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Child Health > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Pathophysiology eczema

A

Defects in skin barrier
Entrance for irritants, microbes and allergens
Can stimulate an immune response
Inflammation and associated symptoms

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2
Q

Distribution of eczema

A

Face and trunk in infants
In younger children extensor surfaces
In older children flexor surfaces and creases of face and neck

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3
Q

Management of eczema

A

Avoid irritants
Emollients
Topical steroids
Wet wraps and oral cyclosporine in severe cases

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4
Q

Severe eczema management

A 
Zinc-impregnated bandages
Topical tacrolimus
Phototherapy
Systemic immunosuppressants
Oral corticosteroids
Methotrexate
Azathioprine
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5
Q

Management of eczema flares

A

Thicker emollients
Wet wraps
Treating infections

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6
Q

Eczema trigger

A 
Cold air
Dietary products
Washing powders
Cleaning products
Emotional event or stresses
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7
Q

Thin emollients

A 
E45
Diprobase
Oliatum cream
Aveeno cream
Cetraben cream
Epaderm cream
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8
Q

Thick, greasy emollients

A 
50:50 ointment
Hydromol ointment
Diprobase ointment
Cetraben ointment
Epaderm ointment
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9
Q

Side effects of topical steroids

A

Thinning of skin, more prone to flares, bruising, tearing, stretch marks, enlarged blood vessels (telangiectasia)

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10
Q

Mild steroids topical

A

Hydrocortisone

0.5-2.5%

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11
Q

Moderate topical steroids

A

Betamethasone valerate 0.025% (Betnovate)

Clobetasone butyrate (Eumovate)

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12
Q

Potent topical steroids

A

Fluticasone propionate 0.05% (Cutivate)

Betamethasone valerate 0.1% (Betnovate)

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13
Q

Very potent topical steroids

A

Clobetasol propionate

0.05% (Dermovate)

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14
Q

Eczema herpeticum causes

A 
HSV 1 (more common) or 2
Varicella zoster virus 
Severe primary infection of skin
Seen in children with atopic eczema 
Rapidly progressing painful rash
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15
Q

Presentation of eczema herpeticum

A 
Widespread, painful, vesicular rash
Rapidly progressing rash
Monomorphic punched-out erosions (1-3mm)
Fever, lethargy, irritability, reduced oral intake 
Lymphadenopathy
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16
Q

Management of eczema herpeticum

A

Viral swabs of vesicles

IV aciclovir

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17
Q

Complications of eczema herpeticum

A

Life-threatening

Bacterial superinfection

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18
Q

Psoriasis presentation

A 
Dry, flaky, scaly, rough 
Faintly erythematous skin lesion
Raised plaques
Over extensor surfaces
Elbows, knees, scalp

Rapid generation of new skin cells, abnormal buildup and thickening of skin in those areas

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19
Q

Plaque psoriasis

A

Thickened erythematous plaques with silver scales
Commonly seen on the extensor surfaces and scalp
1cm-10cm in diameter
Most common form of psoriasis in adults

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20
Q

Guttate psoriasis features

A

More common in children and adolescents
Precipitated by a streptococcal infection 2-4weeks prior to lesions appearing

Tear drop papules on trunk and limbs
Turn into plaques over time

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21
Q

Guttate psoriasis management

A

Resolves within 3-4months
Phototherapy
Tonsillectomy
Topical agents

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22
Q

Pustular psoriasis

A

Systemically unwell
Pustules form under areas of skin
Immediate admission to hospital

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23
Q

Erythrodermic psoriasis

A

Extensive erythematous inflamed areas covering most of the surface area of the skin
Skin comes away in large patches
Raw exposed areas
Medical emergency requiring admission

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24
Q

Specific signs associated with psoriasis

A

Auspitz sign: small points of bleeding when plaques are scraped off
Koebener phenomenon: development of psoriatic lesions in areas of skin affected by trauma
Residual pigmentation of skin after lesions resolve

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25
Q

Management of psoriasis

A 
Psychosocial support
Topical steroids
Topical vitD analogue (calcipotriol)
Topical dithranol 
Phototherapy with narrow band UV B light

Specialist: methotrexate, cyclosporine, retinoids, biologic medications

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26
Q

Complications/ associations of psoriasis

A

Nail psoriasis: nail pitting, thickening, discolouration, ridging, onycholysis

Psoriatic arthritis

Psychosocial

CVD: obesity, hyperlipidaemia, HTN, T2DM

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27
Q

Pathophysiology of acne vulgaris

A

Chronic inflammation and swelling in pilosebaceous unit—>form comedones
From Increased production of sebum, trapping of keratin, blockage of pilosebaceous unit
Androgenic hormones increase production of sebum
Propionibacterium acnes bacteria

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28
Q

Features of acne vulgaris

A

Comedones due to a dilated sebaceous follicle: open top is whitehead, closed top is blackhead

Follicle bursts releasing irritants: papules, pustules

Excessive inflammatory response: nodules, cysts

Scarring: ice pick scars, hypertrophic scars, rolling scars

Drug-induced acne is monomorphic
Acne fulminans: systemic upset, hospital admission, oral steroids

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29
Q

Classification of acne vulgaris

A

Mild: open and closed comedones with/without sparse inflammatory lesions
Moderate: widespread non-inflammatory lesions and numerous papules and pustules
Severe acne: extensive inflammatory lesions, nodules, pitting, scarring

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30
Q

Management of acne vulgaris

A

Single topical therapy: topical retinoids, benzoyl peroxide

Topical combination therapy: topical antibiotics (clindamycin), benzoyl peroxide, topical retinoid

Oral antibiotics or COCP

Oral isoretinoin

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31
Q

Topical benzoyl peroxide acne

A

Reduces inflammation
Helps unblock skin
Toxic to P.acnes bacteria

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32
Q

Topical retinoids acne

A

Chemicals related to vitamin A

Slows production of sebum

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33
Q

Oral antibiotics acne

A

Tetracyclines: lymecycline
Contraindicated in pregnancy/ breast feeding/ <12
Erythromycin used in pregnant
Use for 3 months maximum

Always prescribe with topical retinoid or benzoyl peroxide to prevent resistance

Complications of long-term ax use: gram-negative folliculitis, treat with high dose oral trimethoprim

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34
Q

COCP acne

A

Dianette (co-cyrindiol)
Increases VTE risk
Only give for 3 months, second-line

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35
Q

Oral isoretinoin acne

A

Last-line options
Pregnancy is a contraindication,Need contraception
Roaccutane

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36
Q

Side effects of oral isoretinoin

A

Dry skin and lips
Photosensitivity of skin to sunlight
Depression, anxiety, aggression, suicidal ideation
Stevens-Johnson syndrome and toxic epidermal necrolysis

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37
Q

Human papilloma virus

A

Infects keratinocytes of skin and mucous membranes
Carcinogenic

6&11 genital wards
16&18 cancer, cervical cancer

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38
Q

HPV vaccination

A

12-13year olds in year8 will be offered 2 doses
Daughter may receive vaccine against parental wishes
Protects against 6,11,16,18

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39
Q

Management of genital warts

HPV

A

First line
Multiple, non-keratinised warts: topical podophyllum
Solitary, keratinised warts: cryotherapy

Second line:
Imiquimod topical cream

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40
Q

Impetigo

A

Superficial bacterial infection
Staphylococcal aureus bacteria or strep pyogenes
Complication of eczema, scabies or insect bites
Common in children in warm weather
Contagious, need school exclusion until lesions are crusted and healed or 48hours after antibiotic treatment

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41
Q

Impetigo features

A

Face, flexures and limbs not covered by clothing

Golden crust, around mouth

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42
Q

Impetigo spread

A

Direct contact with discharged from the scabs of an infected person
Spreads by scratching to other sites
Incubation 4-10days

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43
Q

Non-bullous impetigo

A

Typically occurs around nose or mouth
Systemically well
Golders crust from dried exudate

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44
Q

Management of non-bulbous impetigo

A

Antiseptic cream (hydrogen peroxide 1%) first line

Second line topical antibiotic creams:
Topical fusidic acid
Topical mupirocin if resistant

Extensive disease:
Oral flucloxacillin
Oral erythromycin is penicillin-allergic

School exclusion:
Until lesions are crusted and healed
Until 48 hours after ax treatment

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45
Q

Bullous impetigo

A

Staphylococcus aureus infection
Epidermolytic toxins that break down proteins that hold skin cells together
Vesicles-> exudate
More common in <2s and neonates
Systemic symptoms
If severe: staphylococcal scalded skin syndrome
Swabs of vesicles

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46
Q

Treatment of bullous impetigo

A

Flucloxacillin

Oral/IV

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47
Q

Complications of impetigo

A 
Cellulitis
Sepsis
Scarring
Post-streptococcal glomerulonephritis 
Staphylococcal scalded skin syndrome
Scarlet fever
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48
Q

Staphylococcal scalded skin syndrome

A

Caused by staph aureus which produces epidermolytic toxin (protease)
Breaks down proteins that hold skin cells together
Usually affects <5 years old
Older children and adults usually have immunity

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49
Q

Presentation of staphylococcal scalded skin syndrome

A

Patches of erythema on skin
Skin looks thin and wrinkled
Formation of fluid filled blisters called bullae, which burst and leave sore, erythematous skin below
Similar appearance to burn or scald

Nikolysky sign: gentle rubbing of skin causes it to peel away
Systemic symptoms: fever, irritability, lethargy, dehydration

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50
Q

Management of staphylococcal scalded skin syndrome

A

Admission and treatment with IV ax
Fluid and electrolyte balance as patients are prone to dehydration
Children usually make a full recovery without scarring with adequately treated

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51
Q

Steven-Johnson syndrome and toxic epidermal necrolysis

A 
Disproportional immune response
Epidermal necrolysis I
Blistering and shedding of top layer of skin 
SJS <10% surface area affected
TEN: >10% surface area affected 
HLA genetic
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52
Q

Causes of Steven-Johnson syndrome and toxic epidermal necrolysis

A 
Medications: 
Anti-epileptic 
Antibiotics
Allopurinol
NSAIDs
Infections: 
Herpes simplex
Mycoplasma pneumoniae
CMV
HIV
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53
Q

Presentation of Steven Johnson syndrome

A

Maculopapular rash with target lesions
Develop into vesicles or bullae
Mucosal involvement
Fever, arthralgia

Purple/red rash that spreads and blisters
Skin sheds
Pain, erythema, blistering and shedding lips and mucous membranes
Eyes inflamed and ulcerated
Urinary tract, lungs and internal organs involvement

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54
Q

Toxic epidermal necrolysis presentation

A

Systemically unwell, pyrexia, tachycardia
Positive Nikolysky sign: epidermal separates with mild lateral pressure

Purple/red rash that spreads and blisters
Skin sheds
Pain, erythema, blistering and shedding lips and mucous membranes
Eyes inflamed and ulcerated
Urinary tract, lungs and internal organs involvement

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55
Q

Management of SJS and TEN

A 
Medical emergencies
Nutritional
Antiseptics
Analgesia
Ophthalmology input
Steroids
Immunosuppressants: cyclosporine and cyclophosphamide 
Immunoglobulins
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56
Q

Complications of SJS TEN

A

Secondary infection
Permanent skin damage
Visual complications: scarring and blindness

57
Q

Two types of contact dermatitis

A

Irritant contact dermatitis
Allergic contact dermatitis

Caused by cement

58
Q

Irritant contact dermatitis

A

Non-allergic
Due to weak acids or alkalis
Often seen on the hands
Erythema is typical, crusting and vesicles are rare

59
Q

Allergic contact dermatitis

A

TY4 hypersensitivity reaction
Often seen on head following hair dyes
Presents as acute weeping eczema which predominantly affects the margins of the hairline
Topical treatment with potent steroids

60
Q

Viral exanthem

A 
Eruptive widespread rash 
First disease: measles
Second disease: scarlet fever
Third disease: rubella
Fourth disease: Duke’s disease
Fifth disease: parvovirus B19
Sixth disease: roseola infantum
61
Q

Measles exposure

A

Symptoms start 10-12days after exposure
Respiratory droplet spread
Measles virus
Face rash 3-5days after fever

62
Q

Measles features

A

Fever, coryzal symptoms, conjunctivitis
Koplik spots 2 days after fever
Rash behind ears ten to rest of body, erythematous macular rash with flat lesions

63
Q

Measles management

A

Self resolving after 7-10days
Isolate children until 4 days after symptoms have resolved
Notifiable disease

64
Q

Complications of measles

A 
Pneumonia
Diarrhoea
Dehydration
Encephalitis
Meningitis
Hearing loss
Vision loss
Death
65
Q

Scarlet fever transmission and cause

A

Cause: Group A streptococcus (tonsilitis)

Step pyogenes exotoxin

66
Q

Scarlet fever features

A 
Red-pink blotchy macular rash 
Sandpaper skin that starts on trunk and spreads outwards
Red, flushed cheeks
Fever
Lethargy
Flushed face
Sore throat
Strawberry tongue
Cervical lymphadenopathy
67
Q

Scarlet fever management

A

Phenoxymethylpenicillin (Penicillin V) 10 days
Notifiable disease
Keep children off school until 24hours of antibiotics

68
Q

Conditions associated with group A strep infections

A

Scarlet fever
Post-streptococcal glomerulonephritis
Acute rheumatic fever

69
Q

Rubella transmission

A

Rubella virus
Highly contagious
Spread by resp droplets
Symptoms start 2 weeks after exposure

70
Q

Rubella features

A

Symptoms start 2 weeks after exposure
Milder erythematous macular rash compared with measles
Rash starts on face and spreads to rest of body
Lasts 3 days
Mild fever, joint pain, sore throat
Lymphadenopathy behind ears and back of neck

71
Q

Rubella management

A

Supportive and self-limiting
Notifiable disease
Children stay off school for 5 days after rash appears
Children should avoid pregnant women

72
Q

Complications of rubella

A

Thrombocytopenia
Encephalitis
Dangerous in pregnancy-> congenital rubella syndrome (deafness, blindness, congenital heart disease)

73
Q

Dukes disease

A

Non-specific viral rashes

74
Q

Parvovirus B19

A

Fifth disease, slapped cheek syndrome, erythema infectiosum

75
Q

Symptoms of parvovirus B19

A

Mild fever, coryza, non-specific viral symptoms (muscle aches and lethargy)
After 2-5 days rash appears rapidly, diffuse bright red rash on both cheeks
Reticular (net-like) mildly erythematous rash affecting trunk and limbs, raised and itchy

76
Q

Management of parvovirus B19

A

Self-limiting
Symptoms fade over 1-2weeks
Supportive management, fluids, simple analgesia
Infectious prior to rash forming, once rash formed no longer infectious

77
Q

Patients at risk of complications of parvovirus infection

A 
Immunocompromised patients
Pregnant women
Sickle cell anaemia
Thalassaemia
Hereditary spherocytosis 
Haemolytic anaemia

These patients need serology testing to confirm diagnosis
Check FBC, reticulocyte count for aplastic anaemia

78
Q

Complications of parvovirus infection

A

Aplastic anaemia
Encephalitis or meningits
Pregnancy complications including fetal death
Rarely hepatitis, myocarditis, nephritis

79
Q

Roseola infantum

A

Sixth disease
Human herpesvirus6
Human herpesvirus7

80
Q

Roseola infantum presentation

A

Typical pattern of illness
Presents 1-2weeks after infection with a high fever (up to 40degrees), lasts 3-5 days then disappears suddenly
Coryzal symptoms, sore throat, swollen lymph nodes during the illness
Fever settles and rash appears for 1-2days
Mild erythematous macular rash across the arms, legs, trunk and face is not itchy

81
Q

Management of roseola infantum

A

Children make full recovery within a week and don’t generally need to be kept off nursery if they are well enough to attend

82
Q

Complication of roseola infantum

A

Febrile convulsions: high temperatures

Immunocompromised patients at risk of myocarditis, thrombocytopenia, Guillian-Barre syndrome

83
Q

Erythema multiforme

Causes and associations

A

Erythematous rash caused by hypersensitivity reaction
Causes: viral infections, medications
Associations: herpes simplex virus, mycoplasma pneumoniae

84
Q

Erythema multiforme presentation

A

Widespread, itchy, erythematous rash
Target lesions
Sore mouth; stomatitis
Symptoms come on abruptly over a few days, mild fever, stomatitis, muscle and joint aches, headaches, general flu-like symptoms

85
Q

Erythema multiforme management

A 
Diagnosis based on appearance of rash 
Identify underlying cause
CXR for mycoplasma pneumoniae
Self resolves 1-4qeeks 
Severe: IV fluids, analgesia
86
Q

Pathophysiology of urticaria

A

Caused by release of histamine and mast cells
Allergic reaction in acute urticaria
Autoimmune reaction in chronic idiopathic urticaria

87
Q

Causes of acute urticaria

A

Allergies to food, medications or animals
Contact with chemicals, latex or stinging nettles
Medications
Viral infections
Insect bites
Dermatographism

88
Q

Chronic urticaria types

A

Chronic idiopathic urticaria
Chronic inducible urticaria
Autoimmune urticaria

89
Q

Chronic idiopathic urticaria

A

Recurrent episodes of chronic urticaria without a clear underlying cause or trigger

90
Q

Chronic inducible urticaria

A

Episodes of chronic urticaria that can be induced by certain triggers
Sunlight, temperature changes, exercise, strong emotions, hot or cold weather, pressure (dermatographism)

91
Q

Autoimmune urticaria

A

Chronic urticaria associated with a chronic autoimmune condition

92
Q

Management of urticaria

A

Fexofenadine (antihistamine)

Short course of oral steroids for severe flares

93
Q

Management of problematic urticaria

A

Anti-leukotrienes (montelukast)
Omalizumab (IgE)
Cyclosporin

94
Q

Chickenpox presentation

A

Widespread, erythematous, raised, vesicular (fluid-filled) blistering lesions
Rash starts on trunk/face and spreads outwards
Whole body by day 2-5
Scab over and stop being contagious
Fever
Itch
Malaise and fatigue

95
Q

Chickenpox infectivity

A

Highly contagious
Infected droplets from a cough or sneeze
Patients become symptomatic 10days to 3weeks after exposure
Stop bring infectious once lesions have crusted over

96
Q

Chickenpox complications

A 
Bacterial superinfection
Dehydration
Conjunctival lesion
Pneumonia
Encephalitis (ataxia)
Shingles
97
Q

Antenatal and neonatal chickenpox

A

If not immune, give pregnant women varicella zoster immunoglobulin
In pregnancy, congenital varicella syndrome in baby if <28weeks gestation
Infection around delivery time: management with varicella zoster immunoglobulins and aciclovir

98
Q

Management of chickenpox

A

Aciclovir: in immunocompromised, >14 presenting in <24hours, neonates, those at risk of complications
Encephalitis: need admission
Itching: calamine lotion and chlorphenamine (antihistamine)
Off school and avoid pregnant women until lesions have crusted over, 5 days after rash first appears

99
Q

Hand foot and mouth disease presentation

A

Coxsackie A virus
3-5 days incubation
URT symptoms: tiredness, sore throat, dry cough, raised temperature
Small mouth ulcers after 1-2 days
Then blistering red spots around body, hands feet mouth (painful)

100
Q

Management hand foot mouth disease

A

Supportive
Resolves 7-10days
Avoid sharing towels and bedding, washing hands and careful handling of dirty nappies

101
Q

Complications of hand, foot and mouth disease

A

Dehydration
Bacterial superinfection
Encephalitis

102
Q

Molluscum contagiosum features

A

Small, flesh coloured papules
Central dimple
Crops of multiple lesions in an area
Spread through contact, sharing bedsheets

103
Q

Molluscum contagiousum management

A

Resolves spontaneously
Can take up to 18months to resolve
Once resolved skin returns to normal
Avoid scratching or picking at lesions

104
Q

Management molluscum contagiousum

A

Avoid sharing towels or close contact with lesions
If bacterial superinfection: superficial fusidic acid or oral flucloxacillin
Immunocompromised patients: specialist referral, topical potassium hydroxide, benzoyl peroxide, podophyllotoxin, imiquimod, retinoin. Surgical removal and cryotherapy

105
Q

Pityriasis rosea presentation

A

Prodromal symptoms prior to rash developing
Headache, tiredness, loss of appetite, flu-like symptoms
Herald patch (faint red, scaly, oval) >2cm diameter on torso
2days later rest of rash appears
Christmas tree rash on torso
Lesions grey or lighter if darker skin
Itch, pyrexia, headache, lethargy

106
Q

Pityriasis rosea disease course

A

Rash resolves without treatment within 3 months

Skin discolouration resovled in another few months

107
Q

Pityriasis rosea disease course

A

Patient education and reassurance
Not contagious, can resume normal activities
Symptomatic treatment if bothered by itching
Emollients, topical steroids, sedating antihistamines at night to help sleep

108
Q

Scabies

A

Sarcoptes scabiei mites burrow under skin and cause infection and intense itching
Lay eggs in skin, further infection and symptoms
8 weeks for symptoms/rash to appear after initial infection

109
Q

Scabies presentation

A

Itchy small red spots
Track marks where mites have burrowed
Location of rash is between finger webs, can spread to whole body

110
Q

Scabies management

A 
Permethrin cream 
If difficult to treat: oral ivermectin 
Treat household contacts 
Hot wash 
Itching 4 weeks after infecton resolved, crotamitron cream, chlorphenamine at night
111
Q

Crusted scabies

A 
Norwegian scabies 
Infection in immunocompromised patients
Scaly plaques
No itch 
Oral ivermectin and admission/isolation
112
Q

Head lice

A

Pediculus humanus capitis parasites
Cause infestations of scalp
Itchy sca,lp

113
Q

Head lice management

A

Dimeticone 4% lotion to hair left overnight then washed off, 7 day
Bug buster kit, special combs

114
Q

DD non-blanching rash

A 
Meningococcal septicaemia 
HSP
Idiopathic thrombocytopenic purpura 
Acute leukaemia
Haemolytic uraemic syndrome: oliguria, presents in child with recent gastroenteritis 
Mechanical: strong coughing, SVC obstruction, vomiting, breath holding
Viral illness: influenza, enterovirus
Traumatic
115
Q

Erythema nodosum

A

Red lumps across shins
Inflammation of subcutaneous fat on shins (panniculitis)
Hypersensitivity reaction

116
Q

Erythema nodosum hypersensitivity reaction causes

A 
Streptococcal throat infections
Gastroenteritis 
Mycoplasma pneumoniae
Tuberculosis
Pregnancy
COCP
117
Q

Erythema nodosum chronci disease associations

A

IBD
Sarcoidosis
Lymphoma
Leukaemia

118
Q

Erythema nodosum investigations

A

Inflammatory markers
Throat swab for strep infection
CXR: mycoplasma, TB, sarcoidosis, lymphomas
Stool microscopy and culture: campylobacter, salmonella
Faecal calprotectin for IBD

119
Q

Management of erythema nodosum

A

Rest and analgesia
Conservative management
Steroids for inflammation
Most cases will fully resolve in 6 weeks

120
Q

Seborrhoeic dermatitis

A

Inflammatory skin condition that affects the sebaceous glands
Scalp, nasolabial folds and eyebrows
Causes erythema, dermatitis and dry crusted skin
Cradle cap
Malassezia yeast

121
Q

Infantile seborrheic dermatitis

A

Cradle cap, crusted flaky scalp
Self-limiting condition and resolves by 4 months of age, can last until 12 months
First line: oil, brush scalp, white petroleum jelly overnight,
Second line: antifungal clotrimazole, miconazole for up to 4 weeks

122
Q

Seborrheic dermatitis of the scalp

A

Dandruff
Dense oily scaly brown crusting
More common in adolescents and adults
First line: ketoconazole shampoo, topical steroids if severe itching

123
Q

Seborrheic dermatitis of face and body

A

Red, flaky, crusted, itchy skin
Commonly affects eyelids, nasolabial folds, ears, upper chest, back
First line treatment: clotrimazole or miconazole antifungal cream, hydrocortisone 1% for localised inflamed areas

124
Q

Tinea capitis

A

Ringworms affecting scalp

More common in children

125
Q

Tinea pedis

A

Ringworm affected feet
Athletes foot
White or red, flaky, cracked, itchy patches between the toes
Skin may split and bleed

126
Q

Tinea cruris

A

Ringworm of groin

127
Q

Tinea corporis

A

Ringworm on body

128
Q

Onychomycosis

A

Fungal nail infection

Thickened, discoloured and deformed nails

129
Q

Name of fungus causing ringworm

A

Trichophyton

130
Q

Ringworm presentation

A

Itchy rash

Erythematous, scaly, well demarcated

131
Q

Management of ringworm

A

Clotrimazole and miconazole antifungal creams
Ketoconazole shampoo for tinea capitis
Oral antifungal: fluclonazole, griseofulvin, itraconazole
Fungal nail infections: amorolfine nail lacquer for 6-12months, oral terbinafine after checking LFTs
Daktacort: hydrocortisone 1% and miconazole 2%

132
Q

Ringworm advice

A

Wear loose breathable clothing
Keep affected areas clean and dry
Avoid sharing towels, clothes or bedding
Use a separate towel for feet with tinea pedis
Avoid scratching and spreading to other areas
Wear clean dry socks every day

133
Q

Tinea incognito

A

Fungal skin infection that results from the use of steroids to treat an initial fungal infction
Steroids slow down immune response, allowing fungus to grow
Less dermarcated border and less scales

134
Q

Nappy rash

A 
Contact dermatitis 
Friction between skin and nappy
Contact with urine and faeces 
Common 9-12months of age
Added fungal (candida), bacteria (staph/strep) infection
135
Q

Risk factors for nappy rash

A

Delayed changing of nappies
Irritant soap products and vigorous cleaning
Poorly absorbent nappies
Diarrhoea
Oral antibiotics predispose to candida infection
Pre-term infants

136
Q

Nappy rash presentation

A

Sore, red, inflamed skin in nappy area
Skin creases spared
Red papules
Erosions and ulceration eventually

137
Q

More likely candida than nappy rash

A 
Rash extending into skin folds
Larger red macules
Well-dermarcated scaly border
Circular pattern to the rash spreading outwards, similar to ringworm 
Satellite lesions
Oral thrush
138
Q

Management of nappy rash

A

Switch to highly absorbent nappies
Change nappy and clean skin as soon as possible
Use water or gentle products
Ensure nappy area is dry before replacing nappy
Maximise time not wearing nappy

139
Q

Complications of nappy rash

A

Candida infection: clotrimazole cream or miconazole
Cellulitis
Jacquet’s erosive diaper dermatitis
Perianal pseudoverrucous papules and nodules

Child Health (20 decks)

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