Ch 24 - Skin disorders Flashcards
Bullous Impetigo: casuse (1), features (2), rx (1)
C - S. Aureus; uncommon but potentially serious blistering form of impetigo
F - multiple fragile bullae + erosions +/- umbilical granuloma
Rx - Co-amoxiclav
Epidermolysis bullosa: Features (3), Rx (1)
Group of inherited connective tissue disorders with defects in joining of dermis and epidermis - ranges from mild to lethal
F - Blistering of skin + mucous membranes (spontaneous/trauma), worse in warm weather, if severe > finger & toe fusion, contractures
Rx - MDT, adequate nutrition
Albinism: defintion, types (3), features (3), Rx (3)
D - Lack of skin pigmentation due to melanin def - which is due to tyrosinase def (this catalyzes melanin formation from tyrosine)
F:
- Lack of fixation reflex
- pendular nystagmus
- photophobia (constant frowning)
Rx: tinted contact lenses, hat + sun cream under sun
Collodion baby: definition, features (2), Rx (1)
D -rare manifestation of inherited ichthyoses (group of conditions that cause dry flaky skin)
F - Infants born with a tuat parchment-like membrane > this becomes separated in a few weaks > revealing ichthyotic or normal skin
Rx - emmolients
Causes of napkin rashes (4)
- Irritant/contact dermatitis (most common)
- Infantile seborrhoeic dermatitis
- Langerhan cell histiocytosis
- Wiskott-Aldrich syndrome
- atopic eczema
Irritant dermatitis: causes (2), features (3) - which one distinguishes it from other causes of nappy rashes, Rx (2)
C - infreq nappy changes, infantile diarrhoea
F - convex surfaces of buttocks, perineal region affected by erythematous rash, flexural sparing - differentiates from other causes, erosions/ ulcerations if more severe
Rx - emmolients, low dose steroids
Infantile seborrhoeic dermatitis: Features (3), rx; mild, widespread
An eruption of unknown cause that presents within 2 months of life
F:
- Starts on scalp as erythematous scaly eruption
- these scales form a thick yellow layer = cradle cap
- the scaly rash may spread to face + behind ears + flexures
- not itchy & child unperturbed
Rx
- mild - emmolients
- scales - low dose sulphur + salicylic acid ointment
- widespread - mild topical steroid + antifungal agen
Atopifc eczema (atopic dermatitis): Features (3), Ix (1), Complications (1), Rx (4)
Genetic def of skin barrier function imp in its pathogenesis, onset usually in 1st year of life - but uncommon in 1st 2 months (unlike infantile seborrhoeic dermatitis). FH of atopy
F:
- itchy rash - no itch = not eczema
- excoriations become erythematous, weepy, crusted
- accentuation of normal skin marking = lichenification
Ix - clinical diagnosis, if tested:
- elevated plasma IgE, SPT & RAST
Complications:
- 2ndary infection - Staph/strep/HSV (herpeticum)
Rx:
- avoid irritants/ precipitants - avoid soap, nylon/wool
- emollients
- topical corticosteroids - 1% hydrocortisone
- Immunomodulators - tacrolimus
- ABs if infected
Viral warts: cause (1), features (2), Rx (2)
C - HPV
F - finger + sole distribution, may be pain ful
Rx - only if painful/cosmetic problem, usually self resolving,
- Salicylic acid
- cryotherapy
Molluscum contagiosum: cause (1), features (2), Rx (2)
C - pox virus
F - small skin coloured pearly papules, with central punctum, usually multiple and widespread
Rx - spontaneous dissappearance, topical abs, cryo
Fungal infections: ringworm; cause (1), faetures (3), Ix (2) Rx (1)
Scalp Ringworm = tinea capitis
dermatophyte fungi invade dead keratinous structures & form ring like skin lesions
F - kerion (severe inflammaotry pustular ring worm patch), scaling, alopecia
Ix - wood’s light > bright green/yellow fluorescence of infected hairs, skin scrapings - identify fungal hyphae, culture - definitive diagnosis
Rx - topical/systemic antifungals (treat dog or cat if infected)
Parasitic infestations: scabies: cause (1), features (4), Ix (1), Rx (2)
Cause - sarcoptes scabiei infestation
F - causes severe itching, worse at night and warm conditions, family aslo affected, burrows, vesciles between fingers and toes, axillae,
Ix - clinical - burrrows
Rx - treat whole family Permethrin (5%), 2nd line 0.5% Malathion
Pediculosis Captitis (head lice): features (3), Ix (1), Rx (3)
F -
- scalp/nape itching
- suboccipital LNpathy
- louse eggs on hair
Ix - fine-toother combing of hair
Rx - 0.5% malathion o/n > shampoo > remove lice + nits with comb
Thread worms: feature (1), rx (1)
pruritis ani
Single dose mebendazole for family
Guttate Psoriasis: features (3), rx (1)
rare familial disorder
F
- post strep/viral ENT infection
- small rain-drop like erythematous patches
- patchy alopecia
Rx - bland ointments e.g. coal tar
Pityriasis Rosea: features (3), Rx (1)
Thought to be of viral origin
F -
- starts as herald patch on trunk/thigh
- then develop numerous dull pink macules
- follows lines of ribs posteriorly - x-mas tree pattern
Rx - none self resovles within 6 weeks
