Skin diseases in Chinese children at a pediatric dermatology center

Abstract

Understanding the pattern of disease referrals is important in the delivery of a service. We followed 331 new referrals at a pediatric dermatology clinic over 12 months. Fifty percent of the patients were female; 293 patients (88.5%) had a single diagnosis and 36 (10.9%) had two diagnoses. Three leading causes for referrals accounted for 60% of the 371 skin diseases encountered: 124 diagnoses (33%) were of eczema, 73 diagnoses (20%) were of nevi, and 22 diagnoses (6%) were of viral warts. The nevi seen included melanocytic, epidermal, sebaceous, and vascular nevi. Skin biopsies were performed in 23 patients (6.9%), and microscopy and culture for fungal infections in 11 patients (3.3%). Forty-one patients (12%) were referred to the laser clinic for assessment of their nevi or pigmented skin lesions. Topical steroids were prescribed in 47% of patients during their follow-ups. Follow-up appointments were offered to 90% of patients. Eczema required the most frequent follow-up. Gender disparity in referrals was evident only in endogenous eczema (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.04-2.60 in males; p = 0.033). Girls were more likely to be referred to the laser clinic than boys (OR 2.31, 95% CI 1.10-4.92; p = 0.026). Most dermatologic diagnoses were made on clinical grounds and moderately potent topical corticosteroids were the most commonly prescribed medication. Since chronic skin disorders prevailed in the referrals, repeated follow-up appointments were required.