Skin disorders encountered in a Swiss pediatric emergency department

While skin disorders are commonly seen in paediatric emergency departments (PED), the exact frequency of the various dermatological conditions is unknown. Our aim was to evaluate the occurrence and spectrum of skin disorders in an urban PED and the need for a dermatological opinion.

The medical records of patients attending the PED during 120 days over a 1-year period were analysed. The dermatological findings were evaluated as to incidence, demographic details, frequency of dermatological review and treatment. A questionnaire assessed the need for dermatological support.

Skin findings were recorded in 1,572 (17.4%) of the 9,041 attendances. The skin problem was the primary cause of the PED visit or related to the primary complaint in 853 (54.3%) and 335 (21.3%) cases respectively. In 373 patients (23.8%) a diagnosis was only suspected or remained unknown. Inflammatory and allergic disorders were most commonly encountered (42.9%), followed by skin infections (31.8%), physically induced skin lesions (11.9%), varia/unknown (11.1%) and congenital disorders (2.3%). Viral and parainfectious exanthema was the most common diagnosis (17.6%), followed by anogenital dermatitis (7.7%), gingivostomatitis (7.1%), petechiae (6.4%), burns (6.0%), urticaria (5.0%) and insect bite reactions (5.0%). 81 (5.2%) of the patients with skin conditions were hospitalised. The PED doctors expressed the wish for a dermatological opinion in 25% of the patients with skin findings.

We identified a high frequency, broad spectrum and diagnostic difficulties of paediatric skin conditions. Our data highlight the need for educational measures and close collaboration between the two specialities to improve management of these children.