As office-based family physicians, we see patients with skin conditions every day. Worldwide, skin conditions are in the top 5 patient-reported reasons for visits to primary care offices and in the top 10 physician-reported reasons for visits.1 Although we see these conditions on a regular basis, they can present a diagnostic challenge, particularly in patients with different skin tones or various comorbid conditions.
Sometimes it is easy to think that skin conditions are simply a cosmetic issue; however, these conditions can have profound psychosocial consequences for patients. Globally, skin conditions are the fourth leading cause of nonfatal disease burden, accounting for approximately 1.8% of total global disease burden. Dermatitis alone results in the loss of more than 9 million disability-adjusted life-years each year.2
In addition to the significant personal costs associated with skin conditions, there are significant financial costs for our health care system. Acne affects more than 50 million Americans every year, with more than 5 million patients seeking medical care for acne. The annual direct and indirect costs associated with acne are more than $1.2 billion. Approximately 85% of individuals between ages 12 and 24 years have had at least mild acne.3
This edition of FP Essentials reviews the most up-to-date information that family physicians need to know to manage common skin conditions in children and adolescents. Section One reviews the pathophysiology, diagnosis, and management of acne with special consideration of patients with skin of color and gender-affirming care. Section Two explores skin and soft tissue infections, including differentiating among lesions and selection of appropriate treatment. Section Three reviews nonbacterial infections, including tinea infections, warts, and scabies infestation. Section Four includes discussions of atopic and seborrheic dermatitis.
Nearly all of the children and adolescents that we care for will, at some point, experience one or more of the conditions discussed in this edition. The information contained here will enable you to give timely, effective care that can mitigate the significant morbidity that can be associated with these conditions.
Ryan D. Kauffman, MD, FAAFP, CCFP, Associate Medical Editor
Family Medicine Physician
Erie Shores Family Health Team, Leamington, Ontario, Canada
