A clinico-epidemiological study of pyoderma in children

Abstract

Introduction: Pyoderma is defined as any purulent skin disease and represents infections in the epidermis and dermis (eg. impetigo contagiosa, bullous impetigo, ecthyma, erysipelas, cellulitis, etc.) or in hair follicles (eg. folliculitis, furuculosis etc). Primary pyodermas are common in children. Environmental factors like overcrowding, hygiene, poverty, malnutrition etc. have been implicated to predispose to pyoderma, especially in children. Purpose and objectives: To evaluate the epidemiological spectrum of pyoderma in children. To assess the role of predisposing factors. To determine the clinical profile of the cases. Materials and methods: The study was conducted on a group of 160 patients who were admitted to the Mother and Child Centre, based on medical files of patients. Results: A total of 160 cases were included. The incidence of primary pyoderm a among children aged 0-12 years was 1.05% . Maximum cases were seen in the month of July (22%), followed by August (16,25%) . Maximum patients (52%) belonged to the preschool age group while girls constituted 52% of cases One hundred and twenty cases (75%) were from urban areas and maximum cases (63%) belonged to the lower socio-economic class. History of overcrowding was present in (53%) patients while (52%) of cases had poor levels of personal, hygiene. Almost half of the patients (46%) had poor nutritional status . Twenty two children (14%), had a positive past history of similar illness. Five cases gave concurrent history of periporitis and 6 cases gave concurrent history of impetigo in siblings. Maximum lesions were in the face followed by lower limb. Most common clinical type of primary pyoderma was bullous impetigo (29.4%). Impetigo contagiosa, bullous impetigo, periporitis, folliculitis and furunculosis all were common in the preschool age group while majority of ecthyma were in the school going age group Maximum number of bacterial isolates were S. aureus (74%), followed by GAS (12,5%). S. aureus was the most common bacterial isolate in bullous impetigo, impetigo contagiosa, periporitis, furunculosis and folliculitis. GAS was more commonly isolated from lesions of ecthyma. Out o f the 3 cases of cellulitis, GAS was found in two cases and Pseudomonas aeroginosa was isolated in the third. Conclusion: Pyodermas cause significant morbidity in children and frequently cause much anxiety in parents. Environmental, socioeconomic and nutritional factors may have a compounding effect on development of pyoderma in children. However, futher studies are required to find out the statistical association between these factors and pyoderma.