Skin diseases are more common in paediatric age group due to delicate nature of the skin and constant exposure to trauma. Dermatoses in children are influenced by external environment, socio economic status, climate conditions and dietary habits as compared to adults. Skin disorders in children can be transitory or chronic and recurrent(1). Chronic and recurrent dermatoses are associated with significant morbidity and psychological impact(2). Most of the skin diseases which results from intrinsic genetic abnormalities have their onset in the paediatric age group (3,4). The pattern of skin disease in children may differ according to the age, race, geographical area, climate conditions, hygiene, socio economic status, dietary habits and environmental variations(5). In developing countries like India infections and nutritional dermatoses are more common. This may be due to low socio economic conditions, poor hygiene, overcrowding and lack of health education(6,5,7,8). Eczema's are common in developed countries(9). As there are important differences in clinical presentation, treatment and prognosis between paediatric and adult dermatoses(10), dermatoses in children requires different view from adult dermatoses. The incidents of skin disease among the paediatrics age group are found to be ranged from 8.7 % to 38.8 % in various part of India according to different school based surveys(11). The patterns of skin disease in India is different across the states, rural and urban areas and hilly areas. The aim of our study is to find out the various clinical patterns and etiology of dermatoses in children which needs early diagnosis and treatment so that we can reduce the morbidity and psychological impact.

This is a Hospital based prospective observational study done on patients attending DVL Outpatient department at Government General Hospital, Madanapalle, Andhra Pradesh between the period of Nov 2023 to March 2024. All the children between 0 to 16 years age, both sexes presented with any dermatoses are included in the study. Neonate were excluded from the study. A Total of 300 children between 0 to 16 years of both sexes are included in the study. Detailed history, systemic. And cutaneous examination was done. Relevant investigations were carried out wherever necessary and the data obtained was analysed.

Table 1: Age and gender distribution Age groups (years) Male Female Total N( %) <1 28(63.64%) 16(36.36%) 44(14.66%) 1 - 5 64(58.19%) 46(41.81%) 110(36.67%) 6 - 16 83(56.84%) 63(43.12%) 146(48.67%) Total N (%) 175(58.33%) 125(41.67%) 300(100.00%) A total of 300 patients were included in our study. Most of the patients are in the age group of 6-16 years (146, 48.67%) followed by 1-5 years (110, 36.67%). Males outnumbered the females with male to female ratio of 1.4:1 Table 2: Distribution of various infections and infestations according to age (n=300) Infections Age group (years) Total N( %) <1 1 – 5 6-16 Bacterial 10 43 51 104(34.67%) parasitic 5 19 23 47(15.67%) Fungal 3 13 19 35(11.67%) Viral 3 7 9 19(6.33%) Total 21 82 102 205 (68.34%) Infective dermatoses was more common (205 cases, 68.34%) in the present study than non -infective dermatoses (95, 31.66%). Among infections bacterial infections were more frequent (104, 34.67%) followed by parasitic infections (Scabies) (47, 15.67%), Fungal (35, 11.67%) and viral (19, 6.33%) infections. Table 3: Various non - infective dermatoses in different age groups (N=300) Type of Dermatoses Age group (years) Total N (%) <1 1 – 5 6-16 Atopic dermatitis 2 1 2 5(1.67%) Seborrhoeic dermatitis 2 0 1 3(1.00%) Pityriasis alba 1 5 3 9(3.00%) Diaper dermatitis 11 2 0 13(4.33%) Eczema 5 11 13 29(9.67%) Urticaria 3 9 10 22(7.33%) Alopecia areata 0 0 2 2(0.67%) Acne 0 0 9 9(3.00%) Miliaria 1 1 1 3(1.00%) Total 25 29 41 95(31.66%) Among non-infective skin conditions Eczema (29, 9.67%) is more common in 6-16 years age group followed by pre school age 1-5 years and urticaria (22,7.33%) was the second most common condition in both age groups .Diaper dermatitis(13,4.33%) is more common in infants in the present study. Table 4: Distribution of etiology of various dermatoses in children according to gender (N =300) Type of Dermatoses Male Female Total N (%) Pyoderma 35 32 67(22.33%) Scabies 27 20 47(15.67%) Impetigo 21 16 37(12.33%) Tinea 22 11 33(11.00%) Varicella 7 6 13(4.33%) Eczema 18 11 29(9.67%) Urticaria 14 8 22(7.33%) Pityriasis alba 5 4 9(3.00%) Diaper dermatitis 8 5 13(4.33% measles 2 1 3(1.00%) Acne vulgaris 5 4 9(3.00%) Atopic Dermatitis 3 2 5(1.67%) Seborrhoeic dermatitis 2 1 3(1.00%) Viral warts 2 1 3(1.00%) Candidiasis 1 1 2(0.67%) Miliaria 2 1 3(1.00%) Alopecia areata 1 1 2(0.67%) Total 175 125 300(100.00%) Out of 300 patients pyoderma was the commonest infective dermatoses found in 67 patients (22.33%) followed by scabies 47(15.67) and impetigo (37, 12,33%). Tinea was the common fungal infection found in 33 patients (11.00%). Among non-infective dermatoses, Eczema (29 cases 9.67%), urtcaria (22,7.50%), diaper dermatitis(13, 4.33%), pityriasis alba (9, 3.00%) are seen in decreasing order. Pyoderma and varicella are more or less equally found in both the sexes, while scabies and tinea are more common in males than in females.

Skin diseases are more common in paediatric age group and are associated with significant morbidity. Skin disorders in children can be transitory or chronic and recurrent. The patterns of skin disease and their etiologies can be due to various factors like environment, social backwardness, malnutrition, overcrowding, poor hygiene, illiteracy and lack of health education in many parts of our country (12). Status of health, hygiene and personal cleanliness of a society can be judged from the prevalence of certain skin diseases in the children of the community (11). In the present study dermatoses were more frequently found in school going children of 6 -16 years (146, 48.67%) followed by pre-school children 1-5 years (110, 36.67%). It may be due to their exposure to the external environment and to their neighbourhood than infants who are confined to home. Infective dermatoses is more prevalent in our study (205, 68.34%) than non-infective dermatoses (95, 31.66%), which is in accordance with the study by Geet Gunjana et al (69.4%)(13), Khalid et al (63.2%)(14), Jawade S.A et al (56.40%)(8). Among infective dermatoses bacterial infections are frequently found in all the age groups (104, 34.67%), which is comparable with study by Patel N et al(39.10%)(7) and also the study by Thakare S et al (33.10%)(6), Geet Gunjana et al (36.8%)(13). The second most common infective dermatoses was parasitic infestation (scabies 47, 15.67%) followed by fungal (35.,11.67%), viral infection(19, 6.33%) in decreasing order, which is comparable with other studies by Sugat A Jawade(8), Bhatia(15), Negi(16), Sharma et al(17) and Rao G S, Kumar SS et al(18). In the present study pyoderma is more common affecting both males and females equally which is similar to the study done by Geet Gunjana et al(13) and patel et al(7). Varicella is the most common viral infection observed in our study which is comparable to the study by Salvah sarma et al(11). The incidents of fungal infections was (35,11.67%) in our study which is almost similar to other study by Sugat A jaawade (8.65%)(8), Thappa (8.49%)(2). Non-infective dermatoses is found in 95 cases (31.66%) in our study, of which eczema ( 29 , 9.67%) and urticaria (22, 7.33%) were most common in pre-school and school going children, this is similar to the study by Jitendra singh et al. (35.80%)(5) and Geet Gunjana et al (30.60%)(13). In infants diaper dermatitis is the most common finding in our study which is similar to the study done by Geet Gunjana et al(13).

Children are more prone to develop skin diseases due to various factors and are associated with significant morbidity. The disease pattern differs in a given population by different ecological factors. Infections and infestation are more frequently seen in paediatric age group, possibly due to malnutrition, poor hygiene , over crowding, poverty and lack of health education. Dermatoses in children have different clinical presentation and management from that in adults. Therefore it is crucial to have thorough awareness of the varied presentation and their etiologies for early diagnosis and effective management .

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