Pediatric dermatology in primary care medicine

Dermatologic conditions in children pose a special dilemma to primary care physicians. On the one hand, dermatologic problems are so common in childhood that the primary care physician is forced to become involved with many of them; on the other hand, the scope of dermatologic conditions found in children is so broad as to be beyond the skills of most primary care physicians. The secret to managing dermatologic problems in children within a primary care setting is to recognize that a relatively small group of conditions encompass the vast majority of reasons for which a primary care physician will be consulted. By recognizing those conditions and becoming expert in the treatment of those well-defined areas, the primary care physician can perform a true service. Critical to this approach, however, is to establish clear limits and to practice within the framework of one's competence. Recognizing the importance of early referral of those cases that fall outside one's expertise is an important measure of the primary care physician's competence as seen by patients and their families. This article attempts to assist primary care physicians in developing their own set of guidelines.