What are they and how do you recognize them?
Children regularly develop skin disorders, which often differ from those seen in adults. It is also essential to examine the fingernails, palms of the hands, the soles of the feet and the inside of the mouth. It is also necessary to take into account possible external factors, such as irritants or infections by microorganisms, which could cause the skin disorder.
If you suspect a skin infection in your child, you should systematically check whether other children or adults around him (family, daycare, school, etc.) have skin abnormalities.
There are many different skin disorders, the causes of which are also different. We describe here the most frequent.
Atopic eczema
This disorder is characterized by prolonged inflammation of the skin accompanied by itching. The disease can experience an alternation of relapses and remissions: periods of great inconvenience and periods almost without complaints. Most often, atopic eczema affects young children as itchy red patches on dry skin. The plaques appear mainly on the face, neck or wrists, as well as in the folds of the elbows and knees.
Acne
Acne is the medical term for the typical pimples of adolescence. This disorder usually begins during puberty, between the ages of 15 and 24, and is characterized by the formation of pimples and blackheads on the face, back, shoulders or chest. Acne is caused by a blockage of the sebaceous glands. Often it is also a bacterial superinfection, leading to the formation of small ulcers.
Seborrheic dermatitis
It is a form of eczema that is associated with itching, redness and scaly patches, mainly in the scalp, skin folds and near the ears. The disease usually develops in a young child. Seborrheic dermatitis often starts later than atopic eczema.
Irritating (contact) dermatitis
This form of eczema is caused by irritation. This irritation can be due to certain agents or products, but also to friction or maceration. Its most common form in children is diaper rash (diaper dermatitis). It also frequently affects the hands and the area around the mouth. Diaper rash is a collective term for different forms of skin irritation in the area covered by diapers. It is caused by prolonged wearing of wet diapers and can be recognized by the redness and scale of the skin, sometimes associated with pain and itching in the area covered by the diapers.
Impetigo
Impetigo is a contagious infection of the skin caused by bacterial contamination. The typical picture is a “blackcurrant beard”: a cluster of small lesions covered with a yellow crust around the mouth. The disease sometimes occurs as a complication of another condition or as a result of scratching, for example with itchy eczema or a lice infestation.
Miliary
Miliaria is the medical term for the heat button. Mainly affecting babies, miliia appear as small papules on the trunk and limbs. Miliia are born from the occlusion of sweat glands in an environment that is too hot or under non-breathable clothing.
Scabies
Scabies is caused by a parasite, known as the sarcopte or scabies mite. The main symptom is nighttime itching, often onset. The parasite likes warm and humid environments, which makes our beds an ideal environment.
In small children, the blisters are seen mostly on the palms of the hands and the soles of the feet. When the child is a little older, scabies tend to show up as cracks between the fingers and on the wrists, or small skin lesions on the wrists, ankles, nipples and pubic area. There are no visible lesions on the head. The condition is characterized by thin, dark “passages” in the skin on the path followed by the mite.
In the event that a case of scabies is established, the whole family should be examined and treated. Clothing and bed linen should also be washed thoroughly.
Lice
The main symptom is itching on the back of the head and in the back of the neck. The scalp and the skin on the back of the neck are often inflamed and lesions appear on the skin due to scratching. Lymph nodes in the neck and ears may also be swollen.
Allergic reactions
An allergic reaction is an overreaction of defense caused by a specific triggering factor, which can be a food, a color
ant, a preservative, a cosmetic, … This reaction is accompanied by various symptoms, including certain skin disorders. Most often, an allergic reaction manifests as a rapid, searing red rash on the face and trunk. Occasionally, it can also be accompanied by hives (see below).
Exanthema and smallpox-like conditions
An exanthema is a red, sudden, transient and diffuse rash, which is usually caused by a viral infection (measles, chickenpox, rubella, mononucleosis, …) or by taking medications (antibiotics, anti-inflammatories, .. .). The rash can take many different shapes, but most often it’s red patches with papules that spread symmetrically across the body from the trunk to the limbs.
In smallpox-like conditions, there are small vesicles filled with a watery fluid. After a few days, these can be contaminated again with bacteria and form small ulcers. Usually they dry spontaneously and a crust forms. Because this disease is caused by infection, you should carefully monitor your child’s surroundings for infected people and examine their vaccination status.
Warts
Warts are benign thickenings of the skin caused by the human papillomavirus (HPV). They are usually found on the fingers or feet. Sometimes diffuse flat warts develop on the hands or face.
Molluscum
Molluscum contagiosum is also known as a water wart. It takes the form of small sparkling white pearls, marked by a small depression on the top. The cause is viral. This contagious skin infection mainly affects young children.
Nevus
Nevi (moles) are benign spots on the skin. There are different types of nevus, the birthmark being the most common.
There are still many other skin disorders that occur less often in children, and are generally rare.
Tinea versicolor
These brownish, slightly scaly patches are seen mainly in older children. They may fade over time and have a typical pattern. This is a benign skin condition triggered by the fungus Pityrosporon ovale. The plaques are usually located on the upper back, shoulders and chest.
Pityriasis alba
This disorder presents as white, circular patches with fuzzy lines on the face, trunk and limbs. It is often linked to atopic eczema. The disease is mild and recovers spontaneously.
Folliculitis
Folliculitis is inflammation affecting a few hair follicles. Various causes are possible: friction, maceration or application of fatty ointments or oils.
Ringworm
Ringworm is a contagious infection of the skin caused by fungi. The typical lesions appear as clearly demarcated rings, scaly at the margins, red in color. If the infection affects the scalp, there is usually hair loss in the affected area. Secondary bacterial infection is also possible.
Urticaria
We speak of urticaria to designate the rashes on the skin which appear quickly and accompanied by itching, associated with small or large blisters on a large part of the body. We make a distinction between the acute form and the chronic form. In children, it is most often acute urticaria as a result of infection, a drug reaction or an allergy.
Alopecia areata (alopecia areata)
This disease of the hair system is characterized by sudden loss of hair on part of the scalp, without other symptoms. We then observe a bald patch, without redness or scales. The disorder occurs at any age, but especially in young adults. Some of the known causes are fungal infections and stress.
Psoriasis
This chronic skin disease is relatively common in adults, but it also affects children occasionally. The picture is often slightly different: the child has fuzzy patches, which look like eczema, and often less scales than the adult.
However, there is a rarer form of psoriasis, “guttate psoriasis,” which is more common in children than in adults. This form follows a bacterial sore throat (strep infection) and takes the appearance of small drops on the skin.
Lyme disease (Borrelia infection)
Borrelia burgdorferi infection is spread by the bite of an infected tick. The infection leads to Lyme disease. The first phase of Lyme disease is characterized by a rash co
known as erythema migrans. It is recognized by the appearance of a circular red spot around a pale center in the area of the bite site. In rare cases, another skin disorder appears, namely borrelian lymphocytoma. This is manifested by swelling in the skin that is smooth and painless, blue or red-purple in color. This swelling is usually in the earlobes or the pubic area.
Skin tumors
Sometimes the child can develop tumors on the skin, which are usually benign. If necessary, it is sufficient to have them supervised by a doctor. Malignant tumors are possible, but extremely rare in children.
How is the diagnosis made?
Most often, your doctor will be able to make the diagnosis based on the symptoms and appearance of the rash. A thorough questioning of the patient can provide many clarifications:
How did the disease start?
When did the disease start?
Has the child traveled recently?
Is the disease present in the entourage or in the family of the child?
Does the child have any other symptoms, eg fever?
Then comes a careful examination: not only the lesions, but also the hair, nails, palms of the hands, soles of the feet, mucous membranes and, above all, the mouth.
Some additional examinations are sometimes necessary, for example if they are decisive in choosing the right treatment. Some examples of possible exams:
Bacterial culture: the doctor uses a cotton swab to remove a small amount of substance from the skin lesion, which bacteria will be cultivated. This test can give the doctor more information about the type of bacteria causing the skin disorder. It is done in cases of impetigo or folliculitis, for example, but it is only necessary in cases where standard antibiotic therapy does not improve the lesions.
Epicutaneous test or patch test: this test is used to detect allergies. The substances to be tested are placed on patches, which are glued to the skin. After two days, the patches are removed to check if any substance has triggered an allergic reaction.
Microscopy and fungal culture: If the doctor suspects a fungal infection, the doctor will take a small sample of the lesion. If he finds a fungus on microscopic examination and culture it, the doctor can confirm the diagnosis.
Histological examination: this involves analyzing cells and tissues. A biopsy is taken to remove a small piece of tissue from a suspicious lesion and examine it under a microscope. This examination is necessary when the doctor suspects a malignant tumor of the skin, for example.
What can you do ?
Skin disorders are common in children, but most are mild and easy to treat.
The best you can do to prevent a skin disorder is to avoid irritating factors, such as high temperatures, abrasive clothing, maceration, dirt, dust, etc.
Also, there is no point in spreading oily ointments or oils on your child, as they can also irritate their skin.
The best way to avoid diaper rash is to change your baby’s diaper when necessary. Regular grooming and keeping your little butt dry by applying talcum powder can also be helpful.
What can your doctor do?
In general, treatment for skin disorders often depends on age and is usually short-lived. A cortisone-based ointment may be prescribed for many skin conditions. Faced with an infection by a bacterium or a fungus, treatment with antibiotics or antifungals should be initiated. There are also specific products against parasites, such as lice and scabies mites.
Also consult the patient guides relating to each of these skin disorders for their specific treatment.