Dermatology covers all diseases of the skin, the mucous membrane and the sexual organs. At our center, dermatologists collaborate closely with specialists in pediatric and adolescent allergology: this is because skin changes are often different in children as compared to adults and require very specific experience in terms of diagnosis and therapy.
Atopic dermatitis is perhaps the most important inflammatory and chronically relapsing skin disease among children and adolescents. It undergoes significant change over a period of months and years.
Young children in particular are frequently forced to combat the secondary problem of superinfections. Important differential diagnoses of atopic eczema include seborrheic eczema as well as mastocytosis in young children.
Another focus is by acute skin changes with a nettle-like rash, so-called urticarial rashes, which cause an excruciating itch sensation. Since two important fields of specialism are involved here, we collaborate closely with our center's pediatric allergologists in this area.
Bacterial infections of the skin are fairly common among children, as are viral infections such as warts, especially the highly infectious molluscum contagiosum (MC). Fungal skin diseases can also occur at this age, though these are not as widespread as they are among adults.
There are a wide range of other skin changes, in particular reddening and scaling, including pityriasis rosea.
From school age onward, if not before, the assessment of nevus cells - popularly known as liver spots - becomes more important as part of skin cancer screening and prevention. The development of acne is also significant during adolescence.
In addition to the young patient's medical history, close examination of the complete range of skin findings is of course the central diagnostic tool of dermatology. This also includes examinations under special lamps and magnification (incident light microscopy). The large magnification provided generally allows direct diagnostic classification. Images are often taken for documentation purpose to assess progress, especially in skin cancer screening.
Sometimes tissues samples have to be removed from the surface, smears and cultures are created and the specialists will attempt to identify fungi, bacteria and viruses. Frequently an immunological and allergological diagnosis is required, in other words the blood has to be analyzed for lack of nutrients, inflammatory processes, hormonal disorders and allergies. Here again the experts at our center work together across the disciplines.
Our efforts focus on suppressing the causes at the core of the symptoms which are inflicting the damage. The sensitive skin of a child can be permanently aggravated and irritated by the use of the wrong cosmetics, bathwater and contact with allergens. Ultraviolet radiation is a particular problem.
Many illnesses can be alleviated or corrected if, in addition to avoiding critical trigger factors, skin care is applied which is geared consistently towards the skin type.
Medication may also be an option, usually using creams and ointments but sometimes drugs for internal use. These may include anti-allergic drugs such as antihistamines or leukotrien antagonists for allergy sufferers, antibiotics in the case of skin infections and also local treatment with cortisone or locally effective antibacterial agents.
Surgical intervention is very rarely required. It would include the removal of a changing nevus cell which appears suspicious under incident light microscopy.
The treatment of acne in adolescents is an important interdisciplinary challenge. In addition to domestic care and medical cosmetics, interventions in the hormone system may be considered as well as modern therapies such as vitamin A acid. Here, interdisciplinary collaboration between our dermatologist and the adolescent medicine specialist or else the endocrinologist or allergologist is very desirable and immediately possible.