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paeds > common paeds skin > Flashcards

common paeds skin Flashcards

1
Q

what is eczema?

A

chronic atopic condition caused by defect in normal continuity of skin barrier leading to inflammation in skin

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2
Q

is eczema genetically linked?

A

yes but not directly

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3
Q

how does eczema present?

A

: in infancy with dry, red, sore patches of skin over flexor surfaces (inside elbows/ knees)
- Can be on face/ neck
- May have periods where it is worse/ better  flares

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4
Q

what is pathophys of eczema?

A

defect in barrier that skin provides – gaps allow irritants, microbes and allergens to create immune response, resulting in inflammation and associated symptoms

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5
Q

what is maintenance managment of eczema?

A

Maintenance – creates artificial barrier to compensate for defective skin barrier – emollients

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6
Q

how should emollients be applied within eczema?

A
  • Thick and greasy as possible after washing and before bed
  • Avoid hot baths, body washes that remove natural oils
  • Soap substitutes
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7
Q

how should eczema pt approach triggers?

A

identify and avoid

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8
Q

what do you do within flares of eczema?

A

Flares: thicker, topical emollients, topical steroids,
- wet wraps: covering affected areas in thick emollient and applying a wrap to keep moisture locked in overnight
- treating any viral/ bacterial infections

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9
Q

name some specialist management options of eczema?

A

zinc impregnated bandages, topical tacrolimus, phototherapy, systemic immunosuppressants – oral corticosteroids, methotrexate, azathioprine

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10
Q

how should you use steroids within eczema?

A

use for weakest steroid for shortest duration to help get skin under control

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11
Q

what is moa of steroids in eczema?

A
  • settles immune activity and reduces inflammation
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12
Q

what are side effects of steroid use on skin?

A

can lead to thinning of skin, bruising, tearing, stretch marks and telangiectasia

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13
Q

what is telangiectasia?

A

enlarged blood vessels under surface of skin

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14
Q

what areas of body should you avoid with topical steroids?

A
  • avoid thin skin – face, around eyes, genital region
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15
Q

should paeds get topical steroids?

A

not if little
only once old to understand not to touch it

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16
Q

what is urticaria?

A

hives

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17
Q

how does urticaria present?

A
  • small itchy lumps that appear on skin
  • associated with patchy erythematous rash
  • localised to specific area/ widespread
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18
Q

what other symptoms may present with hives?

A
  • link to angioedema/ flushing of skin
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19
Q

what is pathophy of urticaria?

A

release of histamine and other pro-inflamm chemicals by mast cells – allergic reaction
- can be acute urticaria / autoimmune reaction or chronic idiopathic

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20
Q

what can cause acute urticaria?

A

specifically triggered by something that stiulates mast cells to release mast cells:
- allergies to food, medications, animals
- contact with chemicals, latex, stinging nettles
- medications
- viral infections
- insect bites
- dermographism

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21
Q

what is dermographism?

A

rubbing of the skin

22
Q

what can cause chronic idiopathic urticaria?

A

autoimmune – autoAB target mast cells and trigger them to release histamines and other chemical
- chronic idiopathic: no clear cause

23
Q

what can cause chronic inducible urticaria?

A

autoimmune – autoAB target mast cells and trigger them to release histamines and other chemical
sunlight, temp changes, exercise, strong emotions, hot/ cold weather, pressure (dermatographism)

24
Q

what autoimmune conditions are linked to chronic urticaria?

A

systemic lupus

25
Q

how do you manage chronic urticaria?

A

fexofenadine in chronic

26
Q

what can be used to manage acute urticaria?

A

oral pred

27
Q

what management can be used in problematic urticaria?

A
  • problematic: anti-leukotrienes eg montelukast, omalizumab (targets IgE), cyclosporin
28
Q

what are the 6 viral rashes in paeds?

A
  1. measles
  2. scarlet fever
  3. rubella aka german measles
  4. dukes disease
  5. parvovirus B19
  6. roseola infantum
29
Q

how is measles spread?

A

highly contagious by resp droplets

30
Q

what symptoms may arise with measles?

A
  • fever, coryzal symptoms and conjunctivitis
    kolpik spots
31
Q

what are kolpik spots?

A

in measles
- kolpik spots: grey-white spots on buccal mucosa (appear 2days after fever), rash starts on face and then behind ears 3-5days following fever

32
Q

how do you manage measles?

A

self resolving after 7-10days
- need to isolate 4days until symptoms resolve

33
Q

who needs to be notified of measles?

A

PHE

34
Q

how common are measles complications?

A

30% of pt develop a complication

35
Q

what complications can arise form measles?

A
  • pneumonia
  • diarrhoea
  • dehydration
  • encephalitis
  • meningitis
  • hearing loss
  • vision loss
  • death
36
Q

what causes scarlet fever?

A

group A strep, usually tonsilitis
- produced by exotoxin produced by strep.pyogenes

37
Q

how does scarlet fever present?

A
  • red pink, blotchy macular rash with rough sandpaper skin – starts on trunk and spreads outwards
  • red flushed cheeks
  • other symptoms: fever, lethargy, flushed face, strawberry tongue, cervical lymphadenopathy
38
Q

how do you manage scarlet fever?

A

phenoxymethylpenicillin (PenV) for 10 days
- notifiable disease – needs PHE
- children need kept off school until 24hrs after starting AB

39
Q

what are complications of group A strep?

A

post-strep glomerulonephritis, acute rheumatic fever

40
Q

how does rubella spread?

A

highly contagious and spread by resp droplets – symptoms 2wks after exposure

41
Q

how does rubella present?

A
  • presents with milder erythematous macular rash, starts on face and spreads to rest of body
  • rash lasts 3day
  • other symptoms: mild fever, joint pain, sore throat, lymphadenopathy
42
Q

how is rubella managed?

A

supportive and self limiting
- need PHE notifying
- children need to stay off school for at least 5days following rash appearing
- children must avoid pregnant women

43
Q

rubella complications are rare, but what are they?

A

: are rare
- thrombocytopenia and encephalitis
- dangerous in preg and can lead to congenital rubella syndrome  triad of blindness, deafness and CHD

44
Q

what is duke’s disease?

A

known as fourth disease
- similar to rubella
- non-specific viral rah

45
Q

what is roseola infantum?

A

known as 6th disease caused by human herpesvirus 6 (HHV-6) and less freq by HHV-7

46
Q

how does roseola infantum present?

A
  • presents 2wks after infection with high fever that comes on suddenly and lasts 3-5dayd then disappears suddenly
  • can be coryzal symptoms, sore throat, swollen lymph node, after fever rash appears  mild erythematous macular rash on arms and legs, trunk, face and not itchy
47
Q

what are complications of roseola?

A

febrile convulsions due to high temp
- immunocompromised pt may be at risk of myocarditis, thrombocytopenia and GBS

48
Q

what is likely to cause neonatal conjunctivitis?

A

gonococcal infection from mother

49
Q

what is management of neonatal conjuctivits?

A

urgent ophthalmology assessment

50
Q

what are complications of neonatal conjunctivitis?

A

blindness

51
Q
A

paeds (10 decks)

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