Derm and infection Flashcards
-Dry, red, itchy and sore patches on flexor surfaces (inside elbows and knees)
Eczema
what is the maintenance management of eczema
-Emollients
how are flares of eczema managed
- Thicker emollients
- Topical steroids : mildest - hydrocortisone
‘wet wraps; - Rarely : IV Abx or oral steroids
what is the most common organism to cause infection in eczema
staph aureus
- Previous eczema
- widespread PAINFUL, vescicular rash
- Punched - out erosions
- systemic : fever, lethargy, irritability and reduced oral intake
- lymphadenopathy
eczema herpeticum -> caused by HSV, will need IV aciclovir and paeds referal
- Non specific : fever, cough sore throat, mouth, eyes and itchy skin.
- Later : blistering rash across skin
- Pain, erythema, blistering and shredding of lips and mucous membranes
- Eyes, urinary tract, lungs and internal organs can be affected
Stevens-johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)
Explain. thedifference between SJS and TEN
Both a result of epidermal necrosis
SJS : <10% body surface
TEN : >10%
give 4 medications and 4 infective causes of SJS and TEN
- Medication : penicillin, allopurinol, NSAIDs, COCP, anti-epileptics (lamotrigine, carbamazepine, phenytoin)
- Infections : HSV, mycoplasma pneumonia, cytomegalovirus, HIV
Urticaria : definition , pathophysiology, management
- Superficial swelling of the skin
- Pale, pink raised skin (‘hives’, ‘wheals’)
- Caused by histamine release from mast cells
- Managed with antihistamines (fexofenadine) or pred in severe cases
2 causes of impetigo
- Staph aureus
- Strep pyogenes (always non bullous)
- ‘golden’ crusted skin lesions usually around the mouth
Impetigo
Stepwise treatment of impetigo
- Topical 1% hydrogen peroxide for 5 days(non bullous & not systemically unwell)
- Topical 2% fusidic or 2% mupirocin for 5 days if around eyes or above ineffective
- Oral flucloxacillin or clarithromycin if bullous or unwell
Explain school exclusion for impetigo
- Until lesions dry and scab over
- 48 hrs after abx
Explain the steroid ladder
- H : Hydrocortisone (1%)
- E : eumovate (clobetasone)
- A : betnovate (betamethasone)
- D : dermovate (clobetasol)
- Pain, pus, discharge and crusts on existing eczema
- Infected eczema
- Tx with flucloxacillin or clarithromycin)
- Intense itching of hands, wrists and inter-digital webs
- Worse at night
- Disseminated erythematous papules and thin, brown-grey lines 0.2-1cm in length
scabies -> saroptes scabiei
How is scabies managed
- Permethrin 5% cream for everyone in household
- Wash everything >50 degress
what causes anaphylaxis
severe type 1 hypersensitivity
IgE stimulate masts cells to release histamine
how is anaphylaxis managed
- ABCDE
- IM adrenalin (repeat after 5 mins if needed)
Following stabilisation - Antihistamines (chlorphenamine, cetirizine)
how can anaphylaxis be confirmed
measuring serum mast cell trypase within 6 hrs of event
runny, blocked, itchy nose
sneezing
itchy, red, swollen eyes
personal or Fx of atopy
allergic rhinitis - IgE mediated type 1 hypersensitivity reaction
how is allergic rhinitis managed
oral antihistamines
IM adrenaline dose by age
< 6 mnths : 100-150 mcg
6mnths - 6 yrs : 150 mcg
6-12 yrs : 300mcg
>12 : 500mcg
- Port wine stain present from birth
- Grows with infant
- Caused by vascular malformations of capillaries in the dermis
- Tx : laser therapy
Naevus flammeus
white pimples on nose and cheeks
common in newborns
Milia
