Minor skin diseases

Minor skin diseases occur frequently during childhood. Because children may not articulate signs and symptoms of minor skin diseases, parents and caregivers should be aware of the status of children's skin. Early recognition means early evaluation and treatment. It is important to treat the child's skin condition rather than the parent's anxiety. Topical therapy is often preferred because medication can be delivered to the affected site in the desired dose while avoiding systemic effects.

With children, the entire skin should be considered. This is different from adults in whom the focus may be on one area, such as in hand dermatitis. Colour and distribution are sometimes characteristic of specific skin diseases, as are lesion type.(f.1) A checklist of questions for parents may assist in identifying common minor skin diseases:

Who has the skin condition? What is the age of the child?

Sometimes parents have several children with them, or are asking on behalf of a child who is not in attendance. It is important to look at the child's skin. The age of the child may be indicative of the skin condition -- atopic dermatitis usually starts in 2- to 3-month-old children. Seborrheic dermatitis has an earlier onset.

When did the skin condition begin? Can the skin condition be correlated to any change in diet, routine, or activity?

Most skin irritants produce contact dermatitis within 12 to 48 hours after exposure. Changes in food, laundry detergent or fabric softener, hand or bath soap, skin lotions; new clothing or linen; and potential contact with plant or animal material should be noted. Seasonal variations may cause skin conditions as well (for example, dry skin in winter). A daily diary of the child's activities and foods may help identify a problem.

What areas are involved?

If a specific area is involved, the skin condition may be readily identified. If the diaper area is involved, for example, then diaper dermatitis should be suspected; the hands are involved, then the child has touched something or has used something such as a hand soap. Candida albicans infections most often affect the diaper area and the mouth. With more diffuse symptoms, a systemic condition with cutaneous manifestations (a viral infection such as roseola or chicken pox, or a drug eruption, for...