Skin diseases in infancy and childhood often-present patterns, which
may diverge from the same diseases in adults. In young age there is
usually an increased vulnerability to certain infections, allergic and
physico-chemical changes. A few cutaneous diseases are peculiar in
children. Some of the anatomic and physiologic reasons for these
differences may be apparent, but others are entirely unknown.
The less sebum of the skin surface of children, immature collagen,
less firm cohesion of the dermo-epidermal junction, less developed
vascular, neural and skin appendages - all have an important role in
the susceptibility and diversity of certain skin diseases in the young
age groups. There are many curious types of dermatitis, which even the
most experienced consultants consider these as "rashes ".
Eczema, the largest group of skin diseases in infants and young
children offers many uncertainties in their classification and
prognosis. Physicians can expect more than 30 per cent of their
consultations to be different skin diseases.
Unlike other branches of medicine, where the complaint is usually the
disease and there is no disease without discomfort, skin diseases can
exist without complaint and sometimes there is complaint without
obvious clinical manifestations.
The frequency and diversity sometimes form a source of confusion to
practitioners and all concerned with primary medical care. Diagnosis
and management of skin diseases requires knowledge of physiology,
structure and chemistry of normal as well as the pathologic skin.
Management of skin diseases is not merely topical steroids and
anti-histamines, but in fact, it is an art.
Topical preparations in infants and young children such as medicated
creams or cosmetics from over the counter may cause a harmful
effect. Severe toxicity leading to death was recorded from certain
preparations such as talcum powder, hexachlorophene, boric acid,
topical antihistamines, insect repellents and many others.
The idea of publishing such book is to give a brief knowledge on how
to deal better with the most common skin diseases faced during practice. Some
rare genetic dermatoses and other common diseases having a
chronic course in childhood and extending to adulthood were also
briefly
included.
It is not meant by any means that these chapters will provide
enough information to diagnose and treat all skin diseases, but the
advice and judgment of an experienced dermatologist in some cases is
indispensable.
I hope that this modest effort can provide a concise help to
physicians and practitioners to deal better with the main problems of
dermatological diagnosis and management.
Mahmoud Hijazy-MD
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