02014nas a2200229   4500000000100000008004100001653002500042653002400067653002100091653001600112653001900128653002600147653003500173100002100208700001400229700001700243245006500260856007000325300001000395490000600405520137300411       2015                            d10aHealth care delivery10aBacterial Infection10aFungal infection10aInsect bite10aBite reactions10aPediatric dermatology10aSkin signs of systemic disease1 aWhitaker-Worth D1 aBayart CB1 aBenedetti JA00aDermatologic conditions in internationally adopted children.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418670/pdf/main.pdf  a31-360 v13 a<p>Over 200,000 children have been adopted into United States (US) families from abroad since the year 2000. Health care providers who care for children adopted internationally should be aware of the spectrum of illnesses seen in this population, and should be prepared to encounter potentially unusual situations. An appreciation for the unique pre-adoption exposures and vulnerabilities inherent in international adoption is critical for proper diagnosis and treatment of this heterogeneous group of children. It is important to consider the impact of potential early childhood stressors such as nutritional, sensory, and emotional deprivation, trauma and abuse, as well as prenatal exposures to drugs, alcohol, and infectious diseases. Providers must also take into account international variation in health care practices, including immunization, treatment, surgical, and hygiene standards. The differential diagnosis for cutaneous eruptions in children adopted internationally is broad and must encompass endemic systemic illnesses with skin manifestations, such as measles, tuberculosis, leprosy, and congenital syphilis, and primary dermatologic diseases such as scabies and bacterial and fungal infections. The importance of maintaining a broad differential and open mind when addressing the dermatologic needs of these children cannot be overemphasized.</p>