A Review of Common Pediatric Skin Infections

Purpose of Review: Skin infections account for a substantial amount of healthcare visits within the pediatric population, contributing to significant healthcare costs and associated morbidity. We aim to describe the most common infections with a focus on recommended strategies for diagnosis and management. Recent Findings: Evolving trends in antimicrobial resistance continue to be important considerations when treating bacterial skin infections, such as impetigo, cellulitis, and abscess. Clinicians should continue to practice antibiotic stewardship with keen awareness of guideline-driven recommendations and ever-changing resistance patterns. While viral skin infections, such as common warts and molluscum contagiosum, are often self-limiting in children, several treatment options exist and may contribute to improved quality of life. Cryotherapy and salicylic acid have the most supportive evidence for use in warts, while berdazimer gel and cantharidin gel in a pre-dosed applicator have recently received U.S. Food and Drug Administration approval. Summary: Staphylococcus aureus and Streptococcus pyogenes account for the majority of bacterial skin and soft tissue infections. S. aureus should be suspected when purulence is present, and methicillin resistant S. aureus (MRSA) should be considered, especially in high-prevalence communities. The rise of community-acquired MRSA has contributed to unique sonographic features, warranting updated knowledge of abscess characteristics seen on ultrasound. While pediatricians commonly recommend conservative management of warts and molluscum contagiosum, these lesions can often last months to years, contributing to infectious spread and reduced quality of life in some cases. Shared decision making with parents and pediatric patients should be explored when discussing management options.

Duke Scholars

Author Daniela Kroshinsky Dermatology