This document discusses various types of skin infections including bacterial, fungal, and viral infections that commonly affect children. It provides detailed information on specific bacterial infections like impetigo, cellulitis, folliculitis, boils, and carbuncles. It also discusses fungal infections such as candidiasis, tinea infections (ringworm), and tinea versicolor. Finally, it covers some common viral skin infections in children like warts, molluscum contagiosum, and rubella. The document is intended to educate about the causes, symptoms, diagnosis, and treatment of various pediatric skin infections.

1. BY-
RAMYA DEEPTHI PULI
VIJAY MARIE COLLEGE OF NURSING

2. Types of skin infection
 Bacterial infection
 Fungal infections
 Viral infections
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3. BACTERIAL INFECTIONS
1. Impetigo
2. Cellulitis
3. Folliculitis
4. Boils
5. carbuncles.
6. Staphylococcal scaled skin
syndrome
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4. impetigo
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5. Definition Impetigo is a superficial infection of the skin, caused by bacteria.
 The lesions are often grouped and have a red base.
 These lesions open and become crusty and have honey- color
which is typical of impetigo
 It is contagious and can spread to all the members of the family
and also leads to re-infection of children.
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6. ETIOLOGY
 COMMON BACTEIAS THAT ARE FOUND ON SKIN
NORMALLY CAUSES IMPETIGO.
 When bacteria enters an open area in the skin,
infection occur.
 The most common causative organisms are-
1. Group A B hemolytic Streptococcus
2. Staphylococcus aureus.
 Impetigo is most common in children, but adults
may also have it due to poor hygiene and warm
temperatures.
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7. Clinical features'
 Impetigo usually occurs on face, neck, arms and limbs.
But the lesions can be observed on any part of the
body.
 Impetigo starts as a small vesicle or fluid filled lesion.
 The lesion then ruptures and fluid drains leaving areas
that are covered with honey colored crusts.
 The lesions may all look different, with different sizes
and shapes.
 Child may also presents with swollen lymph nodes.
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8. DIAGNOSTIC EVALUATION
 Diagnosed based on complete history
 Physical examination
 The lesions of impetigo are unique and are clearly
diagnosable.
 Culture of lesion can be done to confirm the diagnosis
and the type f bacteria.
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9. Management
 Specific treatment is given based on –
1. Child’s age, over all health and medical history
2. Extent of condition
3. Child’s tolerance to specific medications
 Treatment:
1. For child with many lesions oral antibiotics are given
2. If child has only few lesions, topical antibiotics are
applied directly on the affected area.
3. Bathe the child daily with an antibacterial soap to
help decrease the chance of spreading the infection.
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10. Contd..
 Proper hand washing technique by everyone in the house
hold is very important to help diagnosis the chance of
spreading the infection.
 Keep the child’s finger nails short to decrease the chances of
scratching and spreading the infection.
 Avoid sharing of garments, towels and other house hold
items to prevent the spreading of infection.
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11. Cellulitis
 Cellulitis is a deep bacterial infection of the skin.
 The infection usually involves the face, arms and legs.
 It may happen in normal skin, but it usually occurs
after some types of trauma causing an opening in the
skin.
 This opening can lead to infection.
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12. Etiology
 Cellulitis is caused by a bacterial infection of a wound area of skin
that is no longer intact.
 The most common bacterial cause of Cellulitis include the
following-
1. Group A B – Hemolytic streptococcus
2. Streptococcus pneumoniae
3. Staphylococcus aureus.
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13. Clinical features
 Swelling of the skin
 Tenderness
 Warm skin
 Pain
 Bruising
 Blisters
 Fever
 Headache
 Chills
 Feeling weak
 Red streaks
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14. Emergency manifestations of
cellulitis
 Very large area of red inflamed skin
 Fever
 If the affected area has-
1. Numbness
2. Tingling
 If the skin appears black
 If the child has diabetes or weakened immune
system.
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15. Diagnostic evaluation
 Diagnosis is usually based on medical history and
physical examination of the child.
 Blood and skin samples may be taken to confirm the
diagnosis and the type of bacteria that is present.
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16. Management
 Oral or iv antibiotics
 Warm, wet dressings on infection site
 Surgical intervention
 Elevate the effected part and reduce activity of that part.
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17. Complications
 Meningitis
 Septic arthritis
 Glomerulonephritis
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18. Folliculitis, BOILS,
CARBUNCLES
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19. FOLLICULITIS
 Folliculitis is the inflammation of hair follicles due to an
infection, injury or irritation.
 It is characterized by tender, swollen areas that form around
the follicles, often on the neck, breast, buttocks and face.
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20. Boils
 Boils are pus filled lesions that are painful and usually
firm.
 Boils are usually located I the waist area, groins,
buttocks and under the arm.
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21. Carbuncles
 Carbuncles are clusters of boils.
 These are usually found in the back of the neck or
thigh.
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22. Clinical features
 The following are the most common symptoms of
folluculitis, boils and carbuncles. However each child
may experience symptoms differently.
1. Symptoms of folliculits-
a) Pus in the hair follicle
b) Irritated red follicles
c) Damaged hair
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23. 2. Symptoms of boils-
a) Pus in the centre of boil
b) Whitish, bloody discharge
from the boil
3. Symptoms of carbuncles may
include-
a) Pus in the centre of the boil
b) Whitish, bloody discharge
from the boils
c) Fever
d) Fatigue.
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24. Diagnostic evaluation
 Thorough medical history and physical examination
 Culture of wound
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25. Management
 Specific treatment-
1. Topical antibiotics
2. For carbuncles and boils, a warm compress to
promote drainage of lesion
3. Oral and IV antibiotics
4. Possible removal of boils and carbuncles.
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26. Staphylococcal scaled skin syndrome
 Staphylococcal scaled syndrome is an infective response
occurred due to staphylococcus
 It is characterized by peeling of skin.
 This mostly affects infants, young children and individuals
with depressed immune response or renal insufficiency.
 This can be life threatening.
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27. Clinical features
 This disease usually begins with fever and redness of
skin.
 Then a fluid filled blister may form.
 This blister ruptures very easily leavening an area of
moist skin
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28. Other symptoms includes-
 Crusted infection site
 Red, painful areas around infection site
 Blstering
 Chills
 Weakness
 Fluid loss
 Top layer of skin slips off with rubbing or gentle pressure
(Nikolsky’s Sign)
 After the top layer has peeled off-
1. Fever
2. Chills
3. Weakness
4. Fluid loss.
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29.  In newborns this infection is often observed in diaper
area and around the umbilical cord.
 Older children most common have lesions on their
arms, legs and trunk.
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30. Diagnostic evaluation
 Medical history
 Physical examination
 Biopsy and skin culture
 Blood tests .
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31. Management
 Treatment usually requires hospitalization, often in
the burn unit of hospital.
 Treatment includes the following-
1. Antibiotics ( oral, IV ) against staphylococcus
2. IV fluids to prevent dehydration.
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32. fungal skin infections
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33. Introduction
 Skin fungi live in a deep top layer of skin in moist areas
of the body, such as between the toes, groin, diaper
area.
 Some fungi infections cause only a small amount of
irritation.
 Other types of fungi infections penetrate deeper any
may cause itching, swelling, blistering and scaling.
 In some cases fungal infections can cause reactions
elsewhere in the body.
Eg: a child may develop a rash on the finger or hand
associated with infection on foot or scalp.
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34. Types of fungal skin infections-
 Candidiasis (Yeast Infection)
 Tinea infections (Ring Worm)
1. Athlets foot
2. Jocj itch
3. Scalp ringworm (Tinea Captis)
4. Nail ringworm (Tinea ungium)
5. Body ringworm (Tinea Corpis)
3. Tinea versicolor
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35. Candidiasis (Yeast Infection)
 Candidiasis, sometimes called moniliasis, is an
infection caused by yeast on the skin and or mucus
membranes.
 Although yeast is normally a harmless inhabitant of
the digestive system and vaginal area.
 It causes infection when the skin is damaged or when
conditions are warm and humid or when there is
depressed system.
 Antibiotics can also cause yeast to grow.
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37. Location Symptoms/ signs
Skin folds or navel •Rash
•Patches
•Pimples
•Itching or burning
Vagina White or yellow discharge from vagina
Itching
Redness in the external area of vagina
Burning
Penis Redness on the underside of the penis
scaling on the innerside of the penis
Painful rash on the underside of the penis
Mouth (thrush) White patches on tongue and inside cheeks
Pain
Corners of mouth Cracks and or tiny cuts on the corner of the mouth
Nail beds Swelling
Pain
Pus
White or yellow nail that seperates from the nail bed.
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38. Diagnosis
 Prompt medical history
 Physical examination of child’s skin scraping
 Culture of scrapped part
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39. Management
 Treated highly with medicate ointments
 Yeast infections of vagina and anus are treated with
suppositories
 Oral thrush is treated with medicated mouth wash.
 Severe infection in an immune compromised child may be
treated with oral anti yeast medication.
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40. Tinea infection (Ring Worm)
 Different fungi depending on their location
causes ring worm.
 Ring worm is characterized by ring shaped,
red, scaly patches with clear centers.
 There is an increased risk of contracting
ringworm in child-
1. Who is malnourished
2. Has poor hygiene
3. Lives in warm climate
4. Has contact with other children or pets with
ring worm infection
5. Immunocomprimised due to disease or
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41. Athlete’s foot ( tinea pedis/ foot
ring worm)
 This common condition mostly affects teen and adult males.
 It less frequency affects children before puberty
 Contributing causes include-
1. Sweating
2. Not drying feet well after swimming or batching
3. Wearing tight socks and shoes
4. Warm weather conditions.
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42. Symptoms-
 Whitening of the skin between the toes
 Scaling of the feet
 Itchy rash on the skin
 Blisters over the foot
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43. Jock itch (tinea cruris/ groin
ringworm)
 This condition is also more
common in males and occurs
more often during warm
conditions.
 It is very rare in females.
 symptoms-
1. Red, ring like patches in the
groin area
2. Itching in the groin area
3. Pain in the groin area
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44. Scalp ring worm(Tiena capitis)
 Scalp ringworm is highly contagious
especially among children.
 It occurs mainly in children between
the ages 2-10 years.
 It occurs very rarely in adults.
 Symptoms-
1. Red, scaly rash on the scalp
2. Itching of the scalp
3. Hair loss on the scalp
4. Rash elsewhere on the body
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45. Nail worm (Tinea Ungium)
 It is an infection of the finger or toe nail, characterized by
a thickened and deformed nail.
 This condition is more often affects the toe nails than the
finger nails.
 Tinea ugium occurs more often in adolescents and adults
rather than young children.
 Symptoms-
1. Thickening of the ends of the nails.
2. Yellow color of the nails.
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46. Body ringworm (Tinea Corporis)
 This skin infection is characterized by the
ring like rash anywhere on the body or the
face.
 It occurs in all ages but is seen more
frequently in children.
 It is more common in warmer climates.
 Symptoms-
1. red, circular lesion with raised edges.
2. The middle of the lesion may become
less red as the lesion grows.
3. Itching at the affected are.
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47. Diagnostic evaluation
 Medical history
 Physical examination
 Lesions of the ringworm are unique and allow for a
diagnosis simply based on basis of physical
examination.
 Culture of skin is also advisable.
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48. Management
 Oral anti fungal medications
 Use of antifungal shampoos to eliminate fungus
 Topical anti fungal ointments.
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49. Tinea versicolor
 Tinea versicolor is a common skin infection characterized by
light or dark patches on the skin.
 Patches are more often found on the chest and prevent the
skin from tanning evenly.
 It occurs mostly in adolescents and early adulthood.
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50. Etiology
 Caused by fungi pityrosporum orbiculate
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51. Clinical features
 White, pink patches mostly noticeable in summer
 Infection only on the top layers of there skin
 The rash usually occurs on the trunk
 Rash does not usually occurs on face
 Patches worsen in heat
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52. Diagnostic evaluation
 Medical history
 Physical examination
 UV light is used to visualize the patches more clearly.
 Skin scraping can be taken for culture.
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53. Management
 Medicated antimicrobial dandruff shampoo on the
skin as prescribed by doctor
 Shampoo is left on the skin overnight and washed off
in the morning.
 To be effective, shampoo treatment is effective and
may required for several nights.
 Topical creams or oral antifungal medications may be
prescribed.
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54. Viral skin infections
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55. Introduction
 Many viral infections in childhood are called “viral
exanthemas”.
 Exanthema is another name for a rash or skin eruption.
 This type of rash is mainly caused by virus.
 It may also be caused by medications, especially
antibiotics.
 Common childhood viral exanthemas are-
1. Measles or Rubeola
2. Rubella
3. Varicella (chickenpox)
4. Roseola
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56.  Immunizations has decreased the number of cases of
measles, mumps, rubella and chickenpox.
 Three main groups of viruses that causes majority of
skin infections are-
1. Human Papilloma Virus
2. Herpes Simplex Virus
3. Poxvirus.
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57. Common skin infections in relation
to children-
1. Warts
2. Molluscum contagiosum
3. Rubella
4. Rubeola
5. Chickenpox
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58. warts
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59. Introduction-
 Warts are non-cancerous skin growths caused by Papilloma
virus.
 Warts are more common in children than adults, although
 Warts can spread to other parts f the body and to other
person.
 There are many different types of warts, due to many
different papilloma virus types. (more than 100_
 Warts are not painful, except when located on the feet.
 Most warts go away, without treatment, over an extended
period.
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60. Common types of warts-
1. Common warts: grows around nails and back of
hands. Usually have rough surface, grayish yellow or
brown in color.
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61. 2. Foot warts-
Located on the soles of feet (plantar warts) with black
dots( clotted blood vessels that once fed them).
Clusters of plantar warts are called mosaic. These
warts are painful.
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62. 3. Flat warts-
 Small, smooth growth that grow in group up to 100 at a
time. Most often appear on child’s face.
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63. 4. Genital warts-
 Grow on the genitals, are occasionally sexually
tr4ansmitted. These are soft and do not have a rough
surface like other common warts.
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64. 5. Filliform Warts-
 These are small, long, narrow growth that usually
appear on eyelids, face or neck.
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65. Management-
 Application of salicylic and lactic acid (which soften the
infected area)
 Freezing with liquid nitrogen
 Electrodessication (using an electrical current to destroy the
wart)
 Laser surgery
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66. MOLLUSCUM CONTAGIOSUM
Mollusucm contagiosum is a viral disease of the skin that cuses
small pink or skin colored bumps on the child’s skin.
It is not harmful and usually does not have any other
symptoms.
The virus is inside the bumps and is mildly contagious.
These bumps are usually clear and extend on period of time.
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67. Etiology
 Malluscum contagiosum is a viral disease caused by
virus called the poxvirus.
 It is most common in children and adolescents,
although it can affect adults.
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68. Clinical features
 Bumps are small and are usually pink or skin colored.
 Eventually the bumps tend to have a small sunken centre.
 The number of lesion a child has is usually between 2 to 20.
 The lesion usually occur in groups or clusters.
 They are not harmful but may cause some cosmetic concern
for child if they appear on the face o other visible areas.
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69. Diagnostic evaluation
 Molluscum contagiosum is usually diagnosed based on
medical history and physical examination of the child.
 The lesions are unique and usually are diagnosed on
the basis of physical examination. Additional test are
not routinely required.
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70. Management
 Removal of the lesions
 Use of topical medications.
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71. RUBELLA (GERMAN MEASLES)
 Rubella is a viral illness that
results in a viral exanthema.
 It spreads form one child to other
through direct contact with
discharge from the nose and
throat.
 Infants and children who develop
the disease usually have mild rash
and side effects.
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72. Etiology
 Caused by virus- RUBVIRUS.
 It can spread from a pregnant mother to the unborn
child, or form secretions from infected person.
 It is most prevalent in late winter and early spring.
 Rubella is preventable by proper immunization with
the rubella vaccine.
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73. Clinical features
 14-21 days for child to develop signs and symptoms.
 Rash eruption
 Common symptoms are-
 Begins with a period of not feeling well
 A low grade fever and diarrhea.
 Rash then appears as pink area of small, raised lesions.
 Rash begins on face and then spreads down to the rams and
legs.
 Rash usually fades by 3rd to 5th day.
 Lymph nodes in the neck may also become enlarged
 Older children and adolescents may develop some soreness
and inflammation in their joints.
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74. Diagnosis
 Based on medical history
 Physical examination
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75. Management
 Increased fluid intake
 Rest
Prevention-
 Children should not attend school up to seven days
after onset of rash
 Children who are born with rubella are consiudered
contagious for the first year of life
 Assure that all the child’s conatct have been properly
immunized.
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76. RUBEOLA (MEASLES)
 Rubeola also called measles.
 It is viral illness that results in a viral exanthema.
 Rubeola has a distinct rash that helps in the diagnosis.
 It spreads form one child to another direct contact with
discharge form the nose and throat of infected child.
 Sometimes it spreads through air-borne droplets from an
infected child.
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77. Etiology
 The virus that causes measles, is classified as
Morbillivirus belonging to paramyxoviridae family.
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78. Clinical features
 Hacking cough
 Redness and irritation of the eyes
 Fever
 Small red spots with white centers (KOPLICKS’S SPOTS)
appear on the inside of the cheek
 Rash- deep , red flat rash that starts on the face and spreads
down to the trunk, arms, legs and feet.
 The rash starts as small distinct lesions, which then
combines as one big rash.
 After three to seven days , the rash will begin to clear
leaving brown discoloration and skin peeling.
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79. Serious complications-
 Ear infections
 Pneumonia
 Croup
 Inflammation of brain.
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80. Diagnostic evaluation
 Reubola is usually diagnosed based on complete
medical history and physical examination
 Lesions are unique and allows for diagnosis.
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81. Management
 Increased fluid intake
 Acentaminophen for fever
 WHO recommended two doses of vit-A for all children
to prevent eye damage and blindness
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82. Prevention
 Children should not attend school or daycare for four
days after the rash is positive
 Assure that all child’s contacts have been properly
immunized.
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83. CHICKENPOX
 Chickenpox is a highly infectious disease caused by
Varicella- Zoster Virus (VZV), a form of herpes virus.
 Transmission occurs from person- person by direct
contact or through the air buy coughing and sneezing
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84. Clinical features
 Fatigue and irritability
 Itchy rash on the trunk, face, scalp, armpits, upper
arms, legs and inside the mouth.
 Fever
 Feeling ill
 Decreased appetite
 Muscle or joint pain
 Cough or running nose.
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85. Diagnostic evaluation
 Complete medical history
 Physical examination
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86. Management
 Acetaminophen for fever
 Antibiotics for treating any bacterial infections
 Calamine lotion ( to relieve itching)
 Antiviral drugs
 Bed rest
 Increased fluid intake
 Cool baths( to relieve itching)
 Do no let children scratch the blisters which could
lead to secondary bacterial infections.
 Cut children’s fingernails' short.
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87. Immunity from chicken pox
 Once infections can give them immunity for the rest of
their lives.
Complications-
 Secondary bacterial infections
 Pneumonia
 Encephalitis
 Cerebellar ataxia
 Myelitis
 Reye’s syndrome (a serious condition that affects all major
systems or organs)
 death
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88. Other parasitic skin infections
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89. Introduction
 Parities are small worms that or insects that make a
deep burrow on skin to live there or lay their eggs.
 Includes scabies
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90. Scabies-
 Scabies is an infestation of mites characterized by
small red bumps and intense itching.
 This highly contagious infection often sp[reads from
person to person while they are sleeping together in
the same bed or have close personal personal contact.
 The itching is caused by the mites burrowing into the
skin where they lay eggs that hatch a few days later.
 Scabies can affect of all ages.
 Scabies occurs mostly in children and young adults.
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91. Clinical features
 Itching, usually severe
 Rash with small pimples or red bumps
 Scaly or crusty skin
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92. Diagnosis and management
 Diagnosis of scabies , the skin and skin creases are examined by
the physician
 A sample of skin obtained by scrapping the skin may be
examined under a microscope to confirm the presence of mites.
 Management:
1. Application of prescribed creams and lotions (lindane
solution)
2. Oral antihistamines medications
3. Topical ointments
4. Wash all the cloths and bed sheets in hot water and dry in hot
dryer.
5. Itching may continue for several weeks.
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93. Other disorders- diaper rash
 Rash in the diaper region are common during early infancy.
 It is more common un artificially fed infants, especially those in
whom it is changed infrequently.
 Involves buttocks, scrotal sacs, Mons pubis or inner side of thigh.
 Skin appears red like parchment which becomes infected giving
rise to pustular erosions.
 These are contact dermatitis secondary to detergents.
 Management:
 Single layer porous diapers should be used
 Plastic diapers should not be used
 Wash with mild soap
 Cool wet compress on rash region
 Antimicrobial cream or lotions
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94. Thank you…
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