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Sydney Child Health Program > 9.3 Birthmarks > Flashcards

9.3 Birthmarks Flashcards

1
Q

3 main types of birthmarks?

A

vascular
epidermal
melanocytic

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2
Q

2 main vascular birthmarks?

A

vascular tumours

Vascular Malformations

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3
Q

examples of vascular tumours birthmarks?

A

infantile hemangioma

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4
Q

examples of vascular malformations?

A

capillary
lymphatic
Arteriovenous

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5
Q

who gets infantile haemangiomas more likely?

A 
females 3:1
prematurity
multiple gestation
caucasian
advanced maternal age, placenta paevie
pre-eclampsia
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6
Q

when do infantile haemangiomas grow?

A

first 3-9 months

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7
Q

when is infantile haemangiomas onset?

A

within 1-2 weeks of birth

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8
Q

when does infantile haemangiomas regress?

A

during childhood

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9
Q

tell parents regression ages?

A

50% age 5
70% age 7
90% age 9

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10
Q

if uncertain about infantile haemangiomas dx?

A

ultrasound

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11
Q

two types of infantile haemangiomas?

A

superficial

deep

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12
Q

Complications of infantile haemangioma?

A
  1. Ulceration
  2. Interference of function: amblyopia, airway, oral
  3. Cosmetic disfigurement
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13
Q

What if the baby has a large sacral infantile haemangioma?

A

Spinal defects

urogenital defects

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14
Q

What is baby has mandibular infantile haemangioma?

A

Risk of sub-glottic laryngeal haemangioma impeding airway

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15
Q

Risk of multiple infantile haemangioma?

A

Underlying visceral, liver/cardiac failure

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16
Q

What is multiple haemangioma defined as?

A

More than 5

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17
Q

What is PHACES syndrome?

A
  1. Posterior intracranial fossa anomalies
  2. Haemangioma
  3. Aortic / arterial anomalies
  4. Cardiac Abnomalities
  5. Eye Anomalies
  6. Sternal defects
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18
Q

what kind of haemangioma in PHACES syndrome?

A

segmental haemangioma

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19
Q

investigations for mandibular haemangioma?

A

lateral neck x-ray

ENT exam

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20
Q

investigations for sacral haemangioma?

A

USS

MRI

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21
Q

investigations for multiple haemangioma?

A

liver U/S, doppler

MRI

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22
Q

investigations for PHACES haemangioma?

A

eye exam
MRI head & neck
ECG, ECHO

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23
Q

when to referral for haemangioma?

A

ulceration
interference of function
cosmetic - threatened

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24
Q

Treatment for infantile haemangiomas ulceration?

A

dressings
analgesia
vascular laser

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25
Q

Treatment for infantile haemangiomas functional or cosmetic impairment?

A
  1. propanalol
  2. oral steroids
  3. intralesional steroids
  4. vincristine
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26
Q

difference between infantile haemangiomas vs. congenital haemangiomas?

A

fully developed at birth

-no rapid growth phase

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27
Q

two kinds of congenital haemangiomas?

A

RICH - rapid involution

NICH - non-involuting

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28
Q

Rx for congenital haemangiomas - NICH?

A

surgical

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29
Q

4 kinds of vascular malformations

A

Capillary
Venous
Arteriovenous
Lymphatic

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30
Q

2 main types of capillary malformation?

A
  1. salmon patch (angel’s kiss, stork bite) 40% of newborns

2. Port Wine Stain

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31
Q

where are salmon patches normally?

A 
central face usually bilateral
nuchal region
upper eyelid
perialar region
thoracolumbar
32
Q

how many salmon patches usually?

A

multiple normally

33
Q

facial salmon patches fade?

A

fades in 1-2 years

34
Q

neck salmon patches fade?

A

persists into adulthood

35
Q

Rx for salmon patches ?

A

not really unless persistent on face

36
Q

Port Wine Stains incidence?

A

0.3%of all newborns

37
Q

Port Wine Stains presents?

A

at birth

38
Q

Port Wine Stains description?

A

confluent non-palpable erythema

39
Q

Port Wine Stains locations?

A

dermatomal distribution
85% unilateral
15% bilateral

40
Q

Port Wine Stains resolution?

A

non spontaneous

41
Q

Port Wine Stains Rx?

A

pulsed dye vascular laser

42
Q

Port Wine Stains long term complications?

A

darken
skin hypertrophy
nodules

43
Q

all Port Wine Stains have when kind of problem?

A

underlying AVM, VM, LM

44
Q

Limb Port Wine Stains tend to?

A

hypertrophy (Klippel-Trenauney)

45
Q

Craniospinal Port Wine Stains need investigation?

A

yes

?spinal cord anomalies

46
Q

how to tell if Port Wine Stains is AVM?

A

warm to tough, thril/pulsatile

47
Q

how to tell if Port Wine Stains is VM?

A

bluish

dilated veins

48
Q

how to tell if Port Wine Stains is LM?

A

vesicles, deeper swelling

49
Q

what is Sturge-Weber synfrome

A
  1. Facial port wine stain, V1 or hemifacial
  2. ipsilateral leptomeningeal vascular malformation: epilepsy, intellectual disability etc.
  3. choroidal vascular malformation of the eye: glaucoma
50
Q

limb Port Wine Stains manifests when? how?

A
  • early 1-2 years

- hypertrophy of soft tissue and bones

51
Q

limb Port Wine Stains syndromes?

A

Klippel-Trenauney (CM, VM, LM)

Parkes-Weber (CM, AVM, VM, LM)

52
Q

when does Becker’s naevi appear?

A

at start of puberty

53
Q

epidermal naevi types?

A 
Keratinocytic
Sebaceous
Follicular
apocrine
eccrine
becker's
54
Q

which epidermal naevi likely to have underlying problems?

A

epidermal naevi syndrome

  1. extensive sebaceous naevi
  2. located in centrofacial regions
  3. multiple naevi
55
Q

sebaceous naevi tend to develop where?

A

scalp

56
Q

sebaceous naevi complications?

A

-can have growth, should be biopsied
-usually benign
-

57
Q

sebaceous naevi complications occur when?

A

in adulthood normally

58
Q

pigmented birthmarks 3 kinds:

A
  • hyperpigmented macules
  • hypopigmented macules
  • congenital melanocytic naevi
59
Q

hyperpigmented macules aslo known as?

A

cafe au lait spots

60
Q

-hyperpigmented macules
-hypopigmented macules
usually follow which lines?

A

lines of blaschko

61
Q

multiple cafe au lait spots, how many? worry about?

A

5<

neurofibromatosis type 1

62
Q

multiple hypopigmented naevi, worry about?

A

tuberous sclerosis

63
Q

-hyperpigmented macules treatment

A

no treatment

laser

64
Q

-hypopigmented macules treatment

A

none or

cosmetic camouflage

65
Q

congenital melanocytic naevi

A

dark spots, can have hair in them

66
Q

congenital melanocytic naevi occur when?

A

1st year of life

67
Q

congenital melanocytic naevi classification?

A

small <1.5cm
intermediate 1.5-19.9cm
giant >20cm

68
Q

congenital melanocytic naevi single? multiple

A

can be multiple

69
Q

congenital melanocytic naevi natural history?

A
  • proportionate growth
  • thicken & daken
  • more hairs
  • don’t resolve
70
Q

problems with giant congenital melanocytic naevi?

A
  • neurocutaneous melanosis

- intracerebral/leptomeningeal melanocytic proliferations

71
Q

risk factors for neurocutaneous melanosis?

A
  • > 2 congenital melanocytic naevi

- giant congenital melanocytic naevi

72
Q

prognosis for neurocutaneous melanosis?

A

symptomatic - poor prognosis

73
Q

congenital melanocytic naevi complications?

A

melanoma
2-3% of giant ones
highest risk

74
Q

congenital melanocytic naevi complications for small ones?

A

no increased risk of melanoma

75
Q

giant congenital melanocytic naevi investigations?

A
  1. MRI baseline or symptomatic

2. biopsy

76
Q

congenital melanocytic naevi treatment

A
  1. excision

2. laser not really

Sydney Child Health Program (113 decks)

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