Dermatology Flashcards
I cause the following:
- Itchy skin in the elbow flexor, back of the knees
- I can spread to other body parts like the neck and face
- I cause lichenification of the skin which are thicker.
- I can cause exudation
WHAT AM I?
ECZEMA
What is my triad classification? (ECZEMA)
Includes atopic eczema, asthma, and allergies
How do you manage me (eczema)?
- Emmolients: Epimax cream
- Steroids:
Mildly potent — hydrocortisone 0.1%, 0.5%, 1.0%, and 2.5%.
Moderately potent — Betamethasone valerate 0.025% (Betnovate-RD®) and clobetasone butyrate 0.05% (Eumovate®).
Potent — Betamethasone valerate 0.1% (Betnovate®) and betamethasone dipropionate 0.05% (Diprosone®).
Very potent: Clobetasol propionate (0.05%) Dermovate
Mild eczema: Emmolients and mildly potent steroid
Moderate eczema: Emmolients, Moderate potent steroid, Topical calcineurin inhibitors (control flares)
Severe eczema: Emmolients, potent steroid, Topical calcineurin inhibitors, Oral corticosteroids, bandages, phototherapy
I cause the following:
- Harmless skin condition
- Scaly skin
- Affects the head, face of the skin
- Painless and non-itchy
WHAT AM I?
CRADLE CAP
How do you manage me (Cradle cap)
- Massage with emmolient to loosen scaly skin
- Gently brush with soft brush on scalp to remove the debris with shampoo lightly.
- Clears up 6 - 12 months
I cause the following:
- Irritation due to poop and pee
- Frequent rubbing of the nappy and skin
- Alcohol baby wipes makes me worse
- I cause red bumps, patchy rashes in the bum, groin area
WHAT AM I?
NAPPY RASH
How do you manage me (Nappy rash)?
- Change wet or dirty nappies as soon as possible.
- Bath your baby daily
- Leave their nappy off for as long and as often as you can to let fresh air get to their skin.
- Nappy rash usually clears up after about 3 days if you follow this advice.
- If there is mild erythema and the child is asymptomatic: Advise on the use of a barrier preparation to protect the skin OTC Zinc and Castor Oil ointment.
- If rash appears inflamed and is causing discomfort: For children over 1 month of age, consider prescribing topical hydrocortisone 1% cream once a day.
- Persistent rash and candidal infection topical imidazole cream
- If bacterial infection suspected Prescribe oral flucloxacillin for seven days. If allergic prescribe Oral Clarithromycin
I cause the following:
- Raised rash
- Itchy rash
- Usually starts when you come into contact with allergen like food, pollen and insect bites.
WHAT AM I?
URTICARIA- HIVES
How do you manage me (Urticaria Hives)
- Avoid the trigger, self limiting without treatment
- Persistent rash: Offer a non-sedating antihistamine Cetirizine for 6 weeks
- Severe symptom prescribe Prednisolone 40 mg daily for up to 7 days
- If first line treatments are inadequate, Prescribe a topical antipruritic treatment calamine lotion or topical menthol 1% to relieve itch.
- Prescribe sedative antihistamine Chlorphenamine at night, if itch is interfering with sleep
- Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) to identify further and check if patient has vasculitic Urticaria
I cause the following:
- Red blotches, mainly affecting the face and body (trunk)
- Little, raised spots called papules
- Little pus-filled spots (pustules) or fluid-filled small blisters (vesicles)
- The baby appears well and the rash does not seem to cause any bother
- I commonly occur in new borns
WHAT AM I?
ERYTHEMA TOXICUM (Newborn rash)
How do you manage me (Erythema toxicum)?
Self limiting and usually resolves
Avoid over-washing the baby - babies have delicate skin that can dry out easily with detergents
Resist any temptation to pick, squeeze or burst any pus-filled spots (pustules).
Typically, the rash lasts for a few days only and can last 6 weeks
I cause the following:
- Tends to start on the hands and feet but spreads
- Bulls eye rash, Dark red centre with blister or crusty look, Surrounded by a pale ring centre
- causes headache, swollen lips, inside of the mouth covered in crust.
- Sesitive to light
- slightly itchy
- Ususally fades after 2 weeks
- patches may join and form large areas
WHAT AM I?
ERYTHEMA MULTIFORME
What am I caused by? (Erythema Multiforme)
Cause is unknown however usually after the result to a medication reaction or infection.
- Common causes:
- Herpes
- Antibiotics such as tetracycline, Amoxicillin, Ampicillin
- Nsaids (Ibuprofen)
- (Anticonvulsants Phenytoin)
How do you treat me (Erythema Multiforme)
- Stop all medications triggering symptoms
- Antihistamines and emmolients to reduce ithc
- Steroid cream to reduce inflammation
- Oral acyclovir for patients with coexisting or recent HSV infection
- Pain killers
- Antivirals if viral infection is a causation
- Anaestetic mouth wash
- The condition may take up to three weeks to resolve
I cause the following:
- Flu like symptoms
- High fever of over 38 degrees
- Headache
- Joint pain
- A cough
- After a few days a rash appears looks like a target
- Not usually itchy
- Large blisters develop and occur from mouth to anus
WHAT AM I?
STEVEN JOHNSONS SYNDROME
What am I caused by? SJS
- Usually triggered by a viral infection such as mumps, flu, epstein barrs virus causes glandular fever
- Adverse reaction to medication like: Allopurinol, carbamazepine, Lamotrigine
How do you manage me SJS?
- Intensive care unit admission
- Strong pain killers, Cool moist compress
- Unscented moisturiser
- Nasogastric tube for fluid replacement
- Antiseptic mouthwash
- Short course steriod
- Antibiotics (Sepsis treatment)
I cause the following:
- I usually affect under 5
- A skin rash
- Swollen glands neck
- Dry red cracked lips
- Strawberry tounge, swollen bump
- Red inside the mouth and back of the troat
- Red eyes, bilateral conjunctival injections
WHAT I AM?
KAWASAKI DISEASE
What am I caused by (Kawasaki Syndrome)
Idiopathic self limiting vasculitis
How do you manage me (Kawasaki disease)
- IVIG - Intravenous immunoglobulin: Reduces coronary artery aneurysms.
- Aspirin: Provides antipyretic and antiplatelet effect
I cause the following:
Non specific symptoms which can be flu like
high fever 39
sunburn type rash widespread that can peel in large portions
hypotension
Diarrhoea, nausea and vomiting
WHAT AM I?
TOXIC SHOCK SYNDROME
What are the causes of Toxic Shock Syndrome?
staphylococcus or streptococcus bacteria going deep inside the body releasing toxins
Skin wounds or burns
tampon use
respiratory infection
How do you manage me (Toxic shock syndrome)
- Remove any wound packing, tampon and focus on infection site.
- Fluids for hemodynamically unstable patients
- Purified antibodies that have been taken out of donated blood, known as pooled immunoglobulin
- Antibiotics such as Cephlasporin or vancomycin with Clindamycin
- Steroids to manage inflammation
I cause the following:
Raised red marks on the skin
I usually appear in the first few weeks after birth
I am caused by a collection of blood vessels
I stop growing around 6-10 months and then start to shrink
WHAT AM I?
HAEMANGIOMAS
How am I managed (Haemangiomas)
Most infants do not need treatment Area should be kept washed and dried Paracetamol for pain relief If it is ulcerated or infected antibiotics may be provided long term beta blocker propranolol
I cause the following:
Bacterial infection in the dermis
Usually affect the lower leg
Pain, swelling, warmth, swelling, erythema
Fever, malaise, nausea may occur
Usually can happen after a skin trauma or ulcer
WHAT AM I?
CELLULITIS
How am I classed (Cellulitis)?
Eron Classification
Class I: No signs of systemic toxicity
Class II: Systemically unwell or well but with comorbidity
Class III: Significant systemic upset or unstable comorbidities
Class IV: Sepsis or life threatening infection like necrotising fasciitis
How am I managed (Cellulitis)?
Class I: Oral antibiotics - Flucloxacillin: 5-7 days 1 month to 1 year, 62.5–125 mg x4 daily 2 to 9 years, 125–250 mg x4 daily 10-17 years, 250–500 mg x4 daily
Co-amoxiclav for 5–7 days solution
1–11 months, 0.25 ml/ kg of 125/31 x3 daily
1–5 years: 5 ml of 125/31 x 3 daily
6 –11 years: 5 ml of 250/62 x 3 daily
Clarithromycin for 5–7 days for penicillin allergy
- 8 kg, 7.5 mg/kg twice a day
- 8–11 kg, 62.5 mg twice a day
- 12-19 kg, 125 mg twice a day;
- 20-29 kg, 187.5 mg twice a day;
Erythromycin (in pregnancy) 250–500 mg four times a day for 5–7 days
Class II: Short term 48 hour admission
Class III & IV: Urgent admission
