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3rd Year - Paediatrics > 14. Paediatric Dermatology > Flashcards

14. Paediatric Dermatology Flashcards

1
Q

What is Eczema?

A

Itchy, Dry, Inflammatory Skin Disease

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2
Q

What are the 2 Categories of Eczema?

A
  1. Endogenous

2. Exogenous

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3
Q

What are the Endogenous Eczemas?

A
  1. Atopic - Genetic Barrier Dysfunction
  2. Seborrheoic Dermatitis
  3. Discoid Eczema
  4. Pompholyx Eczema
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4
Q

What are the Features of Atopic Eczema?

A
  1. Commonest Eczema in Children - 1:5 Children

2. In with the Atopic Triad - Asthma / Hayfever / Eczema

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5
Q

What occurs due to the Dry Skin in Atopic Eczema?

A

Impaired Barrier Function:

  1. Penetration of Irritants and Allergens
  2. Penetration of Bacteria and Viruses
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6
Q

What is the Inherited Skin “Barrier Defect”?

A

Abnormality in Filaggrin Expression
Filaggrin Proteins bind Keratin Filaments together, and Help Maintain Moisture
This Results in Trans-Epidermal Water Loss

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7
Q

Where is Atopic Eczema located on Children?

A
  1. Flexural Surfaces in Older Children
  2. Face / Neck / Hands in Infants
  3. Discoid / Generalised
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8
Q

What can Atopic Eczema Flares be associated with?

A
  1. Infections / Viral Illness
  2. Environment - Central Heating / Cold Air
  3. Pets - if Sensitised / Allergic
  4. Teething
  5. Stress
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9
Q

What are the Features of Seborrheoic Dermatitis?

A
  1. Cradle Cap - Scalp / Face + Flexures (Neck / Wrist / ankles)
  2. Infants - Usually Resolves by 1 year
  3. Associated with Proliferation of Malassezia (Yeast)
  4. Treated with:
  5. a) Emollients
  6. b) Anti-Fungal Cream and Shampoo
  7. c) Mild Topical Steroid
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10
Q

What are the Features of Discoid Eczema?

A
  1. Scattered Annular / Circular Patches

2. Can occur in Atopic Eczema

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11
Q

What are the Features of Pompholyx Eczema?

A
  1. Hand and Foot Eczema
  2. Vesicles / Bullae
  3. Intensely Itchy
  4. Treated with High Potency Steroid
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12
Q

What are the Exogenous Eczemas?

A
  1. Allergic Contact Dermatitis
  2. Irritant Contact Dermatitis
  3. Photosensitive / Photoaggravated Dermatitis
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13
Q

What are the Features of Allergic Contact Dermatitis (Allergic Allergic Eczema)?

A
  1. Type 4 Hypersensitivity - Sensitisation to Allergen
  2. Associated with uses of Fragrances / Preservatives / Steroids
  3. Diagnosed using Patch Testing
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14
Q

What are the Features of Irritant Contact Dermatitis (Allergic Allergic Eczema)?

A

Associated with contact with:

  1. Water / Saliva
  2. Soaps - Bubble Baths
  3. Irritant Foods - Citrus / Tomatoes
  4. Chemical Irritants
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15
Q

Are Children with Eczema tested for Allergy?

A

No, the Majority of children with Mild Eczema do not need Allergy Testing

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16
Q

When should a Food Allergy be suspected?

A
  1. Immediate Reactions - Angioedema / Facial Rash
  2. Late Reactions - Worsening of Eczema 24-48 hours after ingestion
  3. G.I. Symptoms - Vomiting
  4. Failure to Thrive
  5. Severe Eczema Unresponsive to Treatment
  6. Sever Generalised Itching - Even when the Skin Appears Clear
17
Q

What are the Features of Allergy Testing?

A
  1. Blood Tests for Specific IgE Antibodies
  2. Skin Prick Testing
  3. Common Dietary - Dairy / Soy / Peanut / Egg / Wheat
  4. Airborne Allergens - House Dust Mite / Pet Dander / Pollens
18
Q

What is the Treatment of Eczema?

A
  1. Emollients - Creams / Ointments
  2. Soap Substitutes
  3. Topical Steroids - Stepwise Strengths (Hydrocortisone - Eumovate - Betnovate - Dermovate)
  4. Calcineurin Inhibitors
  5. UVB Light Therapy
  6. Immunosuppressive Medication
19
Q

What are the Common Forms of Skin Infection?

A
  1. Impetigo
  2. Molluscum Contagiosum
  3. Viral Warts & Verrucas
  4. Viral Exanthems
  5. Chicken Pox - Varicella Zoster
  6. Parovirus
  7. Hand Foot and Mouth
20
Q

What are the Features of Impetigo?

A
  1. Common, Acute Superficial Bacterial Infection - normally Staph. Aureus
  2. Presents with Pustules / Honey Coloured Crusted Erosions
  3. Treated with Topical Antibacterial / Oral Antibiotic - Flucloxacillin
21
Q

What are the Features of Molluscum Contagiosum?

A
  1. Common, Benign, Self-Limiting Infection - Molluscipox Virus
  2. Transmission to Close Direct Contacts
  3. Presents with Pearly Papules, umbilicated Centre
    Note - Can take up to 2 years to clear
22
Q

What are the Features of Viral Warts / Verrucas?

A
  1. Often Skin Coloured
  2. Common
  3. Caused by Human Papillomavirus (HPV)
  4. Transmitted by Direct Skin Contact
23
Q

What are the Features of Viral Exanthems?

A
  1. Common
  2. Associated with Viral Illness - Checken Pox / Measles / Rubella / Roseola (Herpes 6) / Erythema Infectiosum
  3. Caused by:
  4. a) Reaction to a Toxin Produced by the Organism
  5. b) Skin Damage from the Organism
  6. c) Immune Response
24
Q

What are the Features of Chicken Pox?

A
  1. Highly Contagious - 1-2 day Pre-Rash until Crusting
  2. Caused by Varicella-Zoster Virus
  3. One Infection confers Life-Long Immunity
  4. Immunocompromised Susceptible at all Times
  5. Presents as Red Papules - Vesicles - Rupture / Crust
  6. Lesions appear on Trunk / Extremities
  7. Itchy and Viral Symptoms
25
Q

What are the Features of Parvovirus?

A
  1. Fifth Disease / Erythema Infectiosum
  2. Incubation is 7-10 days
  3. Viral Symptoms / Lace-Like Rash / Red Cheek
  4. Virus Targets Red Cells in Bone Marrow
  5. Self Limiting
    Note - Very Rarely Aplastic crises in haemolytic disorders
26
Q

What are the Features of Hand Foot and Mouth?

A
  1. Enterovirus - usually Coxsackie Virus A16
  2. Blisters on Hands / Feet / Mouth + Viral Symptoms
  3. Self-Limiting / Supportive Treatment
    Note - Epidemics = Late Summer / Autumn
27
Q

What are the Skin Signs of Systemic Disease?

A
  1. Orofacial Granulomatosis - Crohn’s Disease
  2. Dermatitis Herpetiformis - Coeliac Disease
  3. Eruythema Nodosum - Infections / IBD / Sarcoidosis

3rd Year - Paediatrics (40 decks)

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