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Published on: January 16, 2019
Skin lesions in children admitted to the paediatric intensive care unit: an observational study
J Henk Sillevis Smitt1, Job B M van Woensel, Albert P Bos
1Department of Dermatology, A0-228, Academic Medical Center, University of Amsterdam, Postbox 22660, 1100 DD Amsterdam, The Netherlands. j.h.sillevissmitt@amc.uva.nl
Insights
Dermatological conditions are common in critically ill children, often indicating serious underlying illnesses. Early dermatological assessment in pediatric intensive care units (PICU) can improve diagnosis and treatment.
Area of Science:
- Pediatric Intensive Care
- Dermatology
- Critical Care Medicine
Background:
- Skin conditions are frequently encountered in pediatric intensive care units (PICU).
- The spectrum of dermatological diseases in critically ill children is broad.
- Dermatological manifestations can be indicative of severe systemic illness.
Purpose of the Study:
- To prospectively analyze the frequency and characteristics of dermatological symptoms and diseases in children admitted to a tertiary pediatric intensive care unit.
- To assess the role of dermatological conditions in the outcomes of critically ill children.
Main Methods:
- Prospective observational study conducted over a 3-year period.
- Inclusion of all children admitted to a university hospital's general pediatric intensive care unit.
- Documentation of dermatological findings and their relation to underlying conditions and patient outcomes.
Main Results:
- Skin problems were identified in 42 out of 1,800 admitted children (2.3%).
- The majority of skin issues (23/42) were manifestations of underlying diseases such as infections, vasculitis, or drug reactions.
- A direct link between dermatological disease and mortality was observed in 4 out of 7 deceased children.
Conclusions:
- Dermatological conditions in the PICU are diverse and often reflect systemic illness.
- While less common, significant dermatological diseases can impact patient mortality.
- Expert dermatological consultation can enhance diagnostic and therapeutic strategies for critically ill pediatric patients.
Abstract:
We analysed, by a prospective observational study over a 3-year period, the frequency and character of dermatological symptoms and diseases in children admitted to a tertiary general paediatric intensive care unit (PICU) of a university hospital. Skin problems were observed in 42 of 1,800 children admitted. There was a large variability in dermatological diseases in the PICU. In the majority (23/42), the skin problem was a dermatological manifestation of an underlying illness that caused admission to the PICU, e.g. infection, vasculitis or drug reaction. In four of the seven children who died, a direct relation between the dermatological disease and the cause of death could be established. Although the number of patients with relevant dermatological problems was limited, we believe that a skilled paediatric dermatologist is able to contribute to the effectiveness of diagnostic and therapeutic processes in paediatric intensive care patients.
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