Key Pediatric Skin Conditions Overview

Aug 28, 2024

Pediatric Dermatologic Conditions

Presenter

  • Ashton: Family and Emergency Nurse Practitioner, Instructor at SM and P reviews.

Overview

  • Discussion on pediatric dermatologic conditions relevant for practice and certification exams.
  • Emphasis on two key conditions: Impetigo and Atopic Dermatitis.

Impetigo

Description

  • Contagious superficial bacterial infection of the skin.
  • Common pathogens: Staphylococcus aureus and Streptococcus pyogenes.
  • Predominantly affects children aged 2-5 years.
  • More prevalent in warm, humid conditions and easily spread among individuals in close contact.

Risk Factors

  • Poverty, overcrowding, poor hygiene.

Types of Impetigo

  • Bullous Impetigo
    • Vesicles enlarge to form bullae with clear yellow fluid.
    • Fluid darkens and vesicles eventually rupture.
  • Non-Bullous Impetigo
    • Lesions start as papules, evolve into vesicles, then pustules.
    • Pustules rupture to form thick, honey-colored crusted lesions.
    • Commonly localized on the face and extremities.

Diagnosis and Treatment

  • Mostly diagnosed clinically based on lesion appearance.
  • Culture or Gram stain for complicated cases.
  • Treatment
    • Topical therapy (e.g., Mupirocin ointment) for limited skin involvement.
    • Oral antibiotics (e.g., Cephalexin, Dicloxacillin) for widespread lesions.
    • For MRSA suspicion: Trimethoprim-sulfamethoxazole, Clindamycin, or Doxycycline.

Atopic Dermatitis (Eczema)

Description

  • Chronic pruritic inflammatory skin disease.
  • Occurs frequently in children.
  • Associated with elevated serum immunoglobulin E (IgE).

Risk Factors

  • Personal or family history of atopy.
  • Environmental exposures: climate, air pollution, water hardness.

Symptoms

  • Dry skin and severe pruritus.
  • Clinical presentation varies by age, ethnicity, and severity.

Case Example

  • A 5-year-old with asthma and allergic rhinitis shows pruritic, dry, erythematous lesions on the face and extensor surfaces.
  • Diagnosis: Atopic Dermatitis.

Atopic Triad

  • Sequence of conditions: Atopic Dermatitis, Allergic Rhinitis, Asthma.
  • Important to know for board exams.

Additional Resources

  • Encouragement to explore further pediatric dermatologic topics for exams.
  • Links to SM and P reviews courses and a supportive Facebook group for board exam preparation.