Andrews Ross M, McCarthy James, Carapetis Jonathan R, Currie Bart J
Menzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Northern Territory 0811, Australia.
Pediatr Clin North Am. 2009 Dec;56(6):1421-40. doi: 10.1016/j.pcl.2009.09.002.
Pyoderma, scabies, and tinea are common childhood skin disorders too often considered to be merely of nuisance value. More than 111 million children are believed to have pyoderma, with many also co-infected with scabies, tinea, or both. These skin disorders cannot be differentiated by ethnicity or socioeconomic status but, in high-prevalence areas, poverty and overcrowded living conditions are important underlying social determinants. Each is transmitted primarily through direct skin-to-skin contact. For many Indigenous children, these skin conditions are part of everyday life. Although rarely directly resulting in hospitalization or death, there is a high and largely unmet demand for effective management at the primary health-care level, particularly for pyoderma and scabies. Despite particularly high prevalence in some settings, treatment is not sought for many children, and when sought, the clinical benefit from such consultations is variable. The lack of standard, evidence-based recommendations is of much concern. The current evidence base for clinical diagnosis and treatment of these common childhood skin disorders is highlighted.
脓疱病、疥疮和癣是常见的儿童皮肤疾病,人们常常认为它们只是小麻烦。据信,超过1.11亿儿童患有脓疱病,许多儿童还同时感染了疥疮、癣或两者。这些皮肤疾病无法根据种族或社会经济地位加以区分,但在高流行地区,贫困和拥挤的生活条件是重要的潜在社会决定因素。每种疾病主要通过直接的皮肤接触传播。对许多原住民儿童来说,这些皮肤状况是日常生活的一部分。虽然这些疾病很少直接导致住院或死亡,但在初级卫生保健层面,对有效治疗的需求很高且在很大程度上未得到满足,尤其是脓疱病和疥疮。尽管在某些情况下患病率特别高,但许多儿童并未寻求治疗,而在寻求治疗时,此类咨询的临床益处也各不相同。缺乏标准的、基于证据的建议令人十分担忧。本文着重介绍了这些常见儿童皮肤疾病临床诊断和治疗的现有证据基础。