Clinician-to-Clinician Update Clinician-to-Clinician Update

From Simple to Complex: Diagnosing Skin Conditions in Children

September 2015 - Dermatology

Skin conditions are the primary or secondary complaint addressed at approximately one-quarter of all pediatric visits to the pediatrician or primary care clinic.1 Proper diagnosis of skin conditions in children, however, can be difficult, as uncommon and potentially serious complaints that require multidisciplinary care, such as vascular malformations or genetic conditions, may superficially resemble common skin conditions that resolve spontaneously. (See Case Studies, pg. 3.) The majority of pediatric skin complaints are common disorders, ranging from eczema and molluscum to viral warts and acne vulgaris.2 However, other concerns include birthmarks, tumors, and inherited conditions.3 Pediatricians and other primary care providers diagnose the majority of skin diseases in children. Even so, a survey study of recently trained general pediatricians revealed that 35% name dermatology as one of the areas in which they felt their training was inadequate.4

97810-UMMCH-PedsDerm-CONSULT-Table1-Sept-2015-Derm
— Table 1. Skin conditions, both simple and complex, affecting children. All are treated by pediatric dermatologists at University of Minnesota Masonic Children’s Hospital.

At University of Minnesota Masonic Children’s Hospital, pediatric dermatologists provide leading-edge care for all pediatric skin complaints (Table 1). Care options include medical treatment or surgical and laser procedures performed in a dedicated procedure suite. Some procedures can even be performed in the clinic using only topical anesthesia, and Child-Family Life Services are available for all pediatric patients undergoing procedures. These specialists work with patients and their families and help children prepare for and cope with their clinic or hospital experience.

For very complex cases, the providers collaborate with other pediatric medical specialists in genetics, hematology and oncology, interventional radiology, neonatology, ophthalmology, otolaryngology, plastic surgery, and rheumatology. University of Minnesota Masonic Children’s Hospital is one of only a few centers in the state to offer subspecialty clinics such as the Center for Pediatric Vascular Lesions, the Epidermolysis Bullosa Specialty Clinic, and the soon-to-be-opened Atopic Dermatitis Specialty Clinic.

Because complex conditions can masquerade as simple rashes or birthmarks, University of Minnesota Health pediatric dermatologists strongly urge primary care providers to refer patients early in the care process. The specialists are available at 2 convenient University of Minnesota Health locations in Minneapolis and St. Paul, and in late 2015, University of Minnesota Health will be opening a Maple Grove location to provide expanded access to care.

References

1. Tunnessen WW Jr. A survey of skin disorders seen in pediatric general and dermatology clinics. Pediatr Dermatol. 1984;1:219-222.

2. Steele K. Primary dermatological care in general practice. J R Coll Gen Pract. 1984;34:22-23.

3. Feigenbaum DF, et al. What should primary care providers know about pediatric skin conditions? A modified Delphi technique for curriculum development. J Am Acad Dermatol. 2014;71:656-662.

4. Freed GL, et al. Research Advisory Committee of the American Board of Pediatrics. Recently trained general pediatricians: perspectives on residency training and scope of practice. Pediatrics. 2009;123 Suppl 1:S38-S43.

When to refer

Our pediatric dermatologists treat all skin disorders, both common and complex. They are members of many complex care teams, including those providing care at the Center for Pediatric Vascular Lesions, the Epidermolysis Bullosa Specialty Clinic, and the Atopic Dermatitis Specialty Clinic. They also work closely with pediatric rheumatologists at University of Minnesota Masonic Children’s Hospital, and patients can often be seen the same day by both specialists.

We encourage referrals for all your patients with skin disorders that have not responded to initial management or that present uncertainty as to diagnosis. It is not necessary to wait until a condition worsens to refer to our clinic, as treatment is often more effective and easier when begun early in the disease course. For your patients’ convenience, we have locations in Minneapolis and St. Paul and, in Oct. 2015, in Maple Grove.

Collaborative Care

Our multidisciplinary approach to care includes the referring physician as a vital part of the care team. We are committed to prompt communication about your patient, and we provide ongoing communication about diagnosis, treatment, and follow-up. In some cases, follow-up care can be provided at the patient’s local center, minimizing time lost from work and school for the patient and family.

Highest ranked children's hospital in the Twin Cities

University of Minnesota Masonic Children’s Hospital was recently named a top children’s hospital in the nation in five specialties:

best-childrens-hospitals-5specs-150x170
  • Cancer
  • Diabetes and Endocrinology
  • Gastroenterology
  • Neonatology
  • Nephrology
Related Articles

September 2015 - Dermatology

Pediatric Specialties Update

University of Minnesota Health adds new locations for pediatric dermatology care. Learn more and find the latest news, research, and conference announcements.

Continue reading

September 2015 - Dermatology

Misdiagnosis of Complex Vascular Malformations

A 9-month-old boy and a 10-month-old girl were separately referred for evaluation of “hemangiomas.” Upon examination, each were diagnosed with more complex vascular malformations that required multidisciplinary care.

Continue reading