Spectrum of pediatric dermatological emergencies at a tertiary care hospital in India: a descriptive study

Abstract

Dermatological emergencies in children are not uncommon. Worldwide, limited studies have been done to study the spectrum of such emergencies. The aim of our study was to analyze the spectrum of dermatological emergencies in the pediatric age group. Over a period of 18 months, ninety consecutive patients under 18 years of age presenting with cutaneous in addition to emergency disorders as assessed by the Nelson's severity scoring system were recruited. The most common emergency was primary cutaneous infections (40%), followed by adverse cutaneous drug reactions (13.33%). Staphylococcal scalded skin syndrome was the most frequent infection, and the most common adverse cutaneous drug reaction was Stevens-Johnson syndrome and toxic epidermal necrolysis. Other emergencies included purpura fulminans (12.22%), congenital dermatoses (11.11%), vasculitis (8.90%), angioedema (6.67%), collagen vascular diseases (2.22%), serum sickness (2.22%), post-varicella cerebellitis (1.11%), post-infected scabies glomerulonephritis (1.11%), and Langerhans cell histiocytosis (1.11%). These emergencies presented in equal numbers to the outpatient department of dermatology or pediatrics and to the emergency department. Our study recommends the use of standard scoring systems such as the Nelson's score to assess sick children. The appropriateness of this scale or other scales for the assessment of dermatological emergencies needs to be established. Over half of our cases were initially assessed by pediatricians and emergency personnel, highlighting the importance of spreading awareness about cutaneous emergencies and providing them with access to a dermatologist's services.