Chapter 28: Integumentary Disorders

Atopic dermatitis represents a chronic inflammatory condition affecting infants, children, and adolescents through distinct developmental presentations, with management strategies focusing on identifying triggers, applying topical corticosteroids appropriately, and implementing systematic skin care routines using emollients and cool compresses to reduce pruritus and prevent secondary infection. Impetigo is addressed as a highly contagious superficial bacterial infection characterized by honey-colored crusty lesions that demands strict contact isolation protocols, appropriate antibiotic therapy both topical and systemic, and rigorous hygiene education to interrupt transmission within school and community settings. Pediculosis capitis requires comprehensive treatment combining pediculicide application with meticulous nit removal through daily combing and extensive environmental decontamination including hot washing of linens, vacuuming of furniture, and proper storage of non-washable items to eliminate reinfestation sources. Scabies management involves understanding the burrow patterns created by the Sarcoptes scabiei mite, applying permethrin preparations to all household members simultaneously, and providing clear guidance on treating clothing and personal items to prevent recurrence. The chapter emphasizes pediatric burn injury care as a critical emergency requiring immediate assessment of airway patency and circulation status, accurate calculation of total body surface area using age-appropriate burn charts rather than the standard rule of nines, and fluid resuscitation protocols based on urine output monitoring and clinical response indicators. Additional focus includes recognizing the heightened vulnerability of children to dehydration, metabolic complications, infection, and potential growth disturbances following significant burn trauma, alongside comprehensive parent education addressing fire prevention, safe water temperature awareness, and smoke detector installation for injury prevention.