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Pediatric Health


Knowing Your Child's Skin


Common (and Uncommon) Childhood Skin Conditions



104289648
January 01, 2011
Five-year-old MaKayla Jordan can't wait to start kindergarten next year. Her mother, Tiffany, is a bit more apprehensive. In addition to the usual parental concerns, MaKayla has epidermolysis bullosa, a skin condition that causes blisters to form on her body. Because it is inherited, her baby sister Tamara also has the condition.

"I actually grew out of it when I was two, but every case is different," Tiffany says – her daughters could have EB their entire lives.

There is no treatment or cure for the girls. Tiffany relies on needles to drain the blisters, antibiotics and other topical creams to try to prevent infections when the blisters burst, and both girls are on prescription painkillers – Oxycontin for MaKayla, Tylenol with codeine for Tamara.

"They're in constant pain all the time," she says, and she worries about the possibilities of addiction and the girls eventually needing stronger drugs because their bodies have gotten used to their current painkillers.

When MaKayla was born, she had no skin on her hands or feet – blisters there had burst from the force of being pushed through the birth canal.

"I don't remember having it, and my parents didn't say anything," Tiffany says, so she had no idea what was happening to her baby. "When I had it, they didn't know what it was."

With Tamara, they were able to prescreen for EB, and Tiffany had a C-section.

Tiffany plans to organize a walk or similar event this year to help raise awareness about EB. Both girls were also involved in a study last year at Children's Memorial Hospital in Chicago to develop a topical treatment to help reduce EB's effects.

Dr. Anita Haggstrom is the director of pediatric dermatology at Riley Hospital for Children, and an assistant professor of dermatology and peds at IU Med School, as well as one of the girls' doctors. "They're complicated, so they see a lot of people," Dr. Haggstrom says.

Fortunately, EB is rare – but there are plenty of more common, and less severe, skin conditions that afflict children.

"Acne's the number-one reason I see kids in the office," said dermatologist Beth Brogan, adding that it can start as young as 8, but peaks in the teen years.

"Dermatitis" refers to any inflammation of the skin from contact dermatitis – an allergy-like reaction to things like poison ivy/sumac/oak – to atopic dermatitis, a form of eczema that Dr. Brogan says affects about one in ten kids, causing red, itchy dry patches.

"These are kids that just have sensitive skin to certain environmental factors," she says. "About 90 percent of kids grow out of their atopic dermatitis."

While many skin conditions are not harmful or go away on their own, Dr. Brogan says certain factors are cause for concern – if there are blisters, or a fever accompanies the rash. Scarlet fever, for example, is strep throat combined with a fine red sandpaper-textured rash.

"The last time I saw it was in my own son," Dr. Brogan says.

As anyone who's read "Little Women" knows, used to be fatal. Fortunately, antibiotics can now cure scarlet fever, but if ignored, it can lead to serious complications.

Another fever-related condition is Roseola, a viral infection caused by the human herpes virus types 6 and 7 and very common in children 6-months- to 2-years-old. A high fever is followed by a pinkish-red rash on the abdomen.

Hives is also often a reaction to a viral infection, or possibly new medications, and usually goes away on its own. Warts, on the other hand, are caused by HPV. They are not inherently harmful, and can be taken care of at home with a salicylic acid formula like Compound W, or at a doctor's office with liquid nitrogen.

Dr. Haggstrom says that joint pain or swelling can also accompany a rash, and is cause for a visit to the doctor.

Thankfully, many conditions are fairly benign – cradle cap, which causes scaliness and redness on the scalp, is common in infants, generally not itchy or uncomfortable and is gone by age 6 months to 1 year.

"It's the same thing that causes adults to have dandruff," Dr. Brogan says, recommending an olive oil massage, followed by shampooing.

Heat rash, which manifests as small red or pink pimples, is just what it sounds like – a baby is too warmly dressed, or too close to heat source. Removing the extra clothing or the heat source should quickly resolve the problem.

Besides bacterial and viral, a skin condition can also be fungal (and treated with anti-fungals), like ringworm – an itchy red patch that turns into a ring with raised, blistery or scaly edges. It can be passed between humans and animals from skin-to-skin contact, or by sharing things like sports equipment and towels.

"It's caused by the same fungus that causes athletes foot," Dr. Brogan says.

It's also important to maintain booster shots for things like chicken pox, Dr. Brogan warns, so that situations like September's outbreak among Zionsville High School students don't happen again.

Allison Tyra is a graduate of Indiana University's School of Journalism. An Indianapolis native, she spends most of her time freelancing for various Midwest-based publications, watching too much Glee/Grey's Anatomy and giving into her cats' demands for attention.

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