SKIN CONCERNS BY AGE 0-10

 

MOLLUSCUM CONTAGIOSUM

Molluscum Contagiosum is a viral skin condition that can affect all ages, although it most commonly affects the pediatric population. This condition causes firm, painless, skin colored or pinkish bumps, also called papules. The papules are about the size of a pencil eraser but can present smaller in size. The bumps may have a divot in the center of them which is known as umbilication. They may also appear shiny or pearly in appearance. The most commonly affected areas of the skin include the trunk, the face, and the extremities. Sometimes just a few papules appear, or they can appear in a cluster. Although this condition can be distressing to both parents and children alike, it is relatively benign and easily treatable. 

WHAT CAUSES MOLLUSCUM CONTAGIOSUM?

Molluscum Contagiosum is caused by the poxvirus and is sometimes referred to as Molluscum Contagiosum Virus. It is typically spread from direct physical person-to-person contact. It can also be spread through indirect contact such as shared towels, clothing, and other linens. It is important to note that it is not transmitted via coughing or sneezing. Children living together in the same household tend to all contract the condition, as it can be contagious. An individual infected with molluscum can also further spread it on other parts of their body by scratching and irritating the papules, a process known as auto inoculation. 

TREATING MOLLUSCUM CONTAGIOSUM

Treatment options for molluscum include watching and waiting for clearance on its own, cryotherapy, curettage, Imiquimod, lasers, acids (i.e. salicylic acid), and topical Cantharidin. Untreated lesions can take up to four years to clear on their own. 

MOLLUSCUM CONTAGIOSUM REFERENCES

  • Leung, A. K., Barankin, B., & Hon, K. L. (2017). Molluscum Contagiosum: An Update. Recent Patents on Inflammation & Allergy Drug Discovery, 11(1). doi: 10.2174/1872213×11666170518114456
  • Meza-Romero, R., Navarrete-Dechent, C., & Downey, C. (2019). Molluscum contagiosum: an update and review of new perspectives in etiology, diagnosis, and treatment. Clinical, Cosmetic and Investigational Dermatology, Volume 12, 373–381. doi: 10.2147/ccid.s187224

 

ATOPIC DERMATITIS (ECZEMA)

Atopic dermatitis, most commonly known as eczema, is an inflammatory skin condition that is caused by a disruption of the skin’s natural barrier. Atopic Dermatitis usually presents as an uncomfortable and itchy rash all over the body but typically affects the facial cheeks, arms, elbows, and behind the knees. Excessive scratching can cause the skin to bleed which can introduce bacteria and lead to skin infections. Unfortunately, this skin condition tends to be chronic in nature, meaning that it is something that occurs throughout one’s life with times of flaring and times of maintenance. 

 

WHAT CAUSES ATOPIC DERMATITIS/ECZEMA

It is not fully understood what causes atopic dermatitis. What is known, is that there is a genetic component and people who have a history of medical conditions such as allergies or asthma, known as atopy, can also develop atopic dermatitis. Environmental factors such as dry climates and excessive hot or cold weather can cause eczema flares. Since people with atopic dermatitis are prone to allergies and have sensitive skin, certain elements should be avoided such as  scented products, products that can be drying to the skin, and certain fabrics such as wool.

 

TREATING ATOPIC DERMATITIS/ECZEMA

Treatment for eczema includes topical steroids, photodynamic therapy, oral probiotics, topical emollients, bleach baths, wet wrapping, and a myriad of other treatments. It is important to limit the amount of bathing and to use minimal amounts of soap with eczema. Moisturization with natural oils such as sunflower seed oil and emollients such as thick unscented creams are essential to apply to the skin daily to maintain the skin barrier. Hydrating the skin and reducing inflammation are key in reducing itch and discomfort when treating this condition.

 

ATOPIC DERMATITIS/ECZEMA REFERENCES

  • Mcpherson, T. (2016). Current understanding in pathogenesis of atopic dermatitis. Indian Journal of Dermatology, 61(6), 649. doi: 10.4103/0019-5154.193674
  • Thomsen, S. F. (2014). Atopic Dermatitis: Natural History, Diagnosis, and Treatment. ISRN Allergy, 2014, 1–7. doi: 10.1155/2014/354250

 

DRY SKIN

Dry skin, also known as xerosis, is a condition in which the skin barrier becomes irritated, which can lead to flaking and cracking of the skin. Dry skin can affect children, especially those suffering from atopic dermatitis and other conditions such as ichthyosis. 

 

WHAT CAUSES DRY SKIN

In children the most common cause of dry skin is insufficient moisturization and skin conditions that affect the skin barrier, such as atopic dermatitis as previously mentioned. Certain environmental factors such as cold weather and the use of heaters in the home can also dry the skin. 

 

TREATING DRY SKIN

Thick emollients such as creams rather than lotions and petroleum jelly are an excellent way to treat dry skin in children. Decreasing the frequency of bathing and limiting the use of soap also helps to maintain the skin’s natural oils, as overbathing and over soaping can further dry the skin. It is important to apply moisturizer within the first 2-3 minutes after bathing to help seal in moisture for dry skin. 

 

DRY SKIN REFERENCES

  • Proksch, E., & Lachapelle, J.-M. (2005). The management of dry skin with topical emollients – recent perspectives. Journal Der Deutschen Dermatologischen Gesellschaft, 3(10), 768–774. doi: 10.1111/j.1610-0387.2005.05068.x. PMID: 16194154
  • Shim, J., Park, J., Lee, J., Lee, D., Lee, J., & Yang, J. (2015). Moisturizers are effective in the treatment of xerosis irrespectively from their particular formulation: results from a prospective, randomized, double-blind controlled trial. Journal of the European Academy of Dermatology and Venereology, 30(2), 276–281. doi: 10.1111/jdv.13472. PMID: 26563519

 

WARTS

Warts, also known as verruca vulgaris, are a common skin condition among children. Warts are raised or flat skin colored, white, or greyish bumps that erupt on the skin. They typically have a rough texture and lack the natural lines of the skin. They are benign in nature, meaning they are non-cancerous. Warts are typically asymptomatic, but on occasion may cause pain. Warts are also highly contagious and can easily be spread to different areas of the body as well as from person to person. Warts can appear anywhere on the body, but most commonly affect the hands and the feet of children. 

 

WHAT CAUSES WARTS?

Warts are caused by the human papilloma virus (HPV). This virus has many different strains and can be picked up virtually anywhere in a child’s environment. Warts are most commonly contracted from other individuals that are infected with HPV through skin to skin contact such as shaking hands. Children are typically more susceptible to warts than adults as their immune systems haven’t fully developed yet.

 

TREATING WARTS

There are a multitude of treatment options to treat warts that include cryotherapy, Cantharidin, salicylic acid, Cimetidine, Imiquimod, laser treatments, electrodessication and curettage, and excision. Sometimes, warts can clear on their own without any treatment. Due to the persistent nature of warts however, it is best to get them treated for a quicker clearance of the lesions. 

 

WARTS REFERENCES

  • Lipke, M. M. (2006). An Armamentarium of Wart Treatments. Clinical Medicine & Research, 4(4), 273–293. doi: 10.3121/cmr.4.4.273. PMID: 17210977
  • Boull, C., & Groth, D. (2011). Update: Treatment of Cutaneous Viral Warts in Children. Pediatric Dermatology, 28(3), 217–229. doi: 10.1111/j.1525-1470.2010.01378.x. PMID: 21517951

 

BIRTHMARKS

Birthmarks are markings on the skin that occurred while in utero that are now presented on the skin post birth. These markings can also develop shortly after birth. Birthmarks can vary in color, size, and placement on the body. Typically, they are red, pink, brown, blueish, or white in color. Some birthmarks may stay on a child’s skin all throughout childhood and into adulthood, while others may fade over time. 

 

WHAT CAUSES BIRTHMARKS

The etiology of birthmarks is not completely known. What is known however is that some birth markings develop in utero when blood vessels do not properly form or when melanocytes (the cells that give skin their color) clump together and form a skin marking. Children that are born premature and those who are born with multiples (i.e. twins or triplets) tend to form birthmarks compared to other singlet and full term infants. Certain medical conditions may also present with birthmarks. 

 

TREATING BIRTHMARKS

Most birthmarks do not require any treatment and only close follow up is warranted to ensure that the markings have not grown in size or cause the child any discomfort or deficit. Some birthmarks such as hemangiomas or other markings that can affect a child’s self-esteem, and may benefit from treatment. Treatments include topical or oral beta blockers, lasers, steroids, and surgery.

 

BIRTHMARK REFERENCES

  • American Academy of Dermatology. Birthmarks: Who gets and causes. (n.d.). Retrieved from https://www.aad.org/diseases/a-z/birthmarks-causes.
  • Techasatian, L., Sanaphay, V., Paopongsawan, P., & Schachner, L. A. (2019). Neonatal Birthmarks: A Prospective Survey in 1000 Neonates. Global Pediatric Health, 6. doi: 10.1177/2333794×19835668. PMID: 30956996

 

DIAPER RASH

Diaper rash, also called diaper dermatitis, is a skin condition that affects infants and toddlers who wear diapers. The sensitive skin in the diaper area can become irritated, inflamed, and reddened due to constant contact with both urine and feces, and other irritating factors. 

 

WHAT CAUSES DIAPER RASH?

There are many causes of diaper dermatitis with irritation from urine and feces being the most common culprit. The prolonged wetness from the excrement can break down and irritate a baby’s very sensitive skin. Another cause may be from an overgrowth of yeast which is known as a candida infection. Some diapers may be made of irritating material, which can also cause a diaper rash. 

 

TREATING DIAPER RASH

Treatments for diaper rash include keeping a baby’s diaper as dry as possible with frequent diaper changes. If at all possible, it is best to let a baby’s bottom breath and let it air out, removing the diaper on occasion. Barrier creams such as zinc oxide in addition to petroleum jelly, lanolin, antifungal creams, and topical steroids can be very helpful in providing relief. 

 

DIAPER RASH REFERENCES

  • Ravanfar, P., Wallace, J. S., & Pace, N. C. (2012). Diaper dermatitis. Current Opinion in Pediatrics, 1. doi: 10.1097/mop.0b013e32835585f2. PMID: 22790100
  • Coughlin, C. C., Eichenfield, L. F., & Frieden, I. J. (2014). Diaper Dermatitis: Clinical Characteristics and Differential Diagnosis. Pediatric Dermatology, 31, 19–24. doi: 10.1111/pde.12500. PMID: 25403935

 

SEBORRHEIC DERMATITIS/CRADLE CAP

Seborrheic dermatitis, also known as cradle cap in infants, is an inflammatory skin condition that causes redness and yellowish, waxy, greasy looking scales on the scalp and body. In infants, it primarily affects the scalp, giving it the colloquial name of “cradle cap”, but can also affect the face, neck, and trunk of babies’ bodies. It is typically asymptomatic and does not tend to bother children except in rare cases. This condition can be concerning to parents due to its unsightliness. It is important to note that, although, it is not aesthetically pleasing, this condition is not typically harmful to children. 

 

WHAT CAUSES SEBORRHEIC DERMATITIS

The etiology of seborrheic dermatitis is not fully known, but it is theorized that it is caused by excess oil production of the skin and also an overgrowth of the natural yeast on our skin called Malassezia. There is also a familial and possible genetic connection to the condition. 

 

TREATING SEBORRHEIC DERMATITIS

Seborrheic dermatitis is often self-limiting in infants, meaning that it tends to go away on its own. If it does not clear, there are treatments such as Ketoconazole shampoo, topical antifungals, topical steroids, and mineral oil that can be beneficial in clearing the condition. Another treatment option includes using a baby brush to help clear the scaling off of the scalp. 

 

SEBORRHEIC DERMATITIS REFERENCES

  • Borda, L. J., & Wikramanayake, T. C. (2015, December). Seborrheic Dermatitis and Dandruff: A Comprehensive Review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852869/. PMID: 27148560
  • Nobles, T. (2019, December 11). Cradle Cap. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK531463/

 

 

HEMANGIOMAS

Hemangiomas are a type of vascular birthmark that appear right after birth or within the first few weeks of an infant’s life. They appear as bright red, purple, or pink papules or nodules that are soft to the touch and can occur on any part of the body. Some hemangiomas are quite persistent and stay on a child for a long period of time, while others fade away as a child grows. For the most part, these vascular growths are relatively benign except for in rare cases. 

 

WHAT CAUSES HEMANGIOMAS

The origin of hemangiomas is not fully known. It is suggested that they are caused by an unusual growth of blood vessels while a fetus is in utero. The unusual cluster and tangles of blood vessels can press upward into the skin, causing a hemangioma.

 

TREATING HEMANGIOMAS

Most hemangiomas do not need treatment, and close follow up and watchful waiting is all that is needed. These growths tend to disappear or reduce in size as a child grows. Other treatment options in persistent cases include oral and topical beta blockers, surgery, and laser treatment. 

 

HEMANGIOMA REFERENCES

  • Bota, M., Popa, G., Blag, C., & Tataru, A. (2015). Infantile hemangioma: a brief review. Medicine and Pharmacy Reports, 88(1), 23–27. doi: 10.15386/cjmed-381. PMID: 26528043
  • Rotter, A., & Oliveira, Z. N. P. D. (2017). Infantile hemangioma: pathogenesis and mechanisms of action of propranolol. JDDG: Journal Der Deutschen Dermatologischen Gesellschaft, 15(12), 1185–1190. doi: 10.1111/ddg.13365. PMID: 26413184
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