Dermatology Flashcards
What is chicken pox caused from?
It is a viral illness caused by Varicella Zoster virus
Who does chicken pox tend to effect?
Most common in children under 10 years
What does chicken pox typically present as?
What body parts are commonly effected?
A rash of itchy spots, turn into fluid filled blisters, that crust over to form scabs and eventually drop off.
The spots are most likely to form on the face, ears, scalp, under arms, chest, belly, arms and legs.
Some children only develop a few spots, whilst others can have a rash all over the body
- Typically starts on face and scalp before spreading to trunk and limbs
Other associated symptoms:
* Nausea
* Myalgia
* Headache
Loss of appetite**
* **High temperature
What is the treatment for Chicken Pox?
No specific treatment, only symptom management
Paracetamol & topical Calamine (aqueous lotion available on NHSPF.
Lifestyle Advice:
* Rest
* Adequate fluid intake
* Avoid scratching – keep nails short
* Dress appropriately to avoid shivering/ overheating
* Wear smooth, cotton fabrics and non-tight clothing
* Advise that the most infectious period is 1–2 days before the rash appears, but infectivity continues until all the lesions are dry and have crusted over (usually about 5 days after the onset of the rash
What does eczema present as?
Where does it typically effect?
Eczema presents as:
* A long-term condition that causes skin to become itchy, red, dry and cracked.
* Often activated by illness of allergy
It typicaly effects:
* Inside of elbows, back of knees, neck, hands.
* In children scalp & face
Who does eczema typically effect?
The most common type is atopic, which mainly effects children, but can persist into adulthood
Usually starts before 2 years
What are associated conditions with eczema?
Other atopic diseases such as hay fever and asthma are also common with eczema
What is the treatment for eczema?
Emollients and CCS for flare ups.
Emollients examples:
* Zeroderm
* Epixmax
* Dermol 500 lotion
(these are available on NHSPF and are first-line)
CCS Example:
* Hydrocortisone 1% cream (NEED TO BE OVER 10 YEARS)
(available on NHSPF) - for flare ups if bad
What advise should be given to patients when using emollients for eczema
Emollient advice
* Emollient usage – liberally and frequent application, even when skin is clear or improved (3-4hr is normal).
* Use all the time and at least twice a day even when you are not experiencing symptoms
* Do not rub it in – smooth it into the skin in the same direction as the hair grows.
* Use emollient after a bath or shower, gently pat the skin dry and apply the emollient while the skin is moist to keep moisture in
* If your emollient is not in a pump dispenser then use a clean spoon or spatula to remove the emollient to reduce the risk of infection
* Wait ~15-30 min after applying emollient before applying CCS
* Emollients – if skin reaction occurs stop and use another one
What advice should you give to patients using CCS for eczema?
Use once a day for 7-14 days if no improvement in 2 weeks return.
What life-style advice can you give for patients with eczema?
- AVOID ALLERGENS
- Wear non-tight clothing and cotton where you can
- Avoid scratching and instead rub area with fingers to alleviate itch
o Keep nails short and clean
o Skin covered in light clothing
o Anti-scratch mitts
o Antihistamines (esp night) - Avoiding using soap and detergents
- Dietary changes:
o E.g. some foods such as eggs and cow’s milk can
trigger symptoms
What is Erythema Multiforme
A usually mild skin rash, that is caused by an allergic reaction, often the herpes simplex virus.
Can also occur due to an allergy to a medicine, this more severe form is SJS
What does Erythema Multiforme present as?
The spots look like targets, with a dark red centre surrounded by a paler ring.
The hands and feet are typically affected first, followed by the limbs, upper body and face.
What is treatment of Erythema Multiform?
Treatment aims to tackle the underlying cause of the condition, relieve your symptoms and stop your skin becoming infected.
Your doctor may recommend:
- stopping any medicine that may be triggering your symptoms – do not try this without speaking to your doctor first
- antihistamines and moisturising cream (emollients) to reduce itching
- steroid cream to reduce redness and swelling (inflammation)
- painkillers for any pain
- antiviral tablets, if the cause is a viral infection (aciclovir?)
- anaesthetic mouthwash to ease the discomfort of any mouth sore
What is hand, foot and mouth disease
Hand-foot-and-mouth disease is a mild, contagious viral infection
What does hand, foot and mouth disease present as?
A common, contagious infection that causes mouth ulcers, and spots and blisters on the palms of hands and soles of feet.
The first signs are:
* a sore throat
* a high temperature, above 38C
* not wanting to eat
A few days inital signs, mouth ulcer and rash appear:
- Red spots develop into blisters which usually appear on hands & feet
- Blisters are grey in centre and can be painful
Who does Hand Foot and Mouth Disease commonly occur in?
Most common in young children (<10)
What should patients with hand, foot and mouth disease be advised?
This infection is self-limiting, but has no cure, so those infected should keep away from school/nursery to avoid passing it on.
Infections typically last 7-10 days
What are the symptoms of impetigo?
Causes fluid-filled blisters or sores, that eventually crust over in a yellow-golden colour.
Can be painful or itchy.
No systemic symptoms
Measles symptoms?
A rash of red-brown blotches, usually develops on head/upper neck and then spreads outwards to the rest of the body
Cold/flu-like symptoms accompany this
What are symptoms of meningitis?
Signs are a fever, N&V, headache,** a blotchy rash that doesn’t fade when a glass is rolled over it, stiff neck, dislike of bright lights, drowsy/unresponsive**, Muscle and joint pain, Cold hand and feet
Symptoms of psoriasis?
- A chronic skin condition, that causes red, flaky, crusty patches of skin covered in silvery scales
- Red, flaky, crusty patches of skin covered with silvery scales
- Can be itchy/sore
- Relapsing/remitting
Anywhere but most common:
Elbows, knees, scalp, lower back
Genetically inherrited
What is ring work and what are symptomS?
Highly infectious, fungal infection that causes a ring-like red or silvery patch on the skin, this can be scaly, inflamed or itchy
The rash often appears on the arms and legs, but can appear almost anywhere on the body
On the head it can cause patches of hair loss
What is ring worm treatment?
Ringworm is easily treated, with OTC antifungals
However, ringworm of the scalp requires oral antifungals, often combined with antifungal shampoo. This can cause scaling and patches of hair loss
What is scabies?
What are symptoms?
- A contagious skin condition that is intensely itchy, caused by tiny mites that burrow into the skin
- The mites like warm places, such as skin folds and between fingers etc.
- They leave small red blotches, often found on palms of hands or soles of feet
- The latter is especially common in infants
- **Extremely itchy, especially at night
Typical sign: line with a dot at the end
**
Treatment of scabies
What are the signs of scarlet fever?
- It causes a distinctive pink-red rash, which feels like sandpaper to the touch and may be itchy
- It often starts with a sore throat, fever and headache, with the rash developing after 2-5 days
- The rash usually occurs on the chest and stomach, before spreading to other areas
- Swollen glands and white tongue coating also possible
What is the treatment of scarlet fever?
What is slapped cheek syndrome and what are symptoms?
A viral infection, with a distinctive bright red rash across both cheeks.
Children do not need to stay off school, unless they feel unwell, this is because the condition isn’t contagious when the rash develops
First sign is feeling unwell for a few days:
* High temp (>38)
* Runny nose and sore throat
* Headache
What is urticaria?
Symptoms?
- Also known as hives, this rash is raised and itchy, which can affect one part or the whole of the body
- It is triggers by an increase in histamine release in response to an allergy
- Sometimes it can be idiopathic too
Treatment of hives?
