derm Flashcards
what is bullous impetigo
superficial blistering skin condition caused by staph a
give flucloxacillin
what happens in albinism to eyes
no fixation reflex because no pigment
pendular nystagmus
photophobia
what is epidermolysis bullosa
genetic condition causing blistering of skin and mucous membranes
can cause fusing of digits following damage and healing
causes of nappy rash
irritant (contact) dermatitis (SPARES THE FLEXURES)
atopic eczema
candida infection
seborrhoeic dermatitis
rare cause - langerhans cell histiocytosis
mx nappy rash
advice - high absorbency nappy, leave nappy off as long as poss, change every 3-4 hours.
wash frequently
mild erythema - barrier preparation at every nappy change (zinc and castor oil)
rash is inflamed - hydrocortisone
if candida - antifungal NO BARRIER PROTECTION
bacterial rash - flucloxacillin
what causes infantile seborrhoeic dermatitis
fungus
features of seb. dermatitis
starts on head (cradle cap) moves down body into flexures NOT ITCHY (unlike eczema)
mx seb dermatitis
ointments to remove crusts
imidazole if persistent
how does atopic eczema present
ITCHY
usually in young children
scratch flexures
most cases resolve in adolescence
mx atopic eczema
mild (small areas of dry skin, infrequent itch, no impact on life) - emollient + hydrocortisone until >48 hours after flare up
moderate - (areas of dry skin, redness, frequent itch, moderate impact on psych wellbeing + sleep) - admit if eczema herpeticum, emollient, moderate steroid til >48 hours after flare (consider calcineurin inhibitor)
severe - bleeding, thickening, oozing, cracking - emollient, potent steroid for flare ups, consider calcineurin inhibitor
bandages - can help with lichenification
anithistamines - if really bad itch
complications of atopic eczema
infected eczema w/ bacteria
eczema herpeticum
mx molluscum
don’t need to tx if immunocompetent (disappears in 18 months)
don’t squeeze papules - makes it worse
don’t share towels
dx of ringworm
find dermatophyte on skin scraping
confrim w/ culture
NB - IF TINEA CAPITIS GIVE SYSTEMIC ORAL ANTIFUNGAL
features of scabies
itch for 2-6 weeks worse at night or in hot weather
in children vesicles + papules between fingers and toes
in infants vesicles + papules on palms and soles
diagnose by viewing burrows
where are viral warts found and what causes them
HPV
on fingers and soles
mx scabies
insecticide to whole body twice two weeks apart
up to ears in child (do face in infants)
advice;
tx members of house
bedding + clothing decontaminated
presentation of guttate psoriasis
oval patches on trunk/limbs after viral or streptococcal ear/throat infection
lasts for 3-4 month
most recur within 3-5 years
mx guttate psoriasis
- phototherapy (narrow band UVB)
2. emollient to reduce itch can add corticosteroid + vit D if scales problematic
features of pityriasis rosea
no known cause
get herald patch (pink) on trunk or limbs then smaller pink patches in fir tree pattern following posterior ribs
NO TX
difference between granuloma annulare and ringworm
G.A has raised flesh coloured non-scaling edge
ringworm has scaling edge
what are open and closed comedones called
open - blackhead
closed - whitehead
advice for acne vulgaris
avoid overcleaning
neutral pH makeups and creams
don’t pick scars
healthy diet
mx mild-moderate acne
mild:
single topical treatment eg. benzyl peroxide or benzyl peroxide + clindamycin
moderate/ unresponsive acne:
consider oral Abx for 3 months
topical retinoid
consider antiandrogens
COCP + topical agents can be used as alternative for systemic treatments in girls
*if 2 courses of abx haven’t worked refer to derm for consider for roaccutane
severe: refer to dermatologist oral isotretinoin high dose oral abx (6 months +) systemic corticosteroids
follow up:
continue tx for 12 weeks if it works
if acne almost cleared can do maintenance w/ topical retinoids
