Update in adolescent dermatology

This dermatology article serves as a quick reference for the physician treating adolescents. We first review the diagnostic approach to a dermatologic problem: configuration, color, pattern, and distribution. The next section discusses diagnosis and management of the most common clinical situations encountered in everyday practice, including skin infections, infestations, dermatitis, hypersensitivity reactions, and papulosquamous disorders. The following section covers conditions that should be managed with the help of a dermatologist, including difficult acute situations such as Stevens-Johnson syndrome, toxic epidermal necrolysis, and necrotizing fasciitis; other chronic situations, including refractory common conditions such as acne and psoriasis, are also considered. We then discuss conditions that should be managed exclusively by a dermatologist, including malignancies, bullous disorders, and less common types of ichthyosis. The final section alerts the physician to dermatologic conditions that may be manifestations of other disorders, necessitating appropriate referral to a different specialist. Examples are immunologic and endocrine disorders, inflammatory bowel disease, collagen vascular disease, and malignancies.