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Foundations of Practise > Birth Marks > Flashcards

Birth Marks Flashcards

1
Q

What is a hemangioma (strawberry naevus)

A
  • Benign tumour of vascular endothelium

- commonly seen at birth or within the first few weeks of life.

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2
Q

What do superficial hemangiomas look like

A

vivid red, well demarcated plaques or nodules

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3
Q

What do deep haemangiomas look like

A

skin-coloured or less well defined

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4
Q

What does a precusor lesion that will develop into a haemangioma look like

A

blanched macule, erythematous or telangtactic patch

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5
Q

What is the course of haemangiomas

A
  1. Pre cursor lesion
  2. prolifertive growth phase (6-9 months)
  3. Stabelisation
  4. Spontaneous involution (around aged 3-4)
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6
Q

What is the most common place for haemngiomas

A

60% occur on the head and neck but they can present anywhere

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7
Q

What should be done if >5 haemangiomas a present

A
  • internal haemangiomatosis may be suspected if >5 lesion.
  • Liver US - most common place
  • brain, GIT and airway may be involved
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8
Q

When should you consider intervention of hemangiomas

A
  • Haemangiomas near eyes, nose, throat, ears, airway/lips and anogenital tract should be referred
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9
Q

What investigations should be done to diagnose hemangioma

A

typicall none - clinical
If unsure dopplers or MRI can be done
US and MRI in complicated strawberry naevus

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10
Q

What are the complications of haemangiomas

A
  • ulceration
  • bleeding
  • disfigurement
  • airway obstruction
  • visual disturbances
  • hepatic haemngiomas associated with high output cardiac failure
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11
Q

What is the management of haemangioma

A
  1. Conservative
  2. Oral propnaolol
  3. topical beta-blockers - timolol
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12
Q

How does propanolol treat haemangiomas

A

beta antagnoist

  1. vasoconstriction
  2. blocking angiogenic signals such as VEGF
  3. Apoptosis
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13
Q

What should every child have before starting propanolol

A
  1. Hx inc signs ans symptoms of pulmonary and cardiac disease
  2. ECG + echo if bradycardic/arrythmias or Hx of familial heart disease
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14
Q

What are the contraindications of propanolol

A
  • cardiogenic shock
  • bradycardia
  • bronchial hypersensitivity
  • allergies to propanolol
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15
Q

What is a sebaceous naeuvus

A
  • epidermal naevus presenting as a yellow-orange hairless patch or plaque, usually on the scalp and face
  • usually oval or circular
  • in Adolescence become warty and bumpy
  • very rare 0.3%
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16
Q

Investigations of sebaceous naeuvus

A

biopsy if unsure.

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17
Q

management of sebaceous naevus

A
  • risk of malignancy not known - some recommend excision, some watch and wait
  • refer to dermatology
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18
Q

Complications of sebaceous Naevus

A
  • cosmetic appearance
  • chance of malignancy
  • complications associated with removal
19
Q

What is congenital melanocytic naevus

A

Proliferation of benign melanocytes which are present at birth or shortly after birth

20
Q

What is the classification of congenital melanocytic naevus

A

Small: < 1.5 cm
Medium: 1.5–19.9 cm.
Large/giant: ≥ 20 cm

21
Q

Complications of congenital melanocytic naevus

A
  • itchiness
  • ulceration
  • cosmetic appearance
  • risk of developing into malignant melanoma
22
Q

What is Neurocutaneous melanosis

A

Proliferation of melanocytes in the CNS
usually assoc with giant congenital melanocytic naevus
very rare
Present as signs of raised ICP

23
Q

What is acquired melancoytic naevus

A

Moles which appear >2yrs as flat lesions that may become elevated
Can vary in colour from pink/flesh to brown

24
Q

What is halo naevus

A

melanocytic naevus with a white ring of depigmentation around it
Common in childhood

25
Q

What diseases are associated with halo naevus

A

Turner syndrome.
Vitiligo
Halo naevi-associated leukoderma

26
Q

What is the managment of halo naevus

A

benign - no management other than reassurance

27
Q

What is dermal melanocytic naevus

A

different types of naevi that appear blue in coluor due to the presence of melanin in the dermmis

28
Q

Examples of dermal melanocytis naevus

A
  • common- raised dome shaped blue lesions
  • naevus of Ota
  • naevus of Ito
  • mongolian Blue spot
29
Q

what is Naevus of Ota

A

in the distribution of the opthalmic and axillary branch of the trigeminal nerve

30
Q

What is a mongolion blue spot

A

blue/grey marking often occuring in the lumbar-sacral region

31
Q

What is Naevus of Ito

A

On the scaupla region

32
Q

What is granuloma annulare

A
  • common inflammatory skin condition
  • annular, smooth, discoloured papules and plaques
  • delayed hypersensitivity reaction
  • often over joints and knuckles
33
Q

Clinical features of granuloma annulare

A
  • widespread
  • tender when knocked
  • plaques tend to slowly change shape, size, and position
34
Q

What is millia

A

tiny superficial pearly white papules
tiny cysts are filled with keratin
Most commonly arise on the face and affect 40-50% newboens

35
Q

What is the management of millia

A

Tend to clear up on their own in a few months

36
Q

What is molluscum contagiosum

A
  • common viral skin infection of childhood that causes localised clusters of epidermal papules
  • due to pox virus
  • common in children with atopic dermatitis
37
Q

What do molluscum contagisum look like

A
  • dome shaped flesh/pink coloured papules
  • waxy with a central pit
  • Often arise in warm/moist areas armpit, behind the knees, groin or genital areas
  • can appear on lips and eyes
38
Q

Course of molluscum contagiosum

A
  • often induces dermatitis around surrounding area causing skin to become pink, dry and itchy
  • As papules resolve they become dry and scabby for 2 weeks
39
Q

Complications of molluscum contagiosum

A
  • second bacterial infection
  • conjuctivitis if eyelid affected
  • disseminated secondary eczema
  • if immunodeficient - widespread ? HIV
  • scarring
40
Q

What is PHACE syndrome

A
  • Large segmental haemangiomas usually on the head or face.

- neurocutaneous syndrome with numerous associations

41
Q

What investigations should be done is suspecting PHACE

A

MRI/MRA brain and neck
cardiac assessment
opthalmic assessment

42
Q

What does PHACE stand for

A

P - posterior fossa brain malformation
H - Haemangiomas - large segental fascial lesions
A - arterial anomalies
C - cardiac anoamlies, coarctation of the aorta
E - eye and endocrine abnormalties

43
Q

What is the management of PHACE

A
  • propanolol but need MRA to detect underlying arterial anomalies first - Increased risk of stroke
  • MDT with derm and cardio
  • TFTs if liver/parotid involvement or very large haemangiomas

Foundations of Practise (20 decks)

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