigmentary disorders, nevi, keratinisation disorders, hair and scalp disorders, papulosquamous disorders, bullous disorders, nail disorders, drug reactions, other dermatoses. Results: The prevalence of pediatric dermatoses in our OPD is 25.21%. Incidence of pediatric dermatoses was found to be more in males 237 (59.39%) than in females 162 (40.60%) and the majority of the patients were in adolescent age group (217; 54.38%). Present study showed that majority of cases belonged to the lower socioeconomic group 186(46.6 %). In our study, majority (58.98%) of dermatoses belonged to infections and infestations group. Of the infective dermatoses, fungal infections (27.88%) were the most common. Conclusions: Infectious dermatoses were commonly seen in this study that may be due to poverty, overcrowding, poor hygiene. There is an increasing trend of fungal infections which might be related to hygiene and environment. Keywords: Paediatric dermatoses, Children, India, Fungal infections, Bacterial infections INTRODUCTION morbidity. Thirty percent of all outpatient visits to a paediatrician includes skin diseases and 30% of all visits 2 Paediatric dermatology deals with diseases and skin care to a dermatologist involve children. Based on school- needs from birth to adolescence, during which significant based surveys, the prevalence of paediatric dermatoses in 1 physiological, psychological and maturity changes various parts of India has ranged from 8.7% to 35%. occur.1 A significant portion of paediatric dermatological disorders is of genetic origin. Majority of these disorders In paediatric age group, skin diseases are a major health 3 problem and they are associated with significant are multisystemic and persist throughout life. Factors International Journal of Research in Dermatology | July-September 2018 | Vol 4 | Issue 3 Page 368 Medasani V et al. Int J Res Dermatol. 2018 Aug;4(3):368-375 like socioeconomic status, dietary habits, climatic 4. Adolescent: 13 yrs-19 yrs exposure and external environment influences dermatoses in children as compared to adults. Cutaneous infections Informed verbal consent was taken from either of the are common in school going children. Paediatric patient’s parents before including into the study. Detailed dermatoses can be transitory or chronic and recurrent and history was taken. Thorough general, systemic and are associated with psychological impact and significant cutaneous examination and relevant investigations were morbidity.1 done. The collected data was tabulated and analysed. The present study was undertaken to know the prevalence RESULTS and patterns of paediatric dermatoses among patients attending Dermatology outpatient department in a tertiary During the study period of 2 years, 8, 472 new cases care hospital in Puducherry. attended our out-patient Department of which 2,136 belonged to paediatric age group. Thus the prevalence of METHODS paediatric dermatoses in our OPD is 25.21%. This study was conducted in Dermatology OPD of our Table 1 shows various dermatoses encountered in Institute, a tertiary care centre in Puducherry, between paediatric population. Of the 434 dermatoses encountered October 2015 and September 2017. in this study, fungal infections (27.88%) constitute majority of the dermatoses followed by bacterial Inclusion criteria infections (11.05%), viral infections (8.98%), infestations (11.05%), eczemas (11.05%), acne (8.06%), All newly diagnosed, untreated male and female hypersensitivity disorders (6.22%), sweat gland disorders paediatric patients (from neonates to adolescents ≤19 (3.68%), pigmentary disorders (1.84%), nevi (2.07%), years of age) attending Dermatology OPD. keratinisation disorders (1.84%), hair and scalp disorders (1.61%), papulosquamous disorders (0.92%), bullous Exclusion criteria disorders (0.46%), nail disorders (0.23%), drug reactions (0.23%) and other dermatoses (2.76%). Exclusion criteria were previously diagnosed and treated cases; patients not willing to consent for the study; Table 2 shows age and sex distribution of paediatric patients in whom definite diagnosis cannot be arrived at. dermatoses. In the present study 8 patients belonged to the age group <1 year, out of which 4 patients were males Methodology and four were females. Seventy six patients belonged to the age group 1-5 years, out of which 51 are males and 25 Patients were grouped according to age: are females. Ninety eight patients belong to the age group 6-12 years, out of which 60 patients are males and 38 are 1. Infant: birth to 1 yr of age females. Two hundred seventeen patients belong to the 2. Pre-school: 1-5 yrs of age age group 13-19 years, out of which 122 patients are 3. School age: 6 yrs-12 yrs males and 95 patients are females. Table 1: Various dermatoses in paediatric population. Total No of Total no of dermatoses Types of dermatoses Male Female patients (%) (N=434) (%) Fungal infections 103 (25.81) 56 47 121 (27.88) Bacterial infections 48 (12.03) 30 18 48 (11.05 ) Viral infections 39 (9.77) 24 15 39 (8.98) Infestations 48 (12.03) 38 10 48 (11.05) Eczemas 47 (11.77) 28 19 48 (11.05) Acne 35 (8.77) 17 18 35 (8.06) Hypersensitivity disorders 27 (6.76) 15 12 27 (6.22) Sweat gland disorders 16 (3.75) 9 7 16 (3.68) Pigmentary disorders 8 (2.00) 4 4 8 (1.84) Nevi 9 (2.25) 5 4 9 (2.07) Keratinisation disorders 8 (2.00) 5 2 8(1.84) Hair and scalp disorders 7 (1.75) 4 3 7 (1.61) Papulosquamous disorders 4 (1.00) 3 1 4 (0.92) Bullous disorders 2 (0.50) 0 2 2 (0.46) Nail disorders 1 (0.25) 0 1 1 (0.23) Drug reactions 1 (0.25) 1 0 1 (0.23) Other dermatoses 12 (3.00) 6 6 12 (2.76) International Journal of Research in Dermatology | July-September 2018 | Vol 4 | Issue 3 Page 369 Medasani V et al. Int J Res Dermatol. 2018 Aug;4(3):368-375 Table 2: Age and sex distribution of paediatric dermatoses. Age (in years) Male Female Total <1 4 4 8 1-5 51 25 76 6-12 60 38 98 13-19 122 95 217 Total 237 162 399 Table 3: Infections & infestations. Infections Infestations Total dermatoses (%) Male Female Pityriasis versicolor 33 (27.27) 16 17 Candidial Intertrigo 4 (3.30) 1 3 T. corporis 36 (29.75) 21 15 T. cruris 41 (33.88) 25 16 Fungal infections T. incognito 4 (3.30) 2 2 T. facieii 2 (1.65) 1 1 Candidial balanoposthitis 1 (0.82) 1 0 Total 121 (100) 67 (55.37%) 54 (44.62%) Impetigo 37 (77.08) 23 14 Folliculitis 6 (12.5) 4 2 Furunculosis 2 (4.16) 0 2 Bacterial infections Pitted keratolysis 1 (2.08) 1 0 Lupus vulgaris 1 (2.08) 1 0 Lepromatous leprosy 1 (2.08) 1 0 Total 48 (100) 30 (62.5%) 18 (37.5%) Chicken pox 2 (5.12) 1 1 Herpes zoster 1 (2.56) 0 1 Molluscum contagiosum 8 (20.51) 6 2 HFMD 2 (5.12) 1 1 Pityriasis rosea 5 (12.82) 4 1 Papular acrodermatitis 1 (2.56) 1 0 Viral infections Verruca vulgaris 14 (35.89) 7 7 Digitate wart 1 (2.56) 1 0 Plane wart 1 (2.56) 1 0 Palmar wart 2 (5.12) 1 1 Plantar wart 2 (5.12) 1 1 Total 39 (100) 24 (61.5%) 15 (38.46%) Scabies 45 (93.75) 38 7 Infestations Pediculosis 3 (6.25) 0 3 Total 48 (100) 38 (79.16%) 10 (20.83%) Table 3 shows various infections and infestations atopic dermatitis in 11 (22.91%) patients, seborrhoeic encountered in this study. Fungal infections (27.81%) dermatitis in 8 (16.66%), subacute eczema in 3 (6.25%), were the commonest infections in this study followed by keratosis pilaris in 3 (6.25%), chronic eczema in 1 bacterial infections (12.03%) and viral infections (2.08%), pompholyx in 1 (2.08%), nipple eczema in 1 (9.77%). Scabies was the most common infestation seen (2.08%), infective eczema in 1 (2.08%), infected eczema in 45 patients (93.75%). Pediculosis is seen in 3 female in 1 (2.08%), allergic contact dermatitis in 1 (2.08%), and patients (6.25%) only.