Derm Flashcards
what is acne?
*chronic inflammatory skin condition affecting mainly the face, back and chest
- Lesions are caused by blockage and inflammation of the pilosebaceous unit in the skin - comedones - increased production of sebum, trapping keratin and causes blockage
what management options are available for acne?
- topical benzoyl peroxide - reduce inflammation, helps unblock skin and toxic to bacteria
- topical retinoids (chemicals related to vitamin A) - slow sebum production, give child bearing aged contraceptions
- oral antibiotics - lymecycline
- oral contraceptive pill - females stabilise hormones and slow production of sebum
- oral retinoids like isotretinoin for severe - highly teratogenic, reducing production of sebum, reducing inflammation and reducing bacterial growth
what are the common patterns of eczema in children?
- Flexural– creases at the elbows, knees, wrists and neck
- Discoid– coin-sized areas of inflammation on the limbs
- Follicular– small circular bumps around hair follicles
how might eczema present?
Infants - generally affected around thescalp, face, and flexures. Hair loss may be noticed where the infant has excessively rubbed their skin
toddlers - increasing age, the distribution of childhood eczema changes. Usually, the distribution becomesflexural
how would you manage eczema?
- bathing with emollients
- moisturisers
- avoid skin trauma
- topical corticosteroids
- topical cacineurin inhibitors
- education
- flares managed with steroids
what is contact dermatitis?
delayed type hypersensitivity reaction in the skin following contact with allergen
why is atopic dermatitis common in children?
- skin thinner
- can absorb more applied substances
- higher surface area to body weight ratio
- more likely to have atopic dermatitis which facilitates sensitisation due to impaired barrier
- newborns and those aged 0-3y
- causes - nickel from piercings, preservatives, fragrance mix, colophonium in tape
how might allergic dermatitis present?
allergic
- red, itchy and scaly skin
- blisters
- in hands, feet, arms, legs and face
- resolution with allergen removal
how might contact dermatitis present?
- dry, peeling skin with bullous eruptions
- well demarcated and rarely spreads
how would you manage atopic dermatitis?
- avoid exposure
- wash with soap and water after contact
- nappy change regularly
- topical corticosteroid, emollient
what is impetigo?
- superficial bacterial skin infection usually caused by staphylococcus aureus - “golden crust”
- occurs when bacteria enter via break in skin
- can be bullies or non
how does impetigo appear on examination?
- non-bullous around nose or mouth with dried exudate appearing like the goden crust, potential systemic illness
- 1-2cm fluid filled vesicles to form on skin —> burst and form golden crust which heal without scarring
what are some complications of impetigo?
- Cellulitis if the infection gets deeper in the skin
- Sepsis
- Scarring
- Post streptococcal glomerulonephritis
- Staphylococcus scalded skin syndrome
- Scarlet fever
- staphylococcus scalded skin syndrome
how is impetigo managed?
- non-bullous
- topical fusidic acid first line, oral flucloxacillin for more widespread
- advice to reduce spread, don’t scratch, hand hygeine, avoid sharing towels, cutlery
- stay off school until healed over or 48h antibiotic treatment
- bullous
- antibiotics - flucloxacillin oral or IV
- isolate where possible
what is psoriasis?
- chronic autoimmune condition that causes recurrent symptoms of skin lesions
- skin lesions caused by rapid generation of new skin cells, resulting in abnormal buildup and thickening of skin
