223 Spectrum changes of pediatric dermatological disorders before and during the COVID-19 pandemic in China: A single national center for children’s health experience

Background: The sudden COVID-19 has changed people's living habits, and skin diseases closely related to lifestyle have also changed quietly. We aimed to analyze the changing of pediatric dermatological disorders spectrum before and during the COVID-19 pandemic in China. Methods: This retrospective study encompasses consecutive patients attending a number of dermatological outpatient clinics in National Center for Children’s Health from 1 January 2019 and 31 December 2021. The information about the season, age, number, disease type and origin of the patients was filled in for all the patients. The diseases were sub-classified on etiological basis. Results: The total number of patients was 449032, including 323142 newly diagnosed patients, with a male/female ratio of 1.15:1. The patients were mainly school-age children. 91.3% of the patients suffered from a single skin disease. During the epidemic of COVID-19-epidemic, Atopic Dermatitis (AD )and other types of dermatitis constituted the main diseases, followed by infectious skin diseases, urticaria, erythema and drug responsive skin diseases, and finally parasites and bite responsive skin diseases. The top three skin diseases ranked in descending order of incidence from 2019 to 2021 were the same, followed by AD, urticaria and papular urticaria. During the epidemic period, the proportion of patients with molluscum contagiosum, verruca vulgaris and vitiligo increased. Because of wearing masks, the proportion of infectious skin diseases transmitted by respiratory tract has decreased significantly. In addition, pediatric telemedicine can be used to increase timely access and improve practical efficiency during the epidemic. Conclusions: The pediatric dermatological disorders spectrum has changed during the epidemic of COVID-19. AD is the most common skin disease, and the proportion of infectious skin diseases has decreased significantly. During the epidemic, pediatric internet medical services were fully used to promote the sustainable development of children's skin health.