Department of Dermatology, Venereology and Leprology, St John's Medical College Hospital, Bangalore, India.
Int J Dermatol. 2013 Jan;52(1):27-31. doi: 10.1111/j.1365-4632.2011.05247.x. Epub 2012 Apr 4.
Dermatological emergencies in children are not uncommon. Worldwide, limited studies have been done to study the spectrum of such emergencies. The aim of our study was to analyze the spectrum of dermatological emergencies in the pediatric age group.
Over a period of 18 months, ninety consecutive patients under 18 years of age presenting with cutaneous in addition to emergency disorders as assessed by the Nelson's severity scoring system were recruited.
The most common emergency was primary cutaneous infections (40%), followed by adverse cutaneous drug reactions (13.33%). Staphylococcal scalded skin syndrome was the most frequent infection, and the most common adverse cutaneous drug reaction was Stevens-Johnson syndrome and toxic epidermal necrolysis. Other emergencies included purpura fulminans (12.22%), congenital dermatoses (11.11%), vasculitis (8.90%), angioedema (6.67%), collagen vascular diseases (2.22%), serum sickness (2.22%), post-varicella cerebellitis (1.11%), post-infected scabies glomerulonephritis (1.11%), and Langerhans cell histiocytosis (1.11%). These emergencies presented in equal numbers to the outpatient department of dermatology or pediatrics and to the emergency department.
Our study recommends the use of standard scoring systems such as the Nelson's score to assess sick children. The appropriateness of this scale or other scales for the assessment of dermatological emergencies needs to be established. Over half of our cases were initially assessed by pediatricians and emergency personnel, highlighting the importance of spreading awareness about cutaneous emergencies and providing them with access to a dermatologist's services.
儿童皮肤科急症并不罕见。全世界范围内,针对此类急症的研究都很有限。我们的研究旨在分析儿科年龄段皮肤科急症的种类。
在 18 个月的时间内,我们共招募了 90 名年龄在 18 岁以下的连续患者,这些患者除了按照纳尔逊严重程度评分系统评估的急症之外,还存在皮肤疾病。
最常见的急症是原发性皮肤感染(40%),其次是药物不良反应(13.33%)。葡萄球菌性烫伤样皮肤综合征是最常见的感染,最常见的药物不良反应是史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症。其他急症包括暴发性紫癜(12.22%)、先天性皮肤病(11.11%)、血管炎(8.90%)、血管性水肿(6.67%)、胶原血管疾病(2.22%)、血清病(2.22%)、水痘后脑炎(1.11%)、感染后疥疮性肾小球肾炎(1.11%)和朗格汉斯细胞组织细胞增生症(1.11%)。这些急症在皮肤科门诊或儿科以及急诊同样常见。
我们的研究建议使用纳尔逊评分等标准评分系统来评估患病儿童。需要确定该量表或其他量表在评估皮肤科急症中的适用性。我们超过一半的病例最初是由儿科医生和急诊人员评估的,这突出了普及皮肤急症意识并为他们提供皮肤科医生服务的重要性。