Mucocutaneous findings among children in the pediatric intensive care unit at a tertiary care center: A prospective observational study from South India

Abstract

AbstractBackground/ObjectivesChildren admitted to a pediatric intensive care unit (PICU) can present with a variety of skin lesions and the need for dermatology consultation is increasing. Dermatoses in the PICU can be primary or secondary to treatment or underlying systemic illness. Our objective was to study the frequency, pattern, and systemic associations of mucocutaneous findings among children in the PICU.MethodsWe conducted a prospective, observational study in the PICU of our hospital for 1 year from January 2019 to December 2019. Detailed history, examination, and treatment of consecutive children admitted with mucocutaneous findings were recorded and the results were tabulated and analyzed.ResultsAmong 2606 children screened, 11.5% (300/2606) had 314 mucocutaneous manifestations. The male‐to‐female ratio was 1.3:1 and their ages ranged from 1 month to 15 years (mean age, 4.4 years). Dermatoses belonged to infectious, 41% (124/314), inflammatory, 29.6% (93/314), nutritional, 12.4% (39/314), hematological/vascular malformations, 3.5% (11/314), rheumatological/vasculitic, 3.2% (10/314), neurocutaneous, 0.6% (2/314), and miscellaneous, 11.1% (35/314) groups. Within this cohort, 25.7% (77/300) had a purely dermatological disorder, 28.3% (85/300) had an associated systemic process, 0.7% (2/300) had iatrogenic skin findings, and 45.3% (136/300) had incidental skin findings. On follow‐up, 4% (12/300) died, 85% (256/300) improved/recovered, 3% (8/300) were lost to follow‐up, and 8% (24/300) did not need active intervention.ConclusionOur study highlights the frequency of dermatologic disorders among children in the PICU. A notable proportion of patients had primary dermatological disorders or mucocutaneous findings associated with systemic illness.