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ORIGINAL ARTICLE
Year : 2016  |  Volume : 17  |  Issue : 4  |  Page : 263-266

Clinical pattern of cutaneous infections and infestations in pediatric age


Department of Dermatology, Venereology and Leprology, Subharti Medical College, Meerut, Uttar Pradesh, India

Date of Web Publication7-Oct-2016

Correspondence Address:
Radha Sharma
O-8, Lawyer's Colony, Bye Pass Road, Agra, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-7250.179501

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  Abstract 

Introduction: Skin disorders are major health problem in the pediatric age group and are associated with significant morbidity. The pattern of pediatric dermatoses has varied in different studies. The majority of dermatoses belonged to infection and infestation group followed by eczematous and hypersensitivity groups.
Objective: To study the clinical pattern of infection and infestation in pediatric age group.
Materials and Methods: All children 0–12 year of either sex, attending Dermatology Outpatient Department between January 2014 and July 2014 are recruited in this study. A detailed history, complete dermatological examination, along with routine investigations wherever required are recorded in predesigned proforma.
Results: The study comprised of 120 patients. A total of 127 cases of infection and infestation were noted. Seven patients were having both. Total of 69.1% infections and 36.7% infestations were noted. Among the various infections and infestations, the most common were bacterial infection 37.5%, fungal infection 15% and viral infection 16.7% and scabies 29.2%, pediculosis 9%.
Conclusion: The dermatoses such as infections and infestations in the pediatric age group are common including rural and urban areas.

Keywords: Clinical pattern, infection and infestation, pediatric


How to cite this article:
Sharma R, Rathore B S, Krishna A. Clinical pattern of cutaneous infections and infestations in pediatric age. Indian J Paediatr Dermatol 2016;17:263-6

How to cite this URL:
Sharma R, Rathore B S, Krishna A. Clinical pattern of cutaneous infections and infestations in pediatric age. Indian J Paediatr Dermatol [serial online] 2016 [cited 2020 Sep 24];17:263-6. Available from: http://www.ijpd.in/text.asp?2016/17/4/263/179501


  Introduction Top


Pediatric dermatology is a separate entity in the developed nations.[1] Skin diseases are a major health problem in the pediatric age group and are associated with significant morbidity.[2] Skin diseases constitute at least 30% of all outpatient visit to a pediatrician, and 30% of all visit to a dermatologist involve children.[2] Infection and infestation are most common dermatoses seen in pediatric age group.


  Materials and Methods Top


This study was conducted in Department of Dermatology in Subharti Medical College. All children 0–12 year of either sex, attended Out Patient Department between January 2014 and July 2014 were recruited in this study. A complete history including age, sex, duration of the disease, family history complete dermatological examination, along with appropriate investigations such as KOH examination, Tzanck test, Gram's staining, hematological investigation, biochemical investigations and skin biopsy etc., wherever required are recorded in predesigned proforma. There is no exclusion criteria in our study. The collected data were analyzed and frequencies and percentages tabulated according to diagnosis.


  Results Top


A total of 127 infections and infestation were noted in 120 patients. Infections are classified into bacterial, viral and fungal. Seven patients had both infection and infestation. Total of 69.1% infections and 36.7% infestations were noted. Infection is further divided in bacterial [Table 1], fungal [Table 2] and viral [Table 3]. Infestations [Table 4] seen are pediculosis and scabies. The most common dermatoses seen were Bacterial infection 34.1%, followed by scabies 27.6%.
Table 1: Pattern of bacterial infection

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Table 2: Pattern of viral infection

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Table 3: Pattern of bacterial infection

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Table 4: Pattern of infestations

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Morphologic pattern of dermatoses include papule 63.3%, 16.6% plaque, 16.6% erosion, 5.8% bullae and 4.1% crust. In socioeconomic status of patients, 40% were from upper middle class, 30.8% from upper middle class, 30.8% were from upper lower class, 7.5% were from upper class and 4% were from upper lower class. The most common complain noted was itching in 64%, pain in 29% and 22% patients were asymptomatic. About 24.3% infection were seen in age group between 0 and 4 year, 30.8% seen between 5 and 8 year and 20% between 9 and 12 year. About 11.6% infestation seen in age group between 0 and 4 year, 14.1% seen between 5 and 8 year and 11.6% seen between 9 and 12 years of age. A total of 81 patients were school going, and 39 were nonschool going, maximum of whom had not started their schooling. Family history was positive in 38.3% patient. In our study, 67.5% patients were school going, and 32.5% were nonschool going, maximum of whom had not started their schooling. Family history was positive in 38.3% patient including both infection and infestation. In demographic profile of patients, 66.6% are from rural and 33.4% were from urban area.


  Discussion Top


The most common infection in our study was bacterial then viral and fungal infections, observed in 37.4%, 16.7% and 15% of the study population. Among bacterial infections, pyoderma was the most common in our study followed by dermatophytic infections fungal infections. Bacterial infections include pyoderma, cutaneous tuberculosis [Figure 1] and acute paronychia. Among all cutaneous tuberculosis was not common. In our study, Pyoderma was periporitis [Figure 2], bullous impetigo [Figure 3], impetigo contagiosum, furuncle and secondary pyoderma. Most common noted dermatophytic infections were tinea corporis, facei [Figure 4] and capitis [Figure 5]. In fungal infections, vaginal candidiasis [Figure 6] is not commonly seen dermatoses in children. Herpes zoster is rare dermatoses seen in children. Other noted common viral infections were molluscum contagiosum [Figure 7] and wart [Figure 8]. Among them, most of the children were school going or having positive family history. In scabies [Figure 9] maximum positive family history was seen.
Figure 1: Cutaneous tuberculosis

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Figure 2: Periporitis

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Figure 3: Bullous impetigo

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Figure 4: Tinea corporis

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Figure 5: Tinea capitis

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Figure 6: Vaginal candidiasis

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Figure 7: Molluscum contagiosum

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Figure 8: Wart

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Figure 9: Scabies

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The pattern of skin diseases in pediatric age group vary from one country to another and within the same country from one state to another.[3] The infants are mostly confined to their household while preschool children aged 1–5 years are exposed to their neighborhood. Thus, childhood age may be considered as a surrogate marker for environmental risks.

Skin diseases are the most frequent diseases of school children in many developing countries. The school environment makes children vulnerable to the cross transmission of communicable skin diseases among themselves and their family.[4]

The prevalence of pediatric dermatoses is higher in rural areas as compared to urban areas in relation to poor socioeconomic status, poor personal hygiene, overcrowded, families lack of general awareness, lack of education, sanitation and specialized health facilities.[5]

Skin diseases in the pediatric age group can be transitory or chronic and recurrent. The chronic dermatoses are associated with significant morbidity and psychological impact. Pediatric dermatoses require a separate view from adult dermatoses as there are important differences in clinical presentation, treatment, and prognosis.[2] Various epidemiological studies have been undertaken across the world including India to study the pattern of pediatric dermatoses.[2] The epidemiological data in Indian studies are based on the pattern of pediatric dermatoses in school going children in both urban and rural areas. The pattern of skin diseases in India is different across the states, rural, urban areas, and hilly areas. There is no study done only on infection and infestation. In a study by Sacchidanand et al., where total number of the patient was 1090, out of all dermatoses bacterial infections were 7.5%, viral infections were 11.9% fungal infections were 6.44% and infestations were 7.42%.[6] Another study by Balai et al., number of patient were 1,000, out of them total number of bacterial infections were 13.72%, viral infection were 3.40%, fungal infection were 6.52% and total infestation were 10.42%.[3]


  Conclusion Top


Our study brings into light the pattern of infections and infestations in pediatric patients. In our study infections were significant. The incidence of infection and infestations in the pediatric age group can be brought down by increasing awareness among the population regarding etiology and spread of pediatric diseases and also by improving sanitation, nutrition and personal hygiene of children.

Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

 
  References Top

1.
Shrestha R, Shrestha D, Dhakal AK, Shakya A, Shah SC, Shakya H. Spectrum of pediatric dermatoses in tertiary care center in Nepal. Nepal Med Coll J 2012;14:146-8.  Back to cited text no. 1
    
2.
Jain N, Khandpur S. Pediatric dermatoses in India. Indian J Dermatol Venereol Leprol 2010;76:451-4.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Balai M, Khare AK, Gupta LK, Mittal A, Kuldeep CM. Pattern of pediatric dermatoses in a tertiary care centre of South West Rajasthan. Indian J Dermatol 2012;57:275-8.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.
Sharma NL, Sharma RC. Prevalence of dermatological diseases in school of tribunal areas of Himachal Pradesh. Indian J Dermatol Venereol Leprol 1990;56:375-6  Back to cited text no. 4
    
5.
Thakare S, Singh A, Madnani A, Lakhar B. Scenario of pediatric dermatoses in rural population of Central India. Glob J Dermatol Venereol 2013;1:7-10.  Back to cited text no. 5
    
6.
Sacchidanand S, Sahana MS, Asha GS, Shilpa K. Pattern of pediatric dermatoses at a referral centre. Indian J Pediatr 2014;81:375-80.  Back to cited text no. 6
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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Abstract
Introduction
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