Table 1. IMCI algorithm used by nurses in two clinics in Fiji to classify common childhood skin conditions.

Sign	Diagnosis	Action
• Any general danger sign	Very severe skin infection	• Give first dose of appropriate antibiotic
• Extensive warm redness or swelling		• Refer URGENTLY to hospital
Swelling or redness around eyes	Periorbital or orbital cellulitis	• Give first dose of appropriate antibiotic
		• Refer URGENTLY to hospital
Localized warm tender swelling and redness	Abscess or cellulitis	• Give first dose of appropriate antibiotic
		• Refer to hospital
Discrete sores/lesions with pus or crusts	Impetigo	• Give appropriate oral antibiotic for 7 days
		• Follow up in 5 days
Itchiness AND papules AND lesions with pus or crusts	Infected scabies	• Give appropriate oral antibiotic for 7 days
		• Give appropriate topical skin cream
		• Treat the whole family with the cream
		• Follow up in 5 days and 2 weeks
Itchiness AND papules	Non-infected scabies	• Give appropriate topical skin cream
		• Treat the whole family with the cream
		• Follow up in 2 weeks
Round to oval flat scaly patches, often itchy	Fungal infection	• Give appropriate topical antifungal for 2 weeks
		• Follow up in 2 weeks
If there are not enough signs to classify in any of the above boxes OR if other signs present are not found in the above boxes	Other skin conditions	• Refer to the doctor or skin clinic

IMCI, Integrated Management of Childhood Illness.