The prevalence of paediatric skin conditions at a dermatology clinic in KwaZulu-Natal Province over a 3-month period

Abstract

Background. Skin conditions are common in children, and studying their spectrum in a tertiary dermatology clinic will assist in quantifying skin diseases associated with greatest burden. 

Objective. To investigate the spectrum and characteristics of paediatric skin disorders referred to a tertiary dermatology clinic in Durban, KwaZulu-Natal (KZN) Province, South Africa. 

Methods. A cross-sectional study of children attending the dermatology clinic at King Edward VIII Hospital, KZN, was carried out over 3 months. Relevant demographic information and clinical history pertaining to the skin conditions were recorded and diagnoses were made by specialist dermatologists. Data were analysed with EPI Info 2007 (USA).

Results. There were 419 children included in the study; 222 (53%) were males and 197 (47%) were females. A total of 64 diagnosed skin conditions were classified into 16 categories. The most prevalent conditions by category were dermatitis (67.8%), infections (16.7%) and pigmentary disorders (5.5%). For the specific skin diseases, 60.1% were atopic dermatitis (AD), 7.2% were viral warts, 6% seborrhoeic dermatitis and 4.1% vitiligo. Dermatitis was significantly more common in males (p<0.05). AD was the most common condition below 12 years of age, while the presence of viral warts was the most prevalent disorder among HIV-infected children. Approximately one-third (37.5%) of the disorders referred by other medical practitioners were misdiagnosed. 

Conclusions. AD constituted the highest burden both numerically and economically. Viral infections were a major contribution from HIV infection. The diverse spectrum and characteristics of skin diseases referred will assist in modifying the dermatology educational curriculum and bridge knowledge gaps among healthcare providers treating children.