title: High frequency, diversity and severity of skin diseases in a paediatric emergency department.
abstract: BACKGROUND
  Skin disorders are a major concern in the Paediatric Emergency Department (PED). We provide an accurate evaluation of the incidence, characteristics and severity of skin disorders seen in our PED over a 1-year period.
  
  
  METHODS
  A total of 20,652 children's medical notes were reviewed in a single centre, retrospective study in the PED of a University Hospital over a 1-year period. The dermatological disorders were analysed on the basis of different criteria including their incidence, patient age, sex ratio, diagnosis, seasonal variations and hospitalization rates.
  
  
  RESULTS
  A total of 1897 (9.2%, F/M: 1.2; mean age: 4.1 ± 3.6 years) children presented with 1999 skin diseases and 69 different diagnoses. This frequency increased in the summer months (more than 14% of all patients). A total of 46.5% of diseases were infectious in nature (27.6% viral and 14.4% bacterial), inflammatory diseases accounted for 26.2% (urticaria and angio-oedema 15.9%, atopic dermatitis 3.5%, Henoch-Schönlein purpura: 2.1%), non-specific focal disease (balanitis, vulvitis, etc.) and insect bites, burns, transient diseases of the newborn and drug reactions for 9.2%, 7.8%, 6.4%, 3.7% and 1.2% respectively. More than 90% of children presented at the hospital for an acute condition and 155 (8.2% of children with skin disorders; F/M: 0.9; age: 4.0 ± 4.0 years) were hospitalized. More than 90% of hospitalizations were for infectious and inflammatory diseases.
  
  
  CONCLUSIONS
  Our data reveal the extremely high frequency, diversity and potential severity of paediatric emergency skin disorders. Specific educational measures and closer co-operation between Dermatologists and Paediatricians are essential if the skin care dispensed to children and teenagers is to be improved.
authors.affiliation: Department of Dermatology, Ambroise Paré University Hospital, University of Versailles-Saint-Quentin en Yvelines, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.
authors.forename: N
authors.initials: N
authors.lastname: Kramkimel
authors.forename: V
authors.initials: V
authors.lastname: Soussan
authors.forename: A
authors.initials: A
authors.lastname: Beauchet
authors.forename: A
authors.initials: A
authors.lastname: Duhamel
authors.forename: P
authors.initials: P
authors.lastname: Saiag
authors.forename: B
authors.initials: B
authors.lastname: Chevallier
authors.forename: E
authors.initials: E
authors.lastname: Mahé
mesh_terms: D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000145:classification / Q000503:physiopathology / Q000628:therapy*