Derm - Infections & Systemic Flashcards
Try to think of the major childhood infections:
- Impetigo
- Molluscum Contagiosum
- Warts
- Viral Exanthems
e. g. Chicken pox, slapped cheek and Hand, Foot & Mouth disease
Define Impetigo?
An acute superficial bacterial infection caused by Staph Aureus
What would impetigo look like?
Honey coloured crusted lesions, often on face
Pustules
How would you treat impetigo?
With Abx:
- Topical (Fucidin)
- Oral (Flucloxacillin)
What does molluscum Contagiosum look like?
Pearly nodules with umbilicated centre
What causes Mollusucum Contagiosum and how do we treat it?
Molluscipox Virus
Self limiting so just reassurance mostly (24 months to clear)
Can use 5% Potassium Hydroxide
What causes viral warts?
HPV
How do you treat viral warts?
SElf-limiting (24 months avg)
- Reassurance
- Cryotherapy
- Topical paints (Salicylic Acid)
What is a viral exanthem?
A widespread rash caused by a viral illness e.g. chicken pox
What causes Chiken pox and how is it transmitted?
Primary VZV infection
Contagious from:
- 1-2days before rash appears
- Until lesions have crusted
What does chicken pox look like?
Red papules –> Vesicles
Itchy
Starts on trunk
+Viral symptoms e.g. runny nose, fever etc
How do you manage chicken pox?
It’s self-limiting so just infection control i.e. keep out of nursery
What are the rare complications of chicken pox?
encephalitis
Pneumonia
What causes Slapped Cheek?
Parvovirus B19 target Red cells in the marrow
What does Slapped Cheek Look like?
A red rash on face
Progresses to a lace-like network rash on the trunk/limbs
+ Viral Symptoms
How do we manage Slapped Cheek?
Self-limiting so mostly just reassure (takes up to 6wks to fade)
Complications of slapped cheek?
Aplastic Crisis (if haemolytic)
Risk to pregnant women of abortion, IUD & Hydrops Fetalis
What causes hand, foot and mouth disease?
Coxsackie Virus A16
What does H, F & M look like?
Blisters on the hand, foot and mouth
+ viral symptoms
How do we manage H, F & M?
SElf-limiting like the other viral exanthems
Just give supportive therapy
What are the major systemic skin conditions in kids?
- Orofacial Granulomatosis ass with crohn’s
- Dermatitis Herpetiformis ass with Coeliac
Erythema Nodosum (ass with IBD)
Urticaria
What does Orofacial granulomatosis look like?
Lip swelling + fissuring
Oral Mucosal lesions with a cobblestone appearance
What could cause erythema nodosum?
- Inf e.g. Strep, mycobacteria or URTI
- Drugs e.g. Penicillin, OCP & Sulphonamides
- Sarcoid
- IBD
- Idiopathic
What does erythema nodosum look like?
Erythematous subcu nodules, mostly on shins
What does Dermatitis Herpetiformis look like?
ITchy clusters of blisters
Often symmetrical
Scalp, shoulder, buttock, knee and elbow
How do you test for an treat Dermatitis Herpetiformis?
Confirm Coeliac:
- HLA test
- Distal Duodenal Biopsy
- Skin Biopsy
Emollients and topical steroids
Dapsone (abx)
Gluten restriction
Finally what does urticaria look like?
Red rash that rises and fall rapidly (minutes up to 24 hours)
+~10% get angioedema
What can cause urticoaria?
Chronic is mostly idiopathic (prob autoimmune)
Acute (<6wk) could be:
- Meds e.g. NSAIDs or Opiates
- Food or Med Allergy
- Viral/Bacterial Inf
- Vaccination
How do you manage Urticaria?
Try removing triggers e.g. meds or foods
1) Antihistamines
2) H2 receptor antagonist (Ranitidine)
3) Montelukast
4) Omalizumab (mAB)
5) Cyclosporin (Immunosuppresant)
