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PubMedDate not supplied

Epidemiology of pediatric dermatology and allergology in the region of Aargau, Switzerland.

Pediatric dermatology is a new topic and no epidemiologic data exist from Switzerland. Therefore we performed a survey of the pediatric population referred to the hospital of Aarau, Switzerland, between 1998 and 2001. All inpatients and outpatients less than 16 years old with a dermatologic diagnosis were included prospectively in our study. Demographic data (age, mean age, sex distribution), referral method, pattern and frequency of the different diagnoses in various age groups, diagnostic pattern, and therapy were analyzed. A total of 1105 children were included, with a slightly higher proportion of girls (53.8% versus 46.2%). The average age was 6.8 years and infants and school children represented 60% of the study population. Half of the patients (51%) were external referrals, almost one-third (29%) presented spontaneously, and the remaining 20% were sent from other hospital departments. With a frequency of 25.9%, atopic dermatitis was the most frequent diagnosis, followed by pigmented nevi (9.1%) and warts (5.0%). Local therapy was prescribed in 66% of patients and systemic therapy in 18.6%. Other treatments such as curettage, surgery, cryotherapy, ultraviolet therapy, and electrotherapy were rarely performed (2%). We found that atopic dermatitis was the most frequent skin disorder seen in all age groups. As this was a dermatologic subspecialty clinic, higher frequencies of chronic and uncommon dermatoses such as genetic and autoimmune diseases were seen, whereas frequent diagnoses such as diaper rash and miliaria were rarely seen and the frequencies of other common skin disorders such as scabies, pediculosis, impetigo contagiosa, warts, and molluscum contagiosum were expected to be higher compared with the figures in the literature. In our study these dermatoses are underreported, as most patients are treated by general practitioners and pediatricians. Our survey documents the most common skin diseases in childhood primarily seen by pediatricians. We emphasize that dermatologic education of medical students, primary care physicians, and pediatricians should focus on allergic skin diseases, skin infections, pigmentary disorders, and vascular lesions.

Adolescent↗
PubMed1987

Occupational dermatosis among sanders in the furniture industry.

The prevalence of occupational skin disease was found to be 3.8% in a study of 479 sanders in the furniture-making industry in Singapore. 17 species of wood imported from South East Asia were used. The most common dermatoses from wood dust were pruritus (1.6%), irritant contact dermatitis (1.6%) and xerosis (1.4%). 2 sanders had miliaria. None had allergic contact dermatitis from wood dust. The arms and trunk were the most common site for pruritus and dermatitis from wood dust. It appeared that the woods commonly used in the furniture making industry are weak sensitizers. Appropriate preventive measures against irritant dermatitis such as dust control, protective clothing, and good personal hygiene should be adequate to prevent occupational dermatoses among the sanders.

Adult↗
PubMed1994

Eruptive clear cell hamartoma of sweat duct.

A histologically unique condition of the sweat duct was found in a miliaria-like papular eruption on the extensor surfaces of extremities of a 41-year-old female patient. The hypertrophic epithelium of the sweat duct wall consisted of extensively vacuolated clear cells. There was mild hyperkeratosis around the sweat duct orifice. The eccrine gland cells showed only partial vacuolization. Since this condition is not related to any of the other known benign changes of the eccrine duct, we report it with a presumptive descriptive diagnosis of eruptive clear cell hamartoma of sweat duct.

Adult↗
PubMed2002

Effluents from a pulp and paper mill: a skin and health survey of children living in upstream and downstream villages.

OBJECTIVES: A health survey of three villages (upstream village Rantau Baru and two downstream villages, Sering and Pelalawan) in the vicinity of a pulp and paper mill along the Kampar river in the province of Riau, Indonesia was conducted to find whether exposure to the effluents from the mill was related to skin conditions and ill health. METHODS: A cross sectional survey was carried out of children living in the three villages. RESULTS: Common skin conditions such as dermatitis, fungal infections, insect bites, and miliaria were found. No significantly increased risk of dermatitis or any illness in general was found with increasing levels of exposure to river water for downstream villages when compared with the upstream village. However, there was an increased risk of diarrhoea in Sering especially with drinking water directly from the river (prevalence rate ratio (PRR) 4.9, 95% confidence interval (95% CI) 0.4 to 63.9). An increased risk was also found within the upstream village Rantau Baru (PRR 2.3, 95% CI 0.9 to 5.8) and downstream village Sering (PRR 1.4, 95% CI 0.4 to 5.2) when children who drank water directly from the river were compared with those who never did. Analysis of the river water also showed physical and chemical variables within the acceptable range except for faecal coliforms (6 MPN/100 ml) found in the sample taken from Sering. CONCLUSIONS: The effluent from the mill is unlikely to be causing skin conditions and ill health. Diarrhoea may be due to faecal coliform contamination of the water because all raw sewerage is deposited in the river. Community health outreach programmes are being implemented based on these findings.

Child↗
PubMedDate not supplied

A prevalence survey of skin diseases in Nigerian children.

A prevalence survey of 5001 Nigerian children aged 0-12 years seen at the Urban Comprehensive Health Centre, Ile-Ife, Nigeria between July 1995 and June 1996 revealed that 492 children (9.8%) had dermatological conditions. Tinea (17.1%), scabies (16.5%) and impetigo (15.7%) were the most commonly observed childhood skin diseases and were followed by miliaria (9.8%), eczema (7.1%) and diaper dermatitis (7.0%) respectively. The major predisposing factor to acquiring either tinea infection or scabies or impetigo by any of the affected children was the low socioeconomic conditions of their parents. The high prevalence of eczema in the high social classes could be attributed to the early exposure of the children to artificial milk in infancy. It is hoped that aggressive health educational programmes and improvement of the socioeconomic status of the people will bring about a decline in the prevalence of childhood skin diseases in Nigeria.

Bottle Feeding↗
PubMed2004

Tacrolimus ointment: utilization patterns in children under age 2 years.

Atopic dermatitis (AD) is a common eczematous skin condition; as many as 10-17 percent of all children are affected, and 35-60 percent of affected patients manifest symptoms manifest during the first year of life. Treatment principles for AD in young children involve conservative measures such as avoidance of hot water and environmental irritants, combined with liberal use of emollients after bathing. Low potency topical corticosteroids (TCS) are the current standard of therapy for AD in young children, reserving mid- and high-potency TCS for severe disease. However, complications of long-term use of TCS include skin atrophy, stria formation, telangiectasia, hypopigmentation, secondary infections, steroid acne, allergic contact dermatitis, and miliaria. The pediatric population is also at increased risk for systemic absorption because of their high ratio of skin surface to body mass. Systemic absorption may result in hypothalamic-pituitary-adrenal axis suppression and ultimately growth retardation. Although most topical and systemic corticosteroids are not approved by the Food and Drug Administration for use in children less than 2 years of age, conservative treatment often fails in this age group and frequently patients are treated with TCS, antibiotics, and antihistamines.

Administration, Cutaneous↗
PubMed1992

[Epidemiology of childhood tuberculosis in the Basque Autonomous Community 1980-89. Efficacy of BCG vaccination].

The cases of tuberculosis in the Pediatric Units of the Basque Autonomous Community during the period of 1980-89 were studied. The annual incidence rate in the 0-4 year old age group was 5.8 per 100.00 in Biscay (95% confidence interval: 4.0-7.6), 5.9 (2.3-9.5) in Alava and 16.7 (12.7-20.7) in Guipúzcoa. Out of the 263 registered cases, 55 (21%) corresponded to meningitis and/or miliaria, 194 (74%) to respiratory tuberculosis and 14 (5%) to other clinical forms. Of these cases, the diagnosis in 83 (32%) was based on results from microbiological cultures, in 8 (3%) on histological examinations and in the remaining 172 (65%) on other diagnostic criteria. In 226 cases (86%) no scars were found nor were there any antecedents of BCG vaccination. In 32 patients (12%), there were scars or antecedents of BCG vaccinations and in 5 cases no information was available. The estimated protective effect of the BCG vaccination in the 0-4 year old group was 88% and in the 5-14 year old group 63%. We recommend that the efficiency of the BCG vaccination program be studied in order to assess the need of this program.

BCG Vaccine↗
PubMed1979

Acne aestivalis. A histopathological study.

Twelve histological sections with the diagnosis acne aestivalis (Mallorca acne) were revised and compared with the clinical diagnosis. Two histological diagnosis were wrong, one being folliculitis necroticans the other an uncharacteristic follicular disease. Non the less this patient had clinical acne aestivalis. In five patients accordance was found between histopathology and the clinical picture. Among the last five patients with histological acne aestivalis one had clinical rosacea, one yersinosis and dermatitis herpetiformis, one acne vulgaris, one miliaria or transcient acantholytic dermatosis, and the last one folliculitis perforans. The two last mentioned patients had the same histological picture which could be consistent with folliculitis perforans. The similarity in histopathology in this disease and acne aestivalis is emphasized. The histopathology in acne aestivalis could indicate, that the disease starts as a damage in corium and that the changes in the pilosebaceous apparatus are secondary.

Acne Vulgaris↗
PubMedDate not supplied

[The risk of grave evolution of tuberculosis in young children (under 2 years of age)].

Between 1971 and 1972, 22% of all children under two years with tuberculosis presented with severe forms of the disease (meningitis, miliaria, caseous forms). In the period 1974-1975, although the number of cases in the group was reduced by half, the severe forms still represented 20,4% of the total. The risk of severe evolution of tuberculosis decreases rapidly, from 55--66% in the first months of life. to 14,2--15,5% at 1--2 years. The risk of death in children aged between 0 and 2 years with tuberculosis (all forms) was of 26,6--58,3% between 0 and 5 months but only 4,5--9,3% in the second year of life. The risk of death in young children with severe forms of tuberculosis was as high as 70--76,7% in those under the age of 6 months. The source of infection was identified in 72,4--76,4% of the severe cases. At the onset of the disease only 57,1% of the sources were known, while 42,9% were discovered later, by epidemiologic investigations. An analysis of cause for a severe evolution of tuberculosis in young children led to the conclusion that BCG vaccination should be performed systematically at birth, and that tuberculin skin test be carried out in all hospitalized children, regardless the diagnosis. They also recommend the use of anamnestic data concerning the possible existence of tuberculosis cases in the families of patients, performing of radiologic controls in young mothers etc. In the case of infants that come into a close contact at a very early age with parents, or other relatives suffering with tuberculosis, chemoprophylaxis with two associated tuberculostatics is indicated.

Age Factors↗
PubMed1987

Occupational skin disease in Singapore: epidemiology & causative agents.

Of 557 patients with occupational dermatoses seen at the Middle Road Hospital, Singapore, 55.7% (310) were irritant contact dermatitis, 38.6% (215) were allergic contact dermatitis and 5.7% (32) were non contact dermatitis. More than half of the patients were below 30 years old and most were from the construction (29.5%), metal/engineering (20.6%), electrical/electronic (16.4%), transport (5.5%) and food catering (3.8%) industries. Common occupational irritants included coolants, oils, cement, solvents, detergents and soldering flux. Chromates in cement was the most common occupational allergen. Other occupational allergens included rubber chemicals from rubber apparels. Thiurammix followed by carba-mix, and PPD-mix were common rubber allergens. Resins including epoxy, acrylate and paratertiary butyl phenol resins and other metals (nickel and cobalt) were less common occupational allergens. 5 workers had contact urticaria to proteinaceous food. Non dermatitic occupational dermatoses included fibreglass dermatoses, miliaria and oil folliculitis.

Adolescent↗
PubMed1988

Etiology and pathophysiology of diaper dermatitis.

Common diaper dermatitis is a group of skin disorders that result from attack of the skin by physical, chemical, enzymatic, and microbial factors in the diaper environment. The integrity of healthy skin is compromised by the very nature of the diaper environment, and normal intact skin therefore remains an elusive goal of current diapering practices. Moist occlusion promotes miliaria, and causes an increase in the coefficient of skin friction. Skin hydration and an increase in skin pH result in impaired barrier function, and fecal enzymes begin to attack the skin, further degrading its normal ability to cope with its environment. Skin in this weakened state is susceptible to a variety of biological, chemical, and physical insults that can cause or aggravate diaper dermatitis. These include attack of the skin by fecal enzymes and other irritants in urine and feces, mechanical abrasion, and infection by C. albicans. Diapering is unquestionably an effective and convenient way of localizing an infant's excreta. Unfortunately, infant skin was not designed to operate continuously in the resulting environment, and is frequently unable to weather this assault. However, by improving the inherently adverse relationship between diapers and diapered skin, one can have a significant effect on the incidence and severity of diaper dermatitis. A diaper that keeps skin drier will result in skin that is less permeable to irritants, supports less microbial growth, is less susceptible to chafing damage, and has less contact with irritants in urine and feces. A diaper that maintains the environment closer to the normal acidic pH of skin will promote skin that is less permeable to irritants, and reduce the irritancy of fecal enzymes. Finally, a diaper that limits the mixing and spreading of urine and feces will result in less potentiation of enzyme activity and less contact of the skin with fecal irritants. Diaper dermatitis, by definition, cannot exist in the absence of diapers. Moreover, diaper dermatitis will become less troublesome for the infant population to the degree that diapered skin can be provided an environment closer to that of undiapered skin.

Diagnosis, Differential↗
PubMed1977

[Clinical picture of erythema neonatorum].

Erythema neonatorum is the most common exanthematous eruption in neonates, which is always associated with an eosinophilic infiltration of the skin. Erythema neonatorum can be present at birth. It is of great importance in the differential diagnosis of pustular eruptions in newborns due to virus or bacteria, of miliaria pustulosa, and of incontinentia pigmenti.

Chickenpox↗
PubMed1993

Alveolar soft part sarcoma. A rare tumor of unusual evolution in pediatrics.

PURPOSE: A case of alveolar soft part sarcoma of the arm with metastatic pulmonary miliaria is reported in a 12-year-old girl. RESULTS: Although the size of the metastases increased greatly and progressively for 9 years with no improvement under chemotherapy, the patient's general condition remained good. CONCLUSIONS: The course in pediatric oncology of this rare mesenchymatous tumor is very unusual; the histologic pattern is characteristic but the histogenesis remains unclear. The treatment of choice is tumoral excision. Other therapies involving secondary deposits are far from satisfactory, and the prognosis is poor because of the high rate of metastases.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Neonatal Malassezia furfur pustulosis.

BACKGROUND: Papulopustular eruptions of the face in neonates are frequently referred to as neonatal acne or sebaceous miliaria. Our findings suggest that there is an association between this type of eruption and Malassezia furfur infection. OBSERVATIONS: Direct examination of pustule smears showed M furfur yeasts in eight of 13 cases involving neonates with erythema and papulopustules of the face, neck, and scalp (mean age at onset, 22 days [range, 7 to 30 days]). The pustules were predominantly neutrophilic. Treatment with 2% ketoconazole cream applied topically twice daily was effective in 1 week. CONCLUSION: Malassezia furfur is frequently associated with a common nonfollicular pustulosis of the newborn, probably improperly termed neonatal acne.

Antifungal Agents↗
PubMed1997

Dermatoses in newborns.

Benign dermatoses in newborns must be distinguished from more serious disorders with cutaneous manifestations. Erythema toxicum neonatorum, transient neonatal pustular melanosis, sucking blister, miliaria and mongolian spots are among the many benign skin conditions that can occur in newborns. Recognition of these dermatoses allows the physician to proceed appropriately, reassure the parents and initiate further evaluation or treatment as necessary. To avoid adverse sequelae, special attention must be given to more persistent conditions and those with the potential for complications or malignant transformation. Consultation with a pediatric dermatologist, a plastic surgeon or a neurosurgeon may be necessary.

Diagnosis, Differential↗
PubMed1997

Occupational skin disease in workers from the electronics industry in Singapore.

Of 149 workers from the electronics industry with occupational dermatoses seen at the Joint Occupational Dermatoses Clinic at the National Skin Centre, Singapore, 51.0% (76) were diagnosed to have irritant contact dermatitis, 40.9% (61) had allergic contact dermatitis, and 8.1% (12) had noncontact dermatitis. More than half of the patients were younger than 30 years of age. Common irritants were soldering flux, oils and coolants, solvents, and acids/alkalis. The most common allergens were nickel and resins, followed by rubber chemicals and the constituents of flux. Of the noncontact dermatitis, 8 were caused by occupationally relevant exacerbation of endogenous eczema, whereas there was one case each of miliaria, frictional dermatitis, and fatal toxic epidermal necrolysis caused by trichloroethylene allergy.

Adult↗
PubMed1999

Factor analysis of dynamic series (FADS) in somatostatin receptor imaging.

UNLABELLED: The aim of this article was to study the physiopathology of tumoral uptake of 111In-pentetreotide using factorial analysis of dynamic series (FADS) and to assess the usefulness of this analysis in somatostatin receptor scintigraphy. METHODS: Forty-one patients were included, 24 women and 17 men. After intravenous injection of 111 MBq 111In-pentetreotide, dynamic image acquisition (68 images of 30 s) began in front of the suspected tumoral site: thoracic in 10 patients with medullary carcinoma of the thyroid and 2 patients with bronchogenic carcinoid, and abdominal in 12 cases of midgut carcinoid and 17 cases of other gastroenteropancreatic neuroendocrine tumors. FADS was performed with FAMIS software. Static images were obtained 4 h and 24 h later. For every patient, surgery and/or clinical follow-up (4 y) was used to classify results as true (T) or false (F) positive (P) or negative (N) and to evaluate both the sensitivity of static images and the usefulness of FADS. RESULTS: Of the 14 cases of carcinoid tumor, 5 patients were TN; 9 patients were TP with static images but only 8 were TP with FADS (a bronchogenic carcinoid of 6 mm was missed). Of the 17 cases of gastroenteropancreatic neuroendocrine tumor, static images were TP in 9 patients, and FADS were TP in 5 of these patients (and 4 FN). Static images and FADS were FN in 4 patients and TN in 3 patients, and in the 2 last patients static images were FP, but FADS were TN. Of the 10 cases of medullary carcinoma of the thyroid, static images and FADS were TN in 1 patient, static images were TP in 3 patients and FADS were TP in 2 of these patients (and 1 FN). In the six last cases, static images were FN, but FADS were FN in 3 patients and TP in 3 patients, showing an infiltrate. CONCLUSION: FADS demonstrates that tumoral kinetics are similar to those of the spleen. FADS can show a diffuse tumoral uptake corresponding to tumoral infiltrate in medullary carcinoma of the thyroid or in hepatic miliaria, whereas static images were normal or doubtful.

Adolescent↗