Paediatric & Adolescent Dermatology

“as they should be”

Paediatric & Adolescent Dermatology Services in the Cayman Islands

Integra Healthcare is privileged to have two tertiary trained and experienced dermatologists both of whom have extensive experience across the spectrum of dermatological issues and both of whom are used to treating these in children and adolescents, as well as adults. Our paediatric and adolescent dermatology team work closely with our paediatricians and expecially Dr Jasmina Marinova, our paediatrician with an interest in dermatology issues in children, creating a truly comprehensive service.

Molluscum Contagiosum
Molluscum contagiosum is a viral skin infection that is most common in children (though it can affect adults, too). The primary symptom of molluscum contagiosum is a series of round, firm, painless bumps that usually appear on the face, neck, armpits, and tops of the hands in children. In adults, the infection may be sexually transmitted and often develops on the genitals, thighs and lower abdomen.

The bumps caused by molluscum contagiosum:

  • Are round and flesh-coloured
  • Are raised
  • Are small
  • May become red and sore if scratched
  • May be itchy
  • Are easily removed by rubbing or scratching
  • Have a characteristic small indentation at the top and centre of the bump

Molluscum contagiosum is more common among children, though it can also affect adults, If you are worried about the skin health of you or anyone else in your family, it is important to book an appointment with one of our dermatologists for more information. Molluscum contagiosum is very contagious (especially in adults) and, though not dangerous, should be treated as soon as possible.

For an appointment, please contact either Dr Alison Duncan, Adult & Paediatric Dermatologist or Dr Davide Altamura, Consultant Dermatologist & Dermatosurgeon, Cayman.

Plant and Wildlife Contact Conditions
Certain plant and other wildlife species can cause contact dermatitis if you get too close, which means they can irritate your skin if you touch them. There are a wide variety of plants that can cause contact dermatitis, but the ones you are most likely to run into are:

  • Poison ivy
  • Poison oak
  • Poison sumac
  • Wood nettles
  • Stinging nettles
  • Ragweed

Evenly lightly brushing up against one of these plants can cause a skin reaction such as itching, burning, swelling, bumps, and other signs of irritation. Certain biting and stinging wildlife species can also cause contact dermatitis, such as:

  • Bees
  • Wasps
  • Hornets
  • Yellow jackets
  • Fire ants

Most of the time, plant and wildlife contact conditions are mild and will clear up by themselves. However, if you have an allergic reaction to whatever stung you, you will need to seek further medical assistance. In case of severe allergic reaction (i.e., anaphylaxis), you will need emergency medical care immediately.

If you have a rash caused by contact with a plant or animal that won’t go away, despite home care, make an appointment with one of our dermatologists in Grand Cayman to find out more.  Either Dr Alison Duncan, Adult & Paediatric Dermatologist or Dr Davide Altamura, Consultant Dermatologist, will be happy to provide the help and answer any questions you have.

Fungal Infections
Fungal skin infections happen when fungi (a type of microscopic organism) starts to grow in your skin. These infections can appear anywhere on the body but are more common in warm, moist areas like the feet, groin, and in the folds between skin.

Many fungal skin infections are common, and few are considered serious or harmful. However, they can cause unpleasant symptoms like itching, burning, tenderness, or stinging of the skin, as well as dryness, redness, or flakiness. Some fungal infections can also lead to the formation of blisters or cracked, bleeding skin.

There are a variety of fungal skin infections, the most common of which include:

  • Athlete’s foot
  • Jock itch
  • Ringworm (of the body or scalp)
  • Tinea versicolor
  • Cutaneous candidiasis
  • Onychomycosis

The majority of fungal skin infections are easily treatable, and can often be cleared up using topical or oral medication. The only way to get the appropriate treatment, however, is to first get a diagnosis.

If you notice any sudden or persistent symptoms that may indicate an infection, both Dr Alison Duncan, Adult & Paediatric Dermatologist, and Dr Davide Altamura, Dermatologist and Dermatosurgeon are highly experienced here in Grand Cayman in the diagnosis and treatment of all common skin complaints, including fungal infections.

Genital or Vulval Skin Conditions
Vulvitis is a condition that cases the skin around the vulva to become inflamed, itchy, and painful, and may also cause pain when urinating. Vulvitis most commonly affects young girls shortly before they hit puberty and is usually a result of irritation caused by soaps, shampoos, and other perfumed hygiene products. Vulvitis is not a serious condition, and usually clears up within a day or two of treatment.

If your child has a vulval or genital skin condition that doesn’t seem to be getting better, schedule an appointment in Grand Cayman with either Dr Alison Duncan, Adult & Paediatric Dermatologist, or Dr Davide Altamura, Dermatologist and Dermatosurgeon.  They are highly experienced in the treatment of both adult and paediatric skin conditions and can expertly and sensitively address any concerns you have about your child’s genital or overall skin health. They will be able to expertly assess the problem and give you the most effective advice for your child’s needs.

Acne Care and Treatment
Acne is almost inevitable for most adolescents, with an estimated 85% of teens afflicted by acne.  For most people, the problem resolves itself with age, but this is of little comfort to those currently suffering with the condition.

There are dozens of acne treatments available for you to try. For those with standard teenage pimples, the condition can often be kept in check by:

  • Washing the face twice daily with warm water
  • Washing the hair with shampoo every day
  • Using over-the-counter topical remedies (such as creams and medicated face washes)
  • Avoiding abrasive facial scrubs, heavily perfumed products, and other cosmetics
  • Not picking at spots

Unfortunately, some people find that the typical remedies don’t work, and that nothing seems to improve their acne. For teens with severe and persistent acne, a consultation with one of our dermatologists can provide them with the exact information they need to make significant improvements to their skin. Both Dr Alison Duncan, Adult & Paediatric Dermatologist, and Dr Davide Altamura, Dermatologist and Dermatosurgeon, in Grand Cayman, have extensive experience in the diagnosis and treatment of skin problems, and are well qualified to advise you on any acne-related queries you may have.

Eczema (Adolescent and Paediatric)
Eczema (AKA atopic dermatitis) is a very common skin condition that can affect people at any age. However, skin irritation caused by eczema can look different depending on the age of the patient.

Typically, eczema symptoms vary widely from person to person, but may include:

  • Dry skin
  • Itchy skin
  • Red, brownish, or greyish patches on hands, feet, ankles, neck, wrists, eyelids and knees
  • Thick, cracked, or scaly skin
  • Small bumps that ooze or crust over when scratched
  • Raw, sensitive, or swollen skin (usually a result of scratching)

Although the symptoms of eczema can differ greatly between individuals, the condition may also present differently in children and adolescents than it does in adults.

Teens with eczema are likely to experience many of the same symptoms as adults do. However, adolescent eczema is more likely to develop in the bends of elbows, backs of knees, on the insides of wrists and ankles, and on the face, neck, and upper chest.

In young children, babies, and toddlers, eczema may show up in different places. In infants (i.e., children younger than 6 months) eczema is most likely to appear on cheeks, chin, forehead, and scalp. In babies (aged 6-12 months) eczema may spread to the knees and elbows. For toddlers (aged 2-5 years) the rash often appears on the face, elbows, knees, wrists, ankles, and hands. In children over the age of 5, eczema rashes usually develop only in the folds of the elbows and/or knees.

If you have any concerns about the skin health of your children or teens, do take them to see one of our dermatologists here in Grand Cayman, Dr Alison Duncan, Adult & Paediatric Dermatologist or Dr Davide Altamura, Consultant Dermatologist, for a formal diagnosis. There are many treatments available to alleviate the symptoms of eczema, and they will be able to advise you on the best course of action for your child’s needs.

Autoimmune Skin Disorders and Conditions
Autoimmune disorders are disorders in which the body’s own immune system starts to mistakenly attack healthy cells and tissues. There are different types of autoimmune diseases and they can affect a variety of different body parts, including the skin.

Skin disorders and conditions relating to autoimmunity differ depending on which type of autoimmune condition a person has. The most common autoimmune diseases that affect the skin are vitiligo, scleroderma, lupus, psoriasis, and vasculitis.


Vitiligo is an autoimmune condition that causes smooth, white patches to appear on the skin. The condition can affect anyone but is more noticeable in people with darker complexions, where there is a more noticeable difference between affected patches of skin and the person’s natural skin tone.


Scleroderma is a condition that causes the tightening and hardening of the skin and connective tissues. There are two types of sclerodermas; localized scleroderma, which mostly affects the skin, and systemic scleroderma, which also affects a variety of internal organs.


Systemic lupus erythematosus (SLE) is an autoimmune disease that affects the whole body but is often characterized by a ‘butterfly rash’ across the nose and cheeks.

There is another type of lupus (known as discoid lupus erythematosus – DLE) that causes skin lesions which, though not usually painful or itchy, can lead to scarring. The lesions caused by DLE can appear on the upper back, neck, hands, face, or scalp.


Psoriasis is a chronic autoimmune condition that causes skin cells to multiply at a much faster rate than usual.  This leads to a build-up of skin cells and the formation of scaly plaques that may be dry, cracked, sore, itchy, or scaly.


Vasculitis is an autoimmune condition that causes inflammation of the blood vessels and can cause serious health complications in severe cases. Some symptoms of vasculitis include red spots, lumps, and sores on the skin.

If you are concerned about the skin health of yourself or a family member, book an appointment with one of our dermatologists right away in Cayman. Most skin problems are completely harmless, but others can be indicators of other, underlying health issues. Therefore, it is very important to seek expert advise on how best to protect and maintain your health.

Both Dr Alison Duncan, Adult & Paediatric Dermatologist, and Dr Davide Altamura, Dermatologist and Dermatosurgeon, are very experienced in the diagnosis and treatment of all skin complaints, including those caused by autoimmune conditions.

Atopic dermatitis (more commonly known as eczema) is a common skin condition that can affect people at any age. Although anyone can get dermatitis, it is most common in babies, children, and young adults. It may be accompanied by asthma or hay fever.

The symptoms of atopic dermatitis can vary significantly between individuals but typically include one or more of the following:

  • Dry skin
  • Itchy skin
  • Discoloration of skin on the hands, feet, ankles, neck, wrists, eyelids and knees
  • Thick, cracked, or scaly skin
  • Small bumps that leak or form a crust when scratched
  • Raw, sensitive, or swollen skin

In babies and younger children, however, the symptoms of dermatitis can present differently than in adults. The key difference in dermatitis between members of different age groups is typically the location of the rash. In babies (from 6 months), dermatitis usually flares up on the face and scalp. In younger children (aged 2 – 5 months) the rash usually appears on the wrists and knees. Teens and adolescents with dermatitis are more likely to notice a rash on their hands and feet.

Skin complaints are usually nothing to worry about but can still cause discomfort, and one of our specialists will be able to expertly advise you on the best treatment plan for your child.

If you notice any persistent abnormalities in your child’s skin, it is advisable to make an appointment for a check-up with either Dr Alison Duncan, Adult & Paediatric Dermatologist or Dr Davide Altamura, Consultant Dermatologist here in Grand Cayman.


Allergic Reactions and Conditions
Your skin is your body’s first line of defence against the outside world and, occasionally, it takes a few hits from pathogens, irritants, and allergens. Skin allergies are any allergic reactions that cause symptoms relating to the skin, such as:

  • Redness
  • Itchiness
  • Bumpiness
  • Swelling
  • Scaliness

There are a variety of conditions that can cause skin allergies, including:

  • Atopic dermatitis (AKA eczema)
  • Contact dermatitis
  • Hives (AKA urticarias)
  • Angioedema

The only way to conclusively diagnose a skin allergy is with the help of one of our professional dermatologists. They will be able to perform an expert, visual analysis of your symptoms, and will also ask relevant questions about your diet, habits, and general lifestyle. If an initial consultation can’t get to the bottom of your skin allergy issues, they may recommend a patch testing for skin allergy assessment. This will be able to provide the conclusive answers you need to avoid allergens and keep your skin healthy.

Either Dr Alison Duncan, Adult & Paediatric Dermatologist or Dr Davide Altamura, Specialist Dermatologist in Grand Cayman, will be able to assist your needs.

Psoriasis is a chronic (i.e., long-lasting) skin condition that is thought to be caused by an overactive immune system. In people with psoriasis, the immune system causes skin cells to grow faster than their body can get rid of them. These excess skin cells start to build up in scaly plaques on the skin, which is the characteristic symptom of psoriasis.

Psoriasis symptoms usually start to show up between the ages of 15 and 25 but, in around one third of cases, the condition first develops in childhood.  Children with psoriasis usually have similar symptoms to adults, which include:

  • Raised, red patches of skin that may have silvery-white scales (in babies, this may be mistaken for diaper-rash)
  • Dry, cracked skin that may bleed
  • Itchy, sore, or burning patches of skin
  • Red patches in skin folds (such as around the elbows and knees)
  • Thick, pitted nails; ridged nails; yellowed or thickened nails; detachment of the nail form the nail bed

In children however, psoriasis usually first appears on the scalp. The most common type of psoriasis (plaque psoriasis) can show up anywhere on the body, but is usually seen on the:

  • Knees
  • Scalp
  • Elbows
  • Torso

Currently, there is no cure for psoriasis However, there are a wide variety of treatments available to soothe symptoms and help patients to effectively manage the condition. If you or your child is suffering from a persistent skin complaint, make an appointment as soon as possible with either Dr Alison Duncan, Adult & Paediatric Dermatologist, or Dr Davide Altamura, Dermatologist and Dermatosurgeon.  Both have expertise in the diagnosis and treatment of all common skin complaints.

Rashes, Lumps, and Bumps
Rashes, lumps, and bumps are all classic features of skin irritation, and could indicate any number of skin conditions.  Common examples of skin disorders that cause rashes, lumps, and bumps in children include:

  • Acne
  • Atopic dermatitis
  • Contact dermatitis
  • Folliculitis
  • Hand-foot—and-mouth disease
  • Heat rash
  • Hives
  • Impetigo
  • Molluscum contagiosum
  • Pityriasis rosea
  • Scabies

Most conditions that cause lumps and bumps on the skin are not considered dangerous, and most clear up easily either by themselves or with the help of topical treatments. Identifying the cause of your child’s rash is more important, as this is the information you need to prevent and treat future irritations.

If you have noticed lumps, bumps, or a rash on your child’s skin, take them to see a dermatologist for an expert assessment. Both Dr Alison Duncan, Adult & Paediatric Dermatologist, and Dr Davide Altamura, Dermatologist and Dermatosurgeon, in Cayman, are very experienced in the identification and treatment of all common skin conditions, and will be able to give your child the care they need.

Warts and Verrucas
Warts and verruca’s are small skin growths caused by the human papilloma virus (HPV).  When they appear on the hands, these small, rough bumps are called warts. They are referred to as verrucas when they grow on the soles of the feet.

Warts and verrucas are both very common, and most people get at least one at some point in their life. Usually, warts and verrucas eventually go away by themselves and don’t require treatment. However, there are a variety of treatments available for the removal of warts and verrucas. The most common methods of wart removal are:

  • Cryotherapy (the freezing method)
  • Salicylic acid (often applied as a topical ointment)

If you have warts or verruca’s you want to get rid of, schedule an appointment with one of our dermatologists to discuss your treatment options. They will likely make a visual assessment of your warts before offering a treatment based on the type and location of the lesions you want removed. Both Dr Alison Duncan, Adult & Paediatric Dermatologist, and Dr Davide Altamura, Dermatologist and Dermatosurgeon, here in Grand Cayman, are very experienced in the diagnosis and treatment of all common skin problems.

Recurrent Boils and Abscesses
Hidradenitis suppurativa (HS) is a chronic skin condition that causes painful, pea-sized lumps to form under the skin. These boil-like lumps usually form in places where the skin rubs together, such as the armpits, breasts, buttocks, and groin. In some cases, these lumps disappear by themselves; in others, they rupture and leak pus for a period of hours or days.

Often, new lumps will then form in a nearby area, and will also rupture and leak. Over time, tunnels (called sinus tracts) can form under the skin, which can also leak pus and lead to further scarring. HS is often very painful and can be emotionally distressing to live with, as the abscesses left by ruptured lumps can be painful, itchy and have an unpleasant odour.

Treatments for recurrent boils and abscesses caused by HS usually focus on managing and reducing symptoms. HS is easiest to manage if it is caught in its earlier stages so, if you think you have symptoms of the condition, book a consultation with one of our dermatologists, Dr Alison Duncan, Adult & Paediatric Dermatologist, or Dr David Altamura, Dermatologist & Dermatosurgeon, Cayman, and they will ensure to give you the correct treatment needed.

Dermatoscopy. Doctor Examines The Patient With A Dermascope

Latest Diagnostic Equipment

We are a practice focused on clinical dermatology and our dermatologists in Cayman are equipped with some of the very latest equipment, from highest quality handheld dermascopes to the dermascope function of our amazing FotoFinder, delivering an examination ability of the highest possible magnification and image quality.

Additionally, we have modern, well-equipped examination rooms from which we can sample skin conditions for laboratory analysis and identication.


Dr Davide Altamura

Specialist Dermatologist
MD Dermato-Surgery
Tel: +1 (345) 745 7450 (clinic)
Email: [email protected]

Dr Davide Altamura is a highly experienced general and specialist consultant dermatologist and dermatology surgeon, with a special interest, awards and multiple publications in the field of skin cancer and in particular Dermoscopy and the identification of both malignant and benign skin lesions.


  • Adult & Paediatric Dermatology
  • Skin Cancer Screening & Management
  • Expert Dermoscopy Services
  • Dermatology Surgery, Procedures & Biopsies
  • Management of Acute & Chronic Conditions

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Dr Alison Duncan

Specialist Dermatologist
Tel: +1 (345) 745 7450 (clinic)
Email: [email protected]

Dr Alison Duncan is a highly experienced dermatologist with more than 12 years at consultant-level, including 7 years at Lancashire Teaching Hospitals NHS Trust, a highly respected university service. She has considerable experience of skin issues related to darker skin pigments and an interest in skin cancer.


  • Adult & Paediatric Dermatology
  • Skin Cancer Screening & Management
  • Allergic, Autoimmune & Other Skin Conditions
  • Procedures, Biopsies & Cryotherapy
  • Genital or Vulval Skin Conditions

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Clinic Location & Open Times

The Grand Pavilion Commercial Centre, Hibiscus Way, 802 West Bay Road.


  • Monday to Friday: 8.30am first appointment, 4.30pm last appointment
  • Saturday: 8.30am first appointment, 12.30pm last appointment