Pediatric Dermatoses Research Articles

Pattern of pediatric dermatoses in a tertiary hospital in South India

Background: Several cross-sectional studies in the form of school surveys and studies on paediatric patients visiting dermatology OPD in tertiary care hospital has been conducted in the last three decades. This study was conducted to note the pattern of paediatric dermatoses and also to compare the difference in disease pattern with other studies conducted in southern India in last decade. Methods: A retrospective cross-sectional study was conducted at the Dermatology department of MVJ teaching hospital to determine the pattern of pediatric dermatoses from May 2021 to October 2021 after obtaining institutional ethics committee clearance. Cases under the age of 18 years were included in the study. Cases with age above 18 years, incomplete data, dermatoses where diagnosis was uncertain were excluded from the study. A total of 150 children were included in the study. The results were entered and tabulated in MS-excel sheet and descriptive analysis was done. Results: 150 children were included in the study.36 types of dermatoses were noted overall. Eczematous diseases (32.7%) contributed to the maximum followed by infections and infestations (25.3%). The most frequent dermatoses found were Atopic dermatoses (10%), pityriasis alba (8.6%), scabies (8.6%), Acne vulgaris (8.6%). Eczematous diseases and hypersensitivity disorders were noted to have increased frequency when compared to other studies in last one decade Conclusions: Rising trend in atopic dermatitis has been noted which might be due to changing environmental factors and also due to better recognition of condition by physicians in last one decade. With respect to spectrum of skin infections and infestations not much of difference is appreciated when compared to previous studies

A cross-sectional study of pediatric dermatoses in a specialized pigment and skin-of-color center in Australia.

There is a paucity of literature on pediatric skin conditions in skin of color, of which old epidemiological data are likely to become outdated as the ethnic diversity in developed countries such as Australia continues to grow. We analyzed the prevalence of presenting conditions of pediatric patients with skin of color attending an urban dermatology clinic in Melbourne, Australia over an 18-month period. The major presenting issues were vitiligo, atopic dermatitis, and acne vulgaris, the majority of which did not significantly differ by ethnicity; however, there was a statistically significantly higher proportion of Chinese and Indian patients presenting with atopic dermatitis. Given the varying presentations of these conditions in skin of color, our findings highlight the importance of increasing education for dermatologists and health personnel in pigmentary disorders and the need for further focused studies comparing the prevalence of skin disease across ethnicities.

Translated article] What Proportion of the Spanish Dermatology Caseload Corresponds to Pediatric Dermatoses? Results From the DIADERM National Random Sampling Survey

BackgroundVisits for skin conditions are very common in pediatric primary care, and many of the patients seen in outpatient dermatology clinics are children or adolescents. Little, however, has been published about the true prevalence of these visits or about their characteristics. Material and methodsObservational cross-sectional study of diagnoses made in outpatient dermatology clinics during 2 data-collection periods in the anonymous DIADERM National Random Survey of dermatologists across Spain. All entries with an International Classification of Diseases, Tenth Revision code related to dermatology in the 2 periods (84 diagnoses) were collected for patients younger than 18 years and classified into 14 categories to facilitate analysis and comparison. ResultsIn total, the search found 20 097 diagnoses made in patients younger than 18 years (12% of all coded diagnoses in the DIADERM database). Viral infections, acne, and atopic dermatitis were the most common, accounting for 43.9% of all diagnoses. No significant differences were observed in the proportions of diagnoses in the respective caseloads of specialist vs. general dermatology clinics or public vs. private clinics. Seasonal differences in diagnoses (January vs. May) were also nonsignificant. ConclusionsPediatric care accounts for a significant proportion of the dermatologist's caseload in Spain. Our findings are useful for identifying opportunities for improving communication and training in pediatric primary care and for designing training focused on the optimal treatment of acne and pigmented lesions (with instruction on basic dermoscopy use) in these settings.

Spectrum of Paediatric Dermatoses in a Private Medical College

Introduction: Dermatoses in children puts a huge burden on the parents as well as their development. Severity of these dermatoses vary from location to location. Environment plays an important role, especially in children and presentation of these dermatoses maybe quite different than those in adults.
 Methods: This is a six months prospective study. All children who presented to the Paediatrics / Dermatology OPD with any skin ailment were included. Diagnosis was done clinically, investigations if required were done. Based on age, cases were divided into six groups. Skin disorders were categorized into 17 groups. The demographic data and other clinical details were recorded on a pre-designed performa.
 Results: 206 children were included in our study. Males were 136 (66.01%) and females were 70 (33.98%) with M:F ratio 1.94:1. The spectrum of skin diseases were infections and exanthems (40.29%), eczematous diseases (19.41%), disorders of sebaceous and sweat glands (13.10%), papulosquamous diseases (6.31%), hypersensitivity syndromes (5.82%), disorders of pigmentation (5.33%), disorders of hair and nail (3.39%), cutaneous tumor and tumor syndromes (1.94%), vascular disorders (1.45%), disorders of cornification (0.97%), photo-dermatoses(0.97%), histiocytosis and malignant skin tumors (0.48%), and miscellaneous (0.48%). Dermatoses according to age were neonatal (0.97%), infant (4.36%), toddlers (9.70%), preschool (18.44%), school-age-children (30.58%), and adolescents (35.92%).
 Conclusions: Skin infections and infestations being the majority explains the status of developing countries like India. This study can help identify (or diagnosing) and treating common dermatological conditions in children and this would also sensitize our fellow paediatricians to this common but often neglected aspect of childcare.

Diagnostic difficulties in pediatric annular dermatoses.

The polymorphic presentation of annular dermatoses in the pediatric population renders them adiagnostic challenge to the clinician. They include various distinct disease entities that can be vaguely categorized according to the age of onset. Herein, we report on ayoung girl with clinical characteristics of Wells' syndrome, while histological findings favored the diagnosis of annular erythema of infancy (AEI). Although morphological and histological similarities do exist, AEI and eosinophilic annular erythema (EAE) of childhood are considered as distinct entities in the literature. Wells' syndrome (WS) is an eosinophilic dermatosis and histologically characterized by eosinophilic dermal infiltration with the hallmark feature of "flame figures." Based on this case, we discuss and review the differential diagnoses of annular dermatoses in children.

DKFD: Optimizing Common Pediatric Dermatoses Detection with Novel Loss Function and Post-Processing

Using appropriate classification and recognition technology can help physicians make clinical diagnoses and decisions more effectively as a result of the ongoing development of artificial intelligence technology in the medical field. There are currently a number of issues with the detection of common pediatric dermatoses, including the challenge of image collection, the low resolution of some collected images, the intra-class variability and inter-class similarity of disease symptoms, and the mixing of disease symptom detection results. To resolve these problems, we first introduced the Random Online Data Augmentation and Selective Image Super-Resolution Reconstruction (RDA-SSR) method, which successfully avoids overfitting in training, to address the issue of the small dataset and low resolution of collected images, increase the number of images, and improve the image quality. Second, for the issue of an imbalance between difficult and simple samples, which is brought on by the variation within and between classes of disease signs during distinct disease phases. By increasing the loss contribution of hard samples for classification on the basis of the cross-entropy, we propose the DK_Loss loss function for two-stage object detection, allowing the model to concentrate more on the learning of hard samples. Third, in order to reduce redundancy and improve detection precision, we propose the Fliter_nms post-processing method for the intermingling of detection results based on the NMS algorithm. We created the CPD-10 image dataset for common pediatric dermatoses and used the Faster R-CNN network training findings as a benchmark. The experimental results show that the RDA-SSR technique, while needing a similar collection of parameters, can improve mAP by more than 4%. Furthermore, experiments were conducted over the CPD-10 dataset and PASCAL VOC2007 dataset to evaluate the effectiveness of DK_Loss over the two-stage object detection algorithm, and the results of cross-entropy loss-function-based training are used as baselines. The findings demonstrated that, with DK_Loss taken into account, its mAP is 1–2% above the baseline. Furthermore, the experiments confirmed that the Fliter_nms post-processing method can also improve model precision.

Evaluation of clinicoepidemiological features of pediatric dermatoses in Egyptian children

Background Epidemiological studies determine the burden of skin diseases, especially in children, which is required for proper health-care planning. Objectives To evaluate the clinicoepidemiologic features of skin diseases among Egyptian children. Patients and methods This was a cross-sectional, community-based study that included 2594 children of both sexes with ages that ranged from birth to less than 18 years. This study included government schools, private schools, and maternity and childhood care centers in Sohag Governorate, Upper Egypt. Sociodemographic data, the general examination included body parameters, and dermatological examination of children were documented. Results Skin diseases were detected in 25.1% (651/2594) of the examined children. Allergic skin diseases were the most common detected, one in 32.4% of children followed by sebaceous gland disorders (acne vulgaris) in 30.7% and then infectious skin diseases in 24.85%. Head was affected in the majority of patients (54.8%). The median age of children with skin diseases was 11 (1–18) years. Females constituted 66% of children with skin diseases. Children with skin diseases from rural areas constituted 63.1%. The median age of children with an infectious skin disease was 8 (2–14) years. Female sex, rural residence, and parents of low educational levels were associated with higher percentages of infectious skin diseases in children. Conclusion This study concluded that the most common detected pediatric skin diseases were allergic skin disorders, sebaceous gland disorders, and infectious skin diseases, respectively. Socioeconomic status, environmental factors, and medical resources are the most important factors affecting the prevalence of skin diseases.

Clinico-Epidemiological Study of Papulosquamous Disorders in Childhood at a Tertiary Care Hospital in South India

Introduction: Papulosquamous disorders in children differ from those in adults in terms of presentations, treatments, and prognosis. The aim of this study was to add to the existing data regarding the presentation of pediatric papulosquamous disorders and analyze the metabolic parameters in children with psoriasis. Materials and Methods: This observational study included 83 patients (age, 0–18 years) with clinically diagnosed papulosquamous disorders. Demographic data and detailed clinical history were collected followed by a detailed clinical examination. In children with psoriasis, we assessed the parameters of metabolic health, such as anthropometry and blood chemistry. The outcomes are expressed as percentages and proportions. Results: Papulosquamous disorders constituted 2.3% of all the pediatric dermatoses with a male-to-female ratio of 1.7:1. They were commonly noted in the age group of 7–12 years. Psoriasis vulgaris (26.5%) was the most common disease followed by lichen planus (19.2%), seborrheic dermatitis (16.8%), pityriasis rosea (13.2%), lichen striatus (12%), lichen nitidus (7.2%), pityriasis lichenoides chronica (3.6%), and pityriasis rubra pilaris (1.20%). None of the 22 patients with psoriasis fulfilled the criteria for metabolic syndrome. However, aberrant serum levels included elevated fasting glucose (n = 5, 22.7%), elevated fasting triglycerides (n = 3, 13.6%), and decreased high-density lipoproteins (n = 2, 9.1%). Anthropometric abnormalities were also not noted. Conclusions: Understanding the morphological and epidemiological features of pediatric papulosquamous disorders can aid in early diagnosis, treatment, and counseling the patients and parents, which can alleviate their anxiety and improve the psychological distress.

Photosensitive dermatoses in paediatric practice

Photodermatoses represent a heterogeneous group of disorders characterized by the development of pathological skin reaction to solar radiation. The development or intensification of inflammatory skin reaction after exposure to ultraviolet or electromagnetic spectrum that is visible to the human eye is a distinctive feature of all photosensitive photodermatoses. Although photodermatoses are less common in children than in adults, they are often associated with genetic or congenital metabolic disorders, and may also point to diffuse connective tissue diseases. Paediatric photodermatoses are often the result of genetic or congenital metabolic disorders, and may also indicate diffuse connective tissue diseases. The epidemiological studies have showed that the global prevalence of photodermatoses diagnosed with photopatch tests is above or equal to 5.7%. The authors presented a modern classification of photosensitive dermatoses according to the etiological factor. The article provides up-to-date information about photosensitive dermatoses, including statistical epidemiological data, pathogenesis features, and also emphasis is placed on the issues of the quality of life of children and their parents. The authors described the clinical presentations of the most common paediatric photosensitive dermatoses and the basic principles of their therapy. Among topical glucocorticosteroids, methylprednisolone aceponate has proven itself in the treatment of paediatric photodermatoses as it has not only a pronounced anti-inflammatory effect, but also is easy-to-use. The timely diagnosis of paediatric photosensitivity will help to minimize the development of complications associated with delayed treatment and insufficient prevention (photoprotection).

Association of socio-demographic factors and personal hygiene with infectious childhood dermatoses.

Paediatric dermatoses vary vastly from adult dermatoses in terms of clinical presentation, management, and prognosis thereby generating special interest in this field. Many factors like geographical area, climatic exposure, seasons, culture, socioeconomic factors, hygiene, dietary habits, literacy influences pattern of skin diseases in children resulting in marked variation in prevalence and pattern. This study aims to find out association of socio-demographic factors and personal hygiene with infectious childhood dermatoses. This was a hospital based cross-sectional study. All children (0-14years) attending Dermatology outpatient clinics were enroled. Proforma was prepared to assess the socio-demographic factors and personal hygiene in the local context. Chi-square test was applied to find the association of the baseline variables with infectious dermatoses. A total of 364 children were enroled with mean age of 6.97± 4.23years. Females (52.5%) were slightly more than males (47.5%). There were 201 (55.2%) infectious and 163 (44.8%) non-infectious dermatoses. Bacterial infections were the most common group (18.7%), followed by dermatitis and eczemas (14.0%) and viral infections (13.7%). Lower educational status of mother (p=0.025), lower monthly family income (p=0.008), lower socioeconomic status (p=0.015) and less frequent bathing habits (p=0.014) were associated with increased risk of infective dermatoses. Infections and infestations were the most common paediatric dermatoses in our Outpatient Department. Female education, upliftment of socioeconomic status of family and improving personal hygiene may reduce the risk of skin infections in children.

Dermoscopy in pediatric dermatosis

Pediatric dermatoses differ from adult dermatoses with respect to clinical presentation, treatment, and prognosis. These can be transitory, chronic, and recurrent. Diagnosing these conditions is at times a challenge, and the use of dermoscope aids it. Dermoscopy in pediatric population has a unique advantage as it poses neither physical discomfort nor emotional stress. Therefore, this review was attempted to highlight the salient dermoscopy features of common dermatoses in pediatric age group. A systematic literature search using PubMed and Google Scholar databases for English language articles published up to the end of May 2019 was done for pediatric dermatoses and dermoscopy. Relevant studies were included. Cross-references from each study are also included. The common dermoscopy features of “atopic dermatitis,” “lichen planus,” “psoriasis,” “paediatric dermatoses,” “keratosis pilaris,” “impetigo,” “pityriasis rosea,” “pityriasis versicolor,” “granuloma annulare,” “vitiligo,” “hypomelanoses of Ito,” “nevus achromicus,” “molluscum contagiosum,” “verrucae,” “lentigines,” “freckles,” “capitis,” “pediculosis,” “alopecia areata,” “linear porokeratosis,” “lichen sclerosus et atrophicus (LS et A),” “pityriasis alba,” “acanthosis nigricans,” “hand foot mouth,” “seborrheic dermatitis,” and “prurigo nodularis” identified from literature search were included. Pediatric dermatoses are unique in presentation as they might overlap to some extent. The diagnosis of these conditions is complicated by the fact that a biopsy may not always be possible since children are not co-operative, and more importantly, parents are reluctant to subject their children to an invasive procedure. It is in this perspective that dermoscopy assumes greater importance in pediatric dermatology as compared to that in adults.

Pattern of Noninfectious Pediatric Dermatoses at a Tertiary Care Center in Gujarat

Introduction: Pediatric dermatoses are commonly encountered in the dermatology outpatient department with various presentations in the form of infective and noninfective dermatoses. The incidence and severity of these dermatoses are influenced by geographic, cultural, genetic factors and socioeconomic status. This study was planned to evaluate the burden and pattern of disease among children. Materials and Methods: This was an ambispective observational cohort study, and all the children <12 years of age with noninfectious dermatoses were included from July 2020 to December 2020. Results: We included a total of 1206 pediatric patients in 0–12 years of age with dermatological complaints, of which noninfectious dermatoses were 53% (n = 639) and infectious dermatoses 47% (n = 567). Out of them, 340 (53%) were males and 299 (47%) were females. Among all noninfectious dermatoses, eczema (30%) was found to be the most common dermatosis in our study. Conclusion: The present study focused on noninfectious dermatoses and highlighted the fact that they form a considerable burden of pediatric dermatoses.

A Retrospective Cross-sectional Study of Paediatric Dermatoses during the COVID-19 Pandemic in a Tertiary Care Hospital in Bengaluru, Karnataka, India

Introduction: Dermatologic conditions constitute at least 30% of all outpatient visits to paediatricians and 30% of all visits to dermatologists involve children. Skin conditions that manifest themselves during childhood and adolescence are referred as paediatric dermatoses and make up their own unique category of skin conditions. Aim: To identify the dermatological conditions which were prevalent during the Coronavirus Disease 2019 (COVID-19) pandemic in a tertiary care hospital in Bangalore. Materials and Methods: This retrospective cross-sectional study was conducted by reviewing records of Outpatient Department (OPD) of Dermatology and Paediatrics in our tertiary care center, Bengaluru from February 2020 to February 2022. The demographic details and diagnosis are recorded. The diagnosis was made according to ICD-10 (International Classification of Diseases 10th Revision) and the prevalence of different dermatoses was calculated. Mean and standard deviation was calculated for descriptive statistics. Data were statistically evaluated with IBM Social Package for Statistical Analysis (SPSS) Statistics for Windows version 26.0., IBM Corp., Chicago, IL. Results: The total number of paediatric cases attended dermatology OPD during the two year pandemic was 558. The prevalence of paediatric dermatoses in the present study was 193 (34.58%). There were 283 girls and 275 boys with Male : Female is 1:1.02. There is a female preponderance of 50.7% against 49.28%. The majority was infectious lesions 153 (27.41%), congenital dermatoses 9 (1.61%), Papulosquamous disorders 23 (4.12%), Pilosebaceous disorders 111 (19.89%), dermatitis 193 (34.58%) followed by Miscellaneous 69 (12.36%). Conclusion: This study was conducted during COVID-19 pandemic which in comparison to the other studies shows a similar distribution of dermatoses. But there was a significant shift of age group affected which can be well explained by the lockdown and social isolation.

Epidemiology and Clinical Pattern of Eczemas among Children and Adolescents – A Hospital-Based Cross-Sectional Study in the Desert Region of Western India

Introduction: Eczemas in the pediatric age group are quite common. It has an impact not only on the child but also on the family. The chronicity and severity of these eczemas can affect the physical and mental growth of the child. Hence, the management includes medical treatment along with proper counseling of the patients and their family on the various precipitating/risk factors and their avoidance. Objective: The present study was conducted to evaluate the epidemiology and clinical pattern of various eczematous conditions occurring in children and adolescents in age group of 0–19 years in the dry desert areas of western India. Materials and Methods: A cross-sectional observational study was conducted in a hospital-based setting in a desert district of western India over 1 year from November 2018 to October 2019. A total of 362 children out of 1389 pediatric dermatoses had eczematous disorders during the study period. Their data were collected and analyzed. Results: Endogenous eczemas were common than exogenous eczemas. Atopic dermatitis (30.1%) was found to be the most common type of eczema in this desert region of India, followed by seborrheic dermatitis (21.5%) and pityriasis alba (15.5%). Conclusions: Atopic dermatitis and seborrheic dermatitis were the most commonly observed eczemas among children and adolescents in a desert region of India.

A Comprehensive Review of Immunosuppressive Drugs in Pediatric Dermatoses

Pediatric dermatoses constitute an array of varied diseases, a few of which may require long-term treatment with immunosuppressants in the form of corticosteroids (CS) and steroid-sparing agents such as azathioprine, cyclosporine, and methotrexate. There are numerous articles mentioning long-term adverse effects of these immunosuppressants in adults, but just a few mentioning the same in the pediatric age group. This concise review focuses on the immunosuppressants commonly used for dermatoses in children and gives a comprehensive list of the various indications for use in each and associated adverse effect on long-term use. A comprehensive search was done using PubMed, Google, EMBASE, Cochrane, and MEDLINE on studies published till date on immunosuppressant use in pediatric dermatoses with special emphasis on the safety and adverse effects on long-term therapy. Only English language articles were considered. Thirty-eight articles were found, of which only 28 were selected after removing duplication and articles having no relevant information. Clinical as well as randomized double-blinded or single-blinded controlled trials, open-label studies, retrospective studies, case series, reviews, and case reports on the use of immunosuppressants in pediatric age group, including their long-term adverse effects were screened and a documented evidence was prepared, analyzed and presented in a narrative fashion to highlight the important pediatric indications for the use of the respective immunosuppressant, with special emphasis on the adverse effects on prolonged usage. The review has been divided into two parts for the reader's benefit. Part I consists of CS, azathioprine, and cyclosporine, whereas, Part II consists of methotrexate and mycophenolate mofetil.

A Comprehensive Review of Immunosuppressive Drugs in Pediatric Dermatoses

Immunosuppressants are required for an array of pediatric dermatoses. Certain dermatological conditions require long-term use of immunomodulators such as methotrexate and mycophenolate mofetil. All immunosuppressants have varying toxicity profiles and long-term use of these in the pediatric age group may lead to significant adverse effects. This concise review focuses on the immunosuppressants commonly used for dermatoses in children and gives a comprehensive list of the various indications for use in each and associated adverse effects on long-term use. An English language search was done on studies published till date on immunosuppressant use in pediatric dermatoses. A documented review was prepared, analyzed, and presented in a narrative fashion to highlight the important pediatric indications for the use of the respective immunosuppressant, with special emphasis on the adverse effects on prolonged usage.

A Clinical Study of the Pattern of Dermatoses among Schoolgoing Children Attending a Tertiary Care Center in North Karnataka

Introduction: Pediatric dermatoses are a distinct group of disorders, comprising skin problems encountered during childhood and adolescence. Objectives of the Study: This study aimed to assess the clinical pattern and prevalence of various dermatoses among schoolgoing children in a tertiary care center in North Karnataka. Materials and Methods: Patients in the age group of 5–14 years with skin diseases attending dermatology outpatient department were enrolled in this study. A predesigned pro forma was used for all cases. A detailed history was taken. Clinical examination and relevant laboratory investigations were done to confirm the diagnosis in doubtful cases. Results: This study included a total of 550 patients. The most common pattern of dermatoses was infections and infestations constituting 40.5% (223 cases). The other common dermatoses in order of prevalence were eczema/dermatitis constituting 14.4% (79 cases), papulosquamous disorders: 6.9% (38 cases), hypersensitivity disorders: 6.2% (34 cases), and pigmentary disorders: 5.1% (28 cases). Among the infections and infestations, fungal infections were most common (14%), followed by parasitic infestations (13.8%), viral infections (8.7%), and bacterial infections (4%). Pityriasis alba was the most common eczematous disease. Conclusion: The most common pattern of dermatoses seen in our study was infections and infestations, followed by eczematous disorders. A detailed knowledge about the pattern of dermatoses among schoolgoing children will help us in implementing essential changes in health education and disease control strategies in the area concerned.

Pattern and Distribution of Pediatric Dermatoses and their Association with Parental Socioeconomic Status

Background: In developing countries, pediatric dermatoses cause significant morbidity and are a major public health problem. Parental socioeconomic status (SES) is an important underlying factor. Aim: The aim of the study is to estimate the prevalence and disease characteristics of pediatric dermatoses at a tertiary care center in Eastern India. Materials and Methods: Patients aged 19 years and below, presenting with at least one skin disorder were included in this cross-sectional study. All patients were subjected to detailed history including parental SES and clinical examination. Results: We evaluated 525 subjects (mean age 9.9 ± 6.2 years; M:F 1:1.1), majority being adolescents (>12–19 years) (40.6%) and belonging to upper-lower socioeconomic class (69.3%). Infections and infestations were most frequent (56.6%), followed by skin appendageal disorders (22.7%), eczema and dermatitis (8.8%), miscellaneous disorders (6.9%), pigmentary and nevoid disorders (3.4%), and papulo-squamous disorders (1.7%). Among infections, dermatophytosis was most common, followed by scabies and impetigo; while acne vulgaris was the most frequent noninfectious disorder followed by seborrhoeic dermatitis. Skin disorders were significantly associated with parental SES (P = 0.04). Infections showed a significant inverse association with parental SES (P = 0.003) while eczematous disorders demonstrated a positive dose-response association (P = 0.005). Higher parental SES increased the risk of acne vulgaris but reduced the risk of impetigo. Conclusion: Infectious diseases occurred most frequently, followed by pilosebaceous disorders. Parental SES is a significant determinant of pediatric dermatoses. Increased awareness is needed to prevent and treat these disorders.

Clinical Pattern and Frequency of Pediatric Dermatoses at Social Security Teaching Hospital, Lahore

Objective: To study the clinical pattern and frequency of pediatric dermatoses at Dermatology department Social Security teaching hospital, Multan road Lahore. Methods: Five hundred and thirteen children up to 12 years presenting to the dermatology OPD of Social Security teaching hospital in Lahore located at Multan road with different kind of skin diseases also were included in the respective study consisted on 4 months overall research period. On the basis of age all subjects were segregated into two different groups. One group comprised of patients from 1-6 years and the group from 7-12 years. Diagnosis was made by thorough history and clinical examination mainly. All patients were categorized into various groups on the basis of etiology. Results: Out of 513 children with skin diseases, 323 (62.96%) were males and 190 (37.03%) were females. 300 (62.96%) children were of the age group 1-6 years and 213(37.03%) children were of the age 7-12 years. Different infestations and certain infections were observed in 349 (68.03%) patients and 164 (31.96%) patients presented with various non-infective dermatomes. Conclusion: Infections and infestations were most commonly seen dermatoses as compared to non-infective dermatoses in this study. Keywords: Clinical pattern, dermatoses, frequency, infections, infestations.

Tofacitinib in paediatric dermatoses: a narrative review.

Tofacitinib has revolutionized the treatment of numerous dermatological conditions in different age groups. However, evidence for its effectiveness, safety and tolerability in the paediatric population is limited. We performed a literature search, which showed that oral tofacitinib is a reliable option in refractory juvenile dermatomyositis, severe alopecia areata, atopic dermatitis and psoriasis. Topical tofacitinib is an effective option in vitiligo and halo naevus. The risk-benefit ratio should be assessed prior to consideration of this molecule. In this narrative review, we have attempted to present a summary of the evidence of using tofacitinib (oral and topical) in paediatric dermatoses.