by: Sumeet Banker, MD, MPH

Anyone who has taken care of children knows that rashes are ubiquitous and can often be the bane of one’s practice. Children acquire rashes for seemingly everything, from benign viral exanthems to chronic systemic diseases and even acute life-threatening emergencies.

Appropriate identification and treatment of skin findings in children can make a significant difference in a parent’s comfort level and a child’s well-being. However, distinguishing among different skin findings can often be more of an art than a science.

The Color Atlas of Pediatric Dermatology is a solid reference tool for providing diagnostic and therapeutic support when evaluating pediatric skin findings.

Based on the McGraw-Hill textbook by the same name, this app provides over 900 rich images and text descriptions and helps even the most experienced pediatric provider determine when a rash is more than just a bug bite.

There are two ways to browse – general categories via the table of contents or specific disease process via the alphabetical index. The most direct way of locating images and text (if you know what you are looking for) is via the index, which allows you to quickly scroll alphabetically to the disease of interest.

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The text description usually includes a brief pathophysiology of the disease, clinical findings, and treatment basics (no dosing). There are also thumbnails of the associated images, which may be easily enlarged and zoomed. Thumbnails are clustered instead of embedded, making for easy reading of the text.

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The table of contents contains 27 chapters ranging from benign neonatal rashes and infectious exanthems to nutritional disorders, hair and nail disorders, and drug eruptions. When taking this route, choosing a category leads to a table of all images from a given chapter.

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Selecting a photo enlarges the image and allows you to view the text description for that section (“Go to text for this topic”).  Also, there may be additional images available for a given disease process.

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To skip ahead to a text section within a given chapter, there is also a convenient “Jump” button for each chapter which allows you to directly choose a topic.

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Unfortunately, the pictures are not labeled in the initial table, nor are there displayed images associated with the topics when you “jump” to a section.

The individual images are labeled, though, so you are essentially forced to select images based on trial-and-error if you are scanning for a particular skin disease based on image alone. Overall, this is a relatively minor issue as long as you do not mind scrolling or clicking “Next” to find an image.

Another convenient feature is the search feature. This allows you to search both text and image captions. Searching by text displays all instances where the word is used in a text description, grouping them by topic. Further, it sorts results based on number of hits per topic for a higher-fidelity search.

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Like most other search functionalities, the app highlights your keyword and allows you to click “Next” to scan search results for the one that best matches what you are looking for. As always, selecting a thumbnail enlarges the image for close-up viewing.

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Searching by a figure is another valuable tool in this app. It allows you to search based on the captions provided for each image. Similar to the text search function, results are grouped based on category, and you may quickly sift through subsequent images by using the “Previous” and “Next” buttons. You can also easily toggle between image and text with one touch.

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Platform:

Universal app for iPhone and iPad

Price:

  • Currently $129.99

Likes:

  • Vast size of collection – over 900 pediatric-specific images
  • Ability to zoom on pictures for close-up viewing
  • No internet connection needed to access information
  • Easy navigability and searchable database

Dislikes:

  • Text portion is quite static – no subheadings (i.e. pathophysiology, clinical findings, management) or font effects
  • Limited text section, no guidance on drug dosing or frequency
  • Image captions contain the diagnosis but do not provide descriptions of the pictures

Conclusion:

  • A dermatological reference is a must-have for anyone who takes care of children due to the tremendous variation in skin findings
  • Children present to primary care offices and emergency rooms with all sorts of lumps, bumps, rashes, and bites, and the Color Atlas of Pediatric Dermatology app helps to make accurate diagnoses and management decisions in a timely and convenient manner
  • As mentioned above, this app is based on an image-first textbook and is therefore limited in terms of the descriptions of the images and amount of disease epidemiology/course/management. Therefore, if you are looking for a resource with more guidance on clinical course and drug dosing/frequency, this may not be your best choice. However, this is your best bet if you are looking for exposure to a high volume of pediatric skin finding pictures (which are often worth a thousand words). Its cost though means anyone interested should be sure that this kind of resource is something they need.
  • Of the many dermatological apps, this one makes the grade because of the high number of images and pediatric-specific diagnoses, and its easy-to-use interface.

Find the app on iTunes here.