دورية أكاديمية
أعرض في EDS

Dermatological changes in a prospective cohort of acutely ill, hospitalised Malawian children, stratified according to nutritional status.

التفاصيل البيبلوغرافية
العنوان: Dermatological changes in a prospective cohort of acutely ill, hospitalised Malawian children, stratified according to nutritional status.
المؤلفون: van den Brink D; Amsterdam Centre for Global Child Health & Emma Children's Hospital, Pediatrics, Amsterdam UMC, Locatie AMC, Amsterdam, The Netherlands d.vandenbrink@alumni.ubc.ca., Mponda K; Department of Dermatology, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi., Thompson D; Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica., van Hees C; Department of Dermatology, Erasmus Medical Center, Rotterdam, The Netherlands., Ngong'a F; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi., Segula E; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi., Mbale E; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi., Boele van Hensbroek M; Amsterdam Centre for Global Child Health & Emma Children's Hospital, Pediatrics, Amsterdam UMC, Locatie AMC, Amsterdam, The Netherlands., Bandsma RHJ; Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.; Childhood Acute Illness Network, Nairobi, Kenya., Walson JL; Childhood Acute Illness Network, Nairobi, Kenya.; Departments of Global Health, Epidemiology, Infectious Disease, University of Washington, Seattle, Washington, USA., Brals D; Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands., Berkely J; Childhood Acute Illness Network, Nairobi, Kenya.; KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.; Centre for Tropcial Medicine & Global Health, Oxford University, Oxford, UK., Voskuijl W; Amsterdam Centre for Global Child Health & Emma Children's Hospital, Pediatrics, Amsterdam UMC, Locatie AMC, Amsterdam, The Netherlands.; Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi.; Childhood Acute Illness Network, Nairobi, Kenya.
المصدر: BMJ paediatrics open [BMJ Paediatr Open] 2024 Jun 08; Vol. 8 (1). Date of Electronic Publication: 2024 Jun 08.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101715309 Publication Model: Electronic Cited Medium: Internet ISSN: 2399-9772 (Electronic) Linking ISSN: 23999772 NLM ISO Abbreviation: BMJ Paediatr Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BMJ Publishing Group, [2017]-
مواضيع طبية MeSH: Nutritional Status*, Humans ; Infant ; Malawi/epidemiology ; Male ; Female ; Prospective Studies ; Acute Disease ; Infant, Newborn ; Skin Diseases/epidemiology ; Skin Diseases/pathology ; Skin Diseases/diagnosis ; Hospitalization/statistics & numerical data ; Kwashiorkor/epidemiology ; Kwashiorkor/diagnosis ; Skin/pathology
مستخلص: Rationale: Since the first documentation of skin changes in malnutrition in the early 18th century, various hair and skin changes have been reported in severely malnourished children globally. We aimed to describe the frequency and types of skin conditions in children admitted with acute illness to Queen Elizabeth Central Hospital, Blantyre, Malawi across a spectrum of nutritional status and validate an existing skin assessment tool.
Methods: Children between 1 week and 23 months of age with acute illness were enrolled and stratified by anthropometry. Standardised photographs were taken, and three dermatologists assessed skin changes and scored each child according to the SCORDoK tool.
Results: Among 103 children, median age of 12 months, 31 (30%) had severe wasting, 11 (11%) kwashiorkor (nutritional oedema), 20 (19%) had moderate wasting, 41 (40%) had no nutritional wasting and 18 (17%) a positive HIV antibody test. Six (5.8%) of the included patients died. 51 (50%) of children presented with at least one skin change. Pigmentary changes were the most common, observed in 35 (34%), with hair loss and bullae, erosions and desquamation the second most prevalent skin condition. Common diagnoses were congenital dermal melanocytosis, diaper dermatitis, eczema and postinflammatory hyperpigmentation. Severe skin changes like flaky paint dermatosis were rarely identified. Inter-rater variability calculations showed only fair agreement (overall Fleiss' kappa 0.25) while intrarater variability had a fair-moderate agreement (Cohen's kappa score of 0.47-0.58).
Discussion: Skin changes in hospitalised children with an acute illness and stratified according to nutritional status were not as prevalent as historically reported. Dermatological assessment by means of the SKORDoK tool using photographs is less reliable than expected.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
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فهرسة مساهمة: Keywords: Data Collection; Dermatology; Epidemiology
تواريخ الأحداث: Date Created: 20240608 Date Completed: 20240608 Latest Revision: 20240612
رمز التحديث: 20240612
مُعرف محوري في PubMed: PMC11163641
DOI: 10.1136/bmjpo-2023-002289
PMID: 38851219
قاعدة البيانات: MEDLINE
الوصف
تدمد:2399-9772
DOI:10.1136/bmjpo-2023-002289