What is Pediatric Dermatology?
Pediatric dermatology includes the examination, diagnosis and treatment of a variety of skin conditions such as: dermatitis; eczema; cradle cap; severe diaper rash; birthmarks or vitiligo; warts; and psoriasis. At Johns Creek Dermatology, you can feel confident that your child will receive personalized attention in the diagnosis and treatment of their dermatologic condition. We take care of children from birth through their teen years. Dr. Timani understands that the approach to treating children differs from adults, as children may not be able to verbalize their problem or answer questions, and may also be scared or apprehensive. She has the experience and patience to keep your child composed and comfortable during their exam and treatment process.
Pediatric Dermatological Services
Johns Creek Dermatology provides services for a variety of skin conditions specific to children, including: diagnosis and treatment of skin conditions; surgical removal of molluscum, warts, cysts and other small lumps in the skin; and skin biopsies. The most common conditions we treat are:
Contact (allergic) Dermatitis
Contact dermatitis is a reaction of the skin to contact with certain substances, caused by either irritants, or allergen, which trigger an allergic response. Common irritants include: soap and shampoo, detergent, saliva, food, lotions, metal, plants, cosmetics (after contact with an adult), medication, and latex. Although each child reacts differently, visible symptoms of contact dermatitis typically include redness, blistering and swelling of the skin, which may be accompanied by itching, scaling and temporary thickening of the skin. The point of contact usually exhibits the most severe symptoms.
Based on your child’s age, overall health, and medical history, Dr. Timani will evaluate the extent of the condition and determine a specific treatment for your child. She will discuss the potential for your child’s tolerance for specific medications, procedures, or therapies, and anticipated resolution of the condition according to your preference. Most importantly, she will work with you to identify the cause of the contact dermatitis to avoid potential future reactions.
Atopic Dermatitis (eczema)
Eczema in children is a common skin disorder. In fact, statistics indicate nearly 60 percent of children may experience some form of eczema by adulthood. Although most cases evolve before a child’s first birthday, almost 85 percent of the cases are evident by age 5.The location of affected skin usually varies according to the age of the child. In younger patients and infants, the rash presents on the face, outside of the elbows, and the knees. As a child ages, the hands and feet, arms, insides of the elbows and the back of the knees are the most affected. This skin disorder is not contagious. Symptoms will differ for each child, and may include: redness, swelling and dry, scaly skin; small bumps that open and weep when scratched; and thickening of the skin over time. Based on the child’s age, the extent of the eczema and other factors, Dr. Timani will establish a treatment plan to reduce the itching and irritation, moisturize the areas, and prevent infection. Typically an ointment or lotion will be prescribed.
Seborrheic Dermatitis (cradle cap)
Seborrheic dermatitis is a condition affecting babies generally under the age of one year, which is typically characterized by fine, dry or greasy white scales that form crusts, that in addition to occurring on the scalp (cradle cap), also is found on the face, neck, trunk and diaper area. The skin underneath the scaly area may appear red, but usually is not accompanied by itching. The cause of Seborrheic dermatitis has not yet been determined, and although treatments are effective in clearing the condition, this rash has the potential to re-occur. Cradle cap is a unique looking rash and is customarily easily diagnosed with a basic physical examination.
Dr. Timani will determine the proper course of treatment for your baby’s cradle cap, which may include the use of a medicated shampoo or corticosteroid cream or lotion, either alone or in combination. She may also recommend rubbing the affected areas with baby oil or Vaseline to soften the crusts prior to application of the prescribed treatment.
Diaper Dermatitis (diaper rash)
Diaper dermatitis affects infants between 9 and 12 months, but may be seen in babies as young as 2 months. It is a skin rash that occurs in the diaper area. Although symptoms vary among children and the type of diaper dermatitis, the most common symptom of the condition is a red, shiny, scaling rash which in extreme cases may also have ulcerated spots. Depending on the cause of the rash, it typically appears either in the folds and creases of the thighs and diaper area, or in the case of contact diaper dermatitis, on the buttocks extending up to the stomach. Many of the symptoms of diaper dermatitis may resemble other skin conditions, so be sure to consult Johns Creek Dermatology to verify the diagnosis.
There are several potential major causes of diaper dermatitis, including: irritation from urine and feces; a yeast infection (Candida) in the diaper area; and Seborrheic diaper dermatitis, a chronic pinkish rash skin condition that most commonly causes cradle cap but can evidence on the face, scalp, or neck simultaneously. Impetigo, group A streptococcus, and allergic dermatitis are also potential triggers of diaper rash. Based on the cause of the dermatitis, Dr. Timani will establish a medical treatment program, which may include: a medicated prescription or moisture-barrier diaper cream; exposure to air to the extent possible; and anti-inflammatory creams to be used in conjunction with a cleansing and reduction of exposure to moisture maintenance program.
Warts are more common in children than adults. Caused by the papillomavirus, warts are noncancerous skin growths that can be transmitted between people and can also be spread from one art of the body to another. At Johns Creek Dermatology, Dr. Timani most often treats common warts on our pediatric patients. These warts occur the back of the hands and around fingernails and are identified by a grayish-yellow or brown color and rough surface. She also frequently treats two kinds of warts which appear on children’s faces: flat warts, small, smooth growths that appear most often in multiple groups, and small, long, narrow filiform warts. Plantar warts found on the soles of the feet and warts on the palms of the hand also affect our pediatric patients, and these warts may be painful so timely consultation with Dr. Timani is important to curing the condition.
Although certain types of warts may disappear on their own, Dr. Timani may recommend a range of treatments, depending on how long the warts have persisted, the type and location of the wart, and the severity of the condition. Most often freezing with liquid nitrogen is recommended on locations other than the face. For deeper and rough warts, an application of salicylic and lactic acid may be used to soften the affected area. Other options include using an electrical current, laser surgery, and immunotherapy where spreading is recurrent.
A common type of benign birthmark, most often located on the head or neck, is the port wine stain (hemangioma), also referred to as strawberry hemangioma, and salmon patch. These birthmarks tend to occur predominantly among females, and may be visible at birth as a faint red mark, or may become evident within a few months, rapidly growing larger until about one year of age. In the majority of cases, the pigmentation will begin lightening in color and become smaller over a period of several years. These pigmentation type birthmarks are generally not considered a threat to a child’s health, and as such, remedial treatment may not be required. An often more serious type of congenital birthmark is a vascular malformation comprised of a network of arteries, veins, capillaries, or lymphatic vessels which enlarges commensurate with the child’s growth.
Dr. Timani will evaluate the size, location, and severity of the hemangiomas to determine treatment. Small, noninvasive birthmarks typically do not require treatment, but a vascular malformation may lead to a number of risk factors, such as difficulty in feeding or breathing, bleeding, interruption of normal growth, or impairment of vision. Treatment options for vascular malformations are predicated on the type of the malformation, as the effectiveness of the procedure varies by type of malformation. Dr. Timani may recommend medical or surgical treatment, such as: steroid medications; injection of material into the blood vessels to block the blood inflow (most effective for arterial malformations); direct injection of a clotting medication to coagulate the blood in the channels (for venous malformations), or removal by laser therapy (most effective on port wine birthmarks and capillary malformations); or surgery in severe cases.
Similar to warts, molluscum contagiosum is a viral disease of the skin. Most common in children and adolescents, the condition is not considered harmful to your child’s health, although if visible on the face or hands it may cause cosmetic concern. The condition is evidenced by small pink or skin-colored bumps, some of which may have a small sunken center, on your child’s skin. The poxvirus is contained within the bumps and is mildly contagious through openings in the skin, often resulting in clusters of the lesions. The lifespan of the virus can extend over a period of up to four years, and in he majority of cases the bumps will clear without treatment over a period of 6 to 12 months. However, when the lesions are located in visible areas, or where rubbing or other irritation may occur, Dr. Timani will perform a physical examination of the lesions, and since they are unique in appearance, diagnosis usually can be made without additional testing. There are a few methods to remove the lesions, including: removal of the lesions, using either lasers or cryotherapy (freezing), and use of prescription topical medications which increase the resolution of the bumps.