Pediatric Skin Infections and Dermatitis

Seborrheic Dermatitis

This is a chronic, recurrent inflammatory reaction, most commonly affecting the scalp. While the exact etiology is unknown, it is believed to be related to sebum production.

Nursing Tip: When managing dermatitis, avoid rubbing the skin to prevent further irritation. Instead, pat the skin dry.

Bacterial Infections

Bacterial skin infections in children can range from mild, self-limiting lesions to more severe, spreading infections.

Impetigo

Impetigo is the most common bacterial skin infection in children and spreads easily from person to person. It is most frequently caused by Staphylococcus aureus. There are two main clinical presentations:

• Nonbullous: Small vesicles that develop into plaques with a characteristic "honey-colored" crust, typically around the nose and mouth.
• Bullous: Large, fluid-filled blisters (bullae) found on the trunk, face, or limbs that eventually rupture and form thick brown crusts.

Treatment usually involves topical antibiotics like mupirocin for 10 to 14 days, though severe cases may require oral antibiotics.

MRSA and Folliculitis

MRSA (Methicillin-resistant Staphylococcus aureus) is a significant concern due to the rise of community-acquired infections and the difficulty of treating abscesses formed by this agent.

Folliculitis is an infection of the hair follicle, often caused by Staphylococcus aureus due to poor hygiene, contaminated water (such as hot tubs), or shaving. It presents as small pustules with an erythematous (red) base around the hair follicle.

Viral Infections

Molluscum Contagiosum

Caused by a poxvirus, these are intracellular parasites that cause the epidermal cells to react by forming small, asymptomatic growths. They are common and spread through direct contact or autoinoculation (scratching a lesion and then touching another part of the body).

Warts

Warts are viral growths that can appear on the fingers, hands, face, or soles of the feet. They can be "regular" warts or "plantar" warts, which occur on the soles.

Fungal Infections

Fungal infections, often referred to as dermatophytosis, vary in name and presentation based on their location on the body.

Oral Candida (Thrush)

Oral candida, or thrush, affects the mucous membranes. It is characterized by white patches on the tongue and the inner lining of the lips.

Ringworm

Ringworm is a common fungal infection that presents as circular, red, scaly rashes. In children, it can also manifest as tinea capitis (scalp ringworm), which may present as "black dot" patches with hair loss.

Chronic and Allergic Conditions

Atopic Dermatitis (Eczema)

Atopic dermatitis is an allergic reaction often associated with other allergies. It is a chronic condition that requires careful management of triggers and skin hydration.

Acne

Acne involves the accumulation of pimples, typically on the face, chest, and back. It is influenced by hormones, menses cycles, and excessive sweat. Treatment ranges from topical benzoyl peroxide and retinoids to oral antibiotics or isotretinoin for severe cases.

Urticaria (Hives)

Urticaria is a self-limiting allergic reaction caused by an IgE response to triggers like food, medication, viral infections, or insect stings. It presents as transient, red wheals that blanch (turn white) when pressed, accompanied by extreme itching.

Critical Safety Alert: When treating urticaria, always educate families on the signs of anaphylaxis. If signs of anaphylaxis occur, emergency medical care is required immediately.