Pediatric dermatological emergencies in tertiary health care
Keywords:Cutaneous emergencies, Pediatric, Skin manifestations
Background: In recent years, the demand for dermatological consultations in the emergency department has increased. However, most of the publications of dermatological emergencies deal with the general population, without taking into account the changes in frequencies found in young children (ages 0-14 years). Dermatological emergencies in pediatric age group are not uncommon. The aim of our study was to analyse the spectrum of dermatological emergencies in the pediatric age group.
Methods: A hospital‑based observational study was conducted at the Department of Dermatology of tertiary care centre, between September 2019 and February 2020. Thirty pediatric patients (age ≤16 years) who had visited Dermatology Outpatient Department (OPD) and emergency department were included in this study.
Results: Total thirty patients were included in this study. The male to female ratio was 2:1. The average age of the study was 7.6 years. Maximum cases were in school-aged children (6 to 12 years), which were 12 (40%). The average duration of illness was 36.04 days. The most common condition was inherited conditions (23%) followed by primary cutaneous infections (20%). The cases were divided as 7 (23%) inherited conditions, 6 (20%) cases of infections, 5 (17%) cases each of vasculitis and cutaneous adverse drug reaction and 7 (23%) miscellaneous cases.Conclusions: Pediatric dermatological emergencies require an interdisciplinary approach for timely intervention. Standardised protocol should be followed in their management to prevent complications like acute skin failure. Early referral of these patients with primary skin conditions to the dermatologists might result in better clinical outcome and decreased mortality.
Gupta S, Sandhu K, Kumar B. Evaluation of emergency dermatological consultations in a tertiary care centre in North India. J Eur Acad Dermatol Venereol. 2003;17:303‑5.
Gil Mateo MP, Velasco Pastor M, Miquel Miquel JB, Quecedo Estébanez E, Martínez Escribano JA, Nagore Enguidanos E, et al. Análisis de las urgencias dermatológicas en el servicio de urgencias de un hospital comarcal. Actas Dermosifiliogr. 1996;87:305-9.
López J, Argila D. Urgencias en dermatología. Arch Dermatol (ed esp). 1996;7:54-64.
Colomés L, Lorenzo A, Ortín R. Demanda pediátrica en urgencias de un hospital general. Aten Primaria. 1987;6:130.
Sarkar R, Basu S, Patwari AK, Sharma RC, Dutta AK, Sardana K. An appraisal of pediatric dermatological emergencies. Indian Pediatr. 2000;37(4):425-429.
Mathias RC, Jayaseelan E, Augustine M. Spectrum of pediatric dermatological emergencies at a tertiary care hospital in India: A descriptive study. Int J Dermatol. 2013;52:27‑31.
Cohen BA. Pediatric dermatology. 3rd ed. Philadelphia: Elsevier Mosby. 2005.
Eichenfiled LF, Frieden IJ, Esterly NB, editors. Neonatal dermatology. 2nd ed. Philadelphia: Elsevier Saunders. 2008.
Gautam M, Tahiliani H, Nadkarni N, Patil S, Godse K. Acitretin in pediatric dermatoses. Indian J Paediatr Dermatol. 2016;17:87-94.
Maguiness SM, Frieden IJ. Management of difficult infantile haemangiomas. Arch Dis Child. 2012;97:266-71.
Eneli I, Davies HD. Epidemiology and outcome of necrotizing fasciitis in children: an active surveillance study of the Canadian Paediatric Surveillance Program. J Pediatr. 2007;151:79-84.
Nayak S, Acharjya B. Adverse cutaneous drug reaction. Indian J Dermatol. 2008;53:2-8.
Sokumbi O, Wetter DA. Clinical features, diagnosis, and treatment of erythema multiforme: a review for the practicing dermatologist. Int J Dermatol. 2012;51:889-902.
Levi N, Bastuji-Garin S, Mockenhaupt M, Roujeau JC, Flahault A, Kelly JP et al. Medications as risk factors of Stevens-Johnson syndrome and toxic epidermal necrolysis in children: a pooled analysis. Pediatrics. 2009;123:e297-304.
Betrosian AP, Berlet T, Agarwal B. Purpura fulminans in sepsis. Am J Med Sci. 2006;332:339-45.
Heide R, Tank B, Oranje AP. Mastocytosis in childhood. Pediatr Dermatol. 2002;19:375-81.
Xing C, Shen H, Xu J, Liu Z, Zhu J, Xu A. A fatal case of febrile ulceronecrotic mucha-habermann disease presenting as toxic epidermal necrolysis. Indian J Dermatol. 2017;62:675.
Thacker NH, Abla O. Pediatric Langerhans cell histiocytosis: state of the science and future directions. Clin Adv Hematol Oncol. 2019;17:122-31.