Type 2 diabetes and dyslipidemias have, until recently, been the traditional realm of the internist and family practitioner, not the pediatrician. Type 1 diabetes, on the contrary, was thought to be a disease of “juvenile onset,” and, by adulthood, a cause of long-term poor outcomes.

Today, as the obesity epidemic moves apace, more children are developing type 2 diabetes and dyslipidemias, although regular exercise and careful management of diet and glycemic control dramatically reduce the risk for long-term sequelae from these diseases. Add to these basic measures the advent of improved pharmacological therapy, and many previously assumed outcomes will not manifest for many affected children.

Medical students rotating in a busy primary care pediatric clinic are often surprised by the volume of dermatology cases treated in this setting. Similarly, many young pediatricians just entering practice find themselves at a disadvantage when confronted by myriad skin conditions that do not necessarily present to the dermatologist first.

Yet, as the center of each their patients’ medical home, the general pediatrician should be skilled in recognizing and addressing common skin conditions, as well as in determining which cases would benefit further from subspecialty evaluation.

This issue of Pediatric Annals provides a focused review of pediatric inflammatory skin conditions, their typical presentations, and the pivotal role the primary care provider plays in the overall care team.

Since the advent of effective vaccines, infectious diseases are no longer the primary concern of general pediatricians. Instead, they are faced with treating an increasing number of other illnesses, such as those related to behavioral health or metabolic syndrome.

For this reason, Pediatric Annals continues with this issue, a series of thoughtful challenges for community-based practitioners, who desire continuing medical education that embraces new paradigms in treatment.

With a shortage of pediatric mental health specialists, care for affected children increasingly falls to the primary care provider. Although more information and evidence-based care is available to help deliver low- to mid-level mental health care in the office setting, limitations such as time constraints and poor reimbursement remain.

This issue of Pediatric Annals is the second in a two-part series focused on the most common mental health issues in children; our October 2011 issue focused on diagnosis; this issue focuses on treatment. Both issues are intended to prepare pediatric primary care providers to treat children with mental health concerns, and to work as a more effective member of an interdisciplinary team.

Pediatric primary care providers, faced with an ever-increasing number of children affected by mental health issues, are not always fully prepared to provide them with appropriate care.

As a result, residency programs have begun to offer mental health training to pediatric house staff, and a growing number of post-residency training programs are available to pediatric primary care physicians. This will help address both the lack of knowledge about mental health in the general pediatric primary care population, but much remains to be done.

This issue of Pediatric Annals is the first of a two-part series designed to help narrow this gap between knowledge and practice when diagnosing pediatric and adolescent mental health concerns.

In the past century, medicine has evolved from essentially a cottage industry of “one doctor, one patient” to a team endeavor with multiple professionals caring for a population of patients. These changes mean it is incumbent upon physicians to keep abreast of the latest advances in technology, communication skills, and processes of care delivery. As American industry has modernized, and patients rapidly integrate new technologies into everyday life, the health care system now looks to them for cues.

This issue of Pediatric Annals provides excellent reviews of key areas that require attention from all practicing child health care providers to meet the evolving needs and expectations of patients.