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[Top: A child stricken with eczema.]
By Jovanda Biston
An "angel's kiss" is a small pink birthmark on a baby's forehead or eyelids that will fade over time.
But not all irregular skin conditions that affect children are harmless. Nor do they have such pretty names.
"Some birthmarks such as giant moles and naevus sebaceus are associated with a small risk of turning cancerous," said Dr Chan Yuin Chew, consultant dermatologist at Dermatology Associates.
Naevus sebaceum: It is usually a single yellow or somewhat oily-looking lesion at birth or in early childhood, said Dr Wendy Subothini Sinnathamby, consultant paediatrician at the National University Hospital's University Children's Medical Institute.
She recommended removal of the lesion before puberty as there is a 10 to 20 per cent risk it will become cancerous in the child's teenage years.
Port-wine stain: This birthmark is a blood vessel abnormality. The most famous person who has one located on his forehead is former Soviet leader Mikhail Gorbachev (right).
The National Skin Centre estimates that this condition affects up to 0.5 per cent of Singapore's population.
Dr Chan said parents of children with cosmetically significant birthmarks on areas such as the face and neck may wish to consider removing the mark so that that their child will not be subjected to psychologically damaging teasing at school.
The port-wine stain can be removed using laser treatment.
Impetigo: Unlike birthmarks, impetigo is an acute bacterial infection of the skin that is contagious.
Assistant Professor Wong Soon Tee, consultant dermatologist at Raffles Hospital, said that it is common among pre-school children in Singapore.
The infection, which appears as skin blisters that later become crusty yellowish scars, spreads when kids come into close contact with an infected child or when they share toys.
Dr Sinnathamby said that topical and oral antibiotics for lesions are used to treat it.
Atopic dermatitis: Commonly known as eczema, it is a chronic inflammatory condition. The skin is initially dry and itchy but can later develop features such as swelling, cracking, scaling and may even blister.
Dr Sinnathamby had a 12-year-old patient whose skin became so itchy, it affected his sleep. The boy felt irritable and tired in the day. His peers also shunned him, believing mistakenly that eczema is contagious.
Dr Chan said that eczema often starts in infancy and early childhood and can persist for years but it tends to improve with age.
The treatment mainly involves controlling the symptoms with avoidance of aggravating factors, frequent moisturising, use of topical steroids and antihistamines for itch.
Psoriasis: Sufferers experience very itchy skin. This chronic inflammatory skin disease is non-contagious and is characterised by rapid growth of the outer skin layer, resulting in thick, silvery scales on raised pinkish red skin.
The National Skin Centre estimates that psoriasis affects 1 to 2 per cent of the population in Singapore. It is one of the top 10 commonest skin diseases treated here.
There is no cure for psoriasis but mild cases are usually treated with topical creams and scalp solutions. More severe psoriasis may require phototherapy with ultraviolet A (UVA) or B (UVB) light.
Ms Josephine Lim, 44, developed psoriasis when she was 12 years old. "I had very bad rashes with red patchy skin that flaked off and a lot of dandruff. I was a sociable kid but become withdrawn when the rashes were especially bad as I was embarrassed," she said.
She remembered seeing people get out of the swimming pool when she got in.
With her itchy skin, she found it hard to sleep at night and hard to concentrate on schoolwork during the day. She enjoyed outdoor activities but could not take part because being under the sun aggravated her psoriasis symptoms.
Hairdressers recoiled in horror from her flaky scalp so Josephine's mother learnt to trim her hair to spare her then teenage daughter from such unpleasant visits to hair salons.
Although she had the support of a caring and close-knit family, she was hurt by the reactions of others.
"I'd think, 'I didn't do anything wrong so why do people shun me?' "
This story was first published in Mind Your Body, The Straits Times, on Sept 25, 2008.
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