Patterns of skin diseases among pediatric patients attending the pediatric dermatological clinic at King Hussein Medical Center

This study was conducted to determine and highlight the spectrum and patterns of skin diseases among pediatric patients attending the pediatric dermatological clinic at King Hussein Medical Center and Queen Rania Abdullah Hospital for Children. All newly diagnosed pediatric patients who presented to the outpatient clinic of pediatric dermatology clinics between February 2008 and March 2013 were included in the study. Inclusion criteria included patients with skin disease below the age of 15 years. Patients were divided into three age groups: infant, preschool and school age children. Skin diagnosis was made clinically and laboratory investigations were ordered when necessary. Descriptive statistical analysis was used to describe the study variables. A total of 5,004 patients were included in the study. Some subjects had more than one disorder. The age ranged from one day to 15 years with a mean of 8.6 +/- 7.4 years. There were 2,577 males [51.5%] and 2,427 [48.5%] females, with a male to female ration of 1.1:1. Preschool children were more frequently affected than other children. Analysis of underlying etiologies revealed that the majority of dermatoses were infections and infestations [35.3%], followed by eczema [30.1%] and hypersensitivity reaction [6.5%]. Skin diseases are common in children especially the preschool age group with no significant difference between genders. The most common skin disease in this study was cutaneous infections followed by eczema. Higher consanguinity, overcrowding and hot humid environment may explain the high prevalence of infections

Drugs causing fixed drug eruption: a clinical study

To identify the causative drugs of fixed drug eruption, and to assess drug-related body site distribution of fixed drug eruption. This study was conducted at Prince Rashid Hospital and Queen Alia Hospital during the period between January 2008 and June 2009. A total of 64 patients who attended the dermatology clinic with fixed drug eruption were asked about the offending drug. Trimethoprim-sulphamethoxazole was the causative agent in 43 cases [70.3%], followed by Furosemide in 5 cases [7.8%], and Tetracyclines in 4 cases [6,3%]. Other causative drugs included Diclofenac sodium 3 [4.7%], Ciprofloxacin 3 [4.7%], Ibuprofen 2 [3.1%], Metronidazole 2 [3.1%], Norfloxacin 1 [1.6%], and aspirin 1 [1.6%]. The glans penis of the male genitalia was the most commonly involved site [58.0%], followed by the extremities [39.0%], the trunk [20.3%], and the lips [6.3%]. The female genitalia [clitoris] was involved only in two patients [3.1%]. Only one patient [1.6%] developed a generalized bullous drug reaction. Our study highlighted the common occurrence of FDEs, and the range of causative drugs. They were most commonly encountered with trimethoprim-sulphamethoxazole, but quinolones were increasingly seen as causative agents for FDEs. Our study also showed that FDE usually presented as solitary lesion, and in terms of body site distribution the genitalia [mainly the glans penis] was the most frequently involved site

Herpes zoster in children

The aim of this study was to describe the epidemiology, clinical manifestations, therapy and outcome of herpes zoster in children. The medical records of 21 patients with herpes zoster who were referred to the dermatology clinic between February 2003 and July 2005 were reviewed. The total numbers of patients were 12 males [57.1%] and nine females [42.9%]. Their age ranged between 5 and 14 years. The diagnosis was made depending on history and the clinical manifestation. Aciclovir therapy was given systemically within three days of the onset of the exanthem. Amongst the 21 subjects, eight patients had underlying hematological malignancy in the form of acute lymphoblastic leukemia and these represent the immunocompromised group. The other 13 patients were otherwise healthy [immunocompetent group]. Two children in the immunocompetent group were born to mothers who had varicella during pregnancy [intrauterine] at two and seven months of gestation. The other 11 patients had varicella under the age of four years and herpes zoster 4-8 years later. Among the immunocompromised children only two patients had varicella under the age of four years, they all had varicella before the appearance of malignancy, and all patients in this group had herpes zoster between the age of 9 -14 years. Zoster is a rare disease in childhood. Varicella in early childhood is a risk factor of herpes zoster in immunocompromised and immunocompetent children. Most cases of childhood zoster occur in otherwise healthy children. The appearance of herpes zoster in a young child does not always imply an underlying immunodeficiency or malignancy. The prognosis is generally excellent