One third of adults with psoriasis stated that they first noticed the onset of their skin lesions during the first two decades of their life. 30% of children have an immediate family history of psoriasis (3). Approximately 1 out of every 3 children has moderate to severe eczema/atopic dermatitis (4). 85% of teens are plagued with acne (1).
We diagnose and treat a variety of skin, hair, and nail disease in the infant, toddler, and adolescent. A systematic approach of inspection, evaluation, and possible biopsy of skin disease is necessary for accurate diagnoses in children. Once diagnosed, therapeutic procedures are implemented such as (but are not limited to) spraying or injecting warts or applying a local irritant on molluscum.
Biopsies and excisions are also performed as intervention, not just as diagnosis. Careful consideration to remove a lesion is based on the maturity of the patient, the location of the lesion, the urgency of removal, and the cosmetic result (3).
Attention to a child’s activity as it factors into the diagnosis as well as the interference of the disease on his/her lifestyle is contemplated and often discussed in a collaborative setting with parents and/or family.
The number of melanoma cases is projected to increase over the next 15 years (2). Unfortunately, melanoma can occur even in children; however, we can take steps to prevent this deadly skin cancer from occurring. Limiting sun exposure and discussing the harmful effects of tanning beds before children become adolescents can prepare them for pressures that occur later on. In addition to educating children on healthy skin behaviors, we can also detect melanoma using the ABCDE criteria: asymmetry, border irregularity, color variegation/variation, diameter, evolving. The CUP screening criteria can be helpful as well (5):
C Color (pink/red), changing
U Ulceration, upward thickening
P Pop up of new lesions
The annual cost of treating newly diagnosed melanomas is estimated to increase from $457 million in 2011 to $1.6 billion in 2030; however, a comprehensive skin cancer prevention program could reduce cases by 230,000 and initial year treatment costs by $2.7 billion between 2020 and 2030 (2).
Childhood is the perfect time to start skin cancer prevention with regular skin examinations.
Schedule your child’s appointment today.
1. Bolognia, J.L., Jorizzo, L.L. & Schaffer, J.L. (2012). Dermatology (3rd ed.). St. Louis, MO: Elsevier/Mosby.
2. Guy, GP Jr., Thomas, CC., Thompson, T., Watson, M., Massetti, GM., Richardson, LC. “Vital signs: melanoma incidence and mortality trends and projections – United States, 1982-2030.” MMWR Morb Mortal Wkly Rep. 2015;64(21):591-596.
3. Mancini, Anthony J., Paller, Amy S. (2016). Hurwitz Clinical Pediatric Dermatology (5th ed.). Canada: Elsevier.
4. Eczema prevalence in the United States. (n.d.). Retrieved February 1, 2016 from https://nationaleczema.org/research/eczema-prevalence/
5. American Journal of Orthopedics.com. (2015). Diagnose Pediatric Melanoma Using the CUP Criteria. Retrieved February 1, 2016 from http://www.amjorthopedics.com/home/article/diagnose-pediatric-melanoma-using-the-cup-criteria/11a3e463df22e9cf468d6d0cece15bb4.html?ooct=AJO-related