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Pediatric Cutaneous Emergencies and their Outcome: Study from a Tertiary Care Center in South India
Dharshini Sathishkumar1, Parthiban Udhayakumar1, Debasis Das Adhikari2
1Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India.
Insights
Pediatric skin emergencies are common in emergency departments. Severe cases can lead to systemic inflammatory response syndrome (SIRS) and require hospitalization, highlighting the need for prompt diagnosis and treatment.
Area of Science:
- Pediatric Emergency Medicine
- Dermatology
- Clinical Outcomes Research
Background:
- Skin conditions are frequent in pediatric emergency departments (PEDs).
- Limited data exists on outcomes for hospitalized children with skin ailments.
- Understanding these outcomes is crucial for effective patient management.
Purpose of the Study:
- To analyze the clinical characteristics of pediatric skin manifestations in a PED.
- To evaluate the impact of these skin lesions on patient outcomes, including hospitalization and mortality.
Main Methods:
- Screened children under 16 in the PED over one year.
- Referred children with skin lesions to dermatology for evaluation.
- Tracked hospitalized patients' outcomes: hospital stay, systemic inflammatory response syndrome (SIRS), and mortality.
Main Results:
- 0.83% of screened patients (203/24,324) had skin lesions; 22.16% (45/203) required admission.
- Inflammatory disorders (50.24%) and infections (44.82%) were the most common diagnoses.
- Hospitalized patients had high SIRS rates (55.6%), with two deaths (purpura fulminans, febrile exanthem).
Conclusions:
- Pediatric skin emergencies present a diverse spectrum with varying outcomes.
- A significant subset of children experience severe skin conditions and SIRS.
- Early diagnosis and rapid intervention are critical for improving outcomes in severe pediatric skin emergencies.
Background:
Skin problems are commonly encountered in the pediatric emergency department (PED). Although there are a few studies on the prevalence and spectrum of skin conditions in children attending the PED, only limited information is available on the outcome of the children with skin-related ailments requiring hospitalization.
Aim:
To study the clinical profile of skin manifestations in children presenting to the PED over a period of one year and assess the impact of skin lesions on the clinical outcome.
Materials And Methods:
All children <16 years of age attending the PED were screened and children with skin lesions were referred to the dermatologist for further evaluation, and those admitted were followed up until discharge. Children with skin lesions were categorized into seven subsets based on their diagnosis. Outcomes evaluated were duration of hospital stay, associated systemic inflammatory response syndrome (SIRS), and mortality.
Results:
Of the 24,324 patients screened, 203 (0.83%) had skin lesions, of whom 158 (77.83%) were discharged from the PED. Forty five (22.16%) patients required admission of whom 2 (0.99%) died. Inflammatory disorders were the most common, 102 (50.24%), followed by infections in 91 (44.82%) patients. Among the hospitalized patients, 25 (55.6%) had SIRS, which included infections in 14 (56%), vasculitis in 5 (20%), and urticaria in 3 (12%) patients. Two patients with SIRS died and the causes were purpura fulminans and febrile exanthem of probable viral etiology.
Conclusion:
Our study highlights the spectrum of pediatric cutaneous emergencies and their outcome. A subset of patients can present with severe skin ailments and SIRS in whom early diagnosis and prompt treatment can impact the outcome.
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