Clinical study of primary pyodermas in children in a tertiary care setup

Introduction: The normal human skin is colonized by huge numbers of bacteria that live harmlessly as commensals on its surface and within its follicles. Cutaneous bacterial infections may be divided into primary and secondary types.Bacterial skin infection is the single most common diagnosis among those with skin problems, accounting for 17% of all clinic visits.5 These infections are the most common cause of childhood morbidity and constitute one of the prime causes for hospital attendance in children.
Aim of the study: To study the clinical profile of primary pyodermas in children.
Materials and Methods: Study Design: Descriptive study Study Setting: Dermatology & Venereology department, Medical College hospital, Thiruvananthapuram. Duration of study: 1 year .Sample size: 50. Inclusion criteria: Clinically diagnosed cases of primary pyoderma of both sex and age between 1 to 12 years. Exclusion criteria: Those children between 1 to 12 years with primary pyoderma started on antibiotic therapy.
Observation: Primary pyodermas were more common in children between 1 to 4 year age group (56%). Male to female sex ratio was 2.33:1. Children belonging to low socioeconomic status (64%) were more commonly affected by primary pyodermas. Primary pyodermas were seen more commonly in adequately nourished (76%) children. Children attending anganwadis, nurseries and schools (72%) were more commonly affected by primary pyodermas which points to the necessity of providing anganwadi and nursery teachers adequate awareness regarding pyodermas. Concurrent systemic diseases were present in 22% of cases. Among these the most common disease was febrile seizures (6%), Regional lymphadenopathy in 52% cases; most of such cases were impetigo contagiosa indicating that it is much more commonly associated with lymphatic spread than other pyodermas. Impetigo contagiosa (76%) was the most common clinical type of primary pyoderma in both boys (77.14%) and girls (73.34%) and also in both pre-school (75%) and school going children (77.27%).
Conclusion: Impetigo contagiosa (76%) was the most common clinical type of primary pyoderma in both boys (77.14%) and girls (73.34%) and also in both pre-school (75%) and school going children (77.27%). Leukocytosis and elevated ESR in 42% cases and neutrophilia in 18% cases were noted. Lymphocytosis was also a consistent finding in 70% cases.