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Year 4 - Paediatrics > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is exanthem?

A

Eruptive widespread rash.

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2
Q

What are the viral exanthemas?

First disease.

A

Measles

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3
Q

What are the viral exanthemas?

Second disease.

A

Scarlet fever

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4
Q

What are the viral exanthemas?

Third disease.

A

Rubella (AKA German measles)

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5
Q

What are the viral exanthemas?

Fourth disease.

A

Dukes’ disease

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6
Q

What are the viral exanthemas?

Fifth disease.

A

Parvovirus B19

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7
Q

What are the viral exanthemas?

Sixth disease.

A

Roseola infantum

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8
Q

Presentation of first disease.

A

Measles:
- fever
- coryzal sx
- conjunctivitis
- white spots on buccal mucosa

Rash:
- starts on face
- spreads to rest of body
- macular rash
- erythematous

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9
Q

Management of measles.

A

Isolate until 4 days after symptoms resolve.

Supportive treatment.

Notifiable disease.

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10
Q

Complications of measles.

A
  • pneumonia
  • diarrhoea
  • dehydration
  • encephalitis
  • meningitis
  • hearing loss
  • vision loss
  • death
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11
Q

What is the cause of scarlet fever?

A

Exotoxin produced by streptococcus pyogenes bacteria.

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12
Q

Presentation of Scarlet fever.

A

Rash:
- sandpaper skin
- red/pink
- blotchy
- flushed

Other features:
- fever
- lethargy
- flushed face
- sore throat
- strawberry tongue

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13
Q

Treatment of Scarlet fever.

A

Phenoxymethylpenicillin for 10 days.

Keep off school for first 24 hours of antibiotics.

Notifiable disease.

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14
Q

Presentation of rubella.

A

Rash:
- erythematous
- macular

Other features:
- mild fever
- joint pain
- sore throat
- lymphadenopathy

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15
Q

Treatment of rubella.

A

Self-limiting / supportive therapy.

Notifiable disease.

Stay off school.

Avoid pregnant women.

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16
Q

Complications of rubella.

A
  • thrombocytopenia
  • encephalitis
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17
Q

Triad of congenital rubella syndrome.

A
  • deafness
  • blindness
  • congenital heart disease
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18
Q

Cause of fifth disease.

A

Parvovirus B19

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19
Q

Features of fifth disease.

A
  • slapped cheeks
  • reticular rash on trunks and limbs
  • raised and itchy

Other sx:
- mild fever
- coryza
- non-specific viral symptoms

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20
Q

Management of fifth disease.

A

Self-limiting (1-2 weeks).

Infectious prior to rash forming; once rash has developed not infectious so can go to school.

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21
Q

Which patients are at risk of complications of Fifth disease?

A
  • immunocompromised patients
  • pregnant women
  • haematological conditions
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22
Q

Complications of Parvovirus B19 infection.

A
  • aplastic anaemia
  • encephalitis / meningitis
  • pregnancy complications (ie. fetal death)
  • hepatitis
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23
Q

Aetiology of Sixth disease.

A

Roseola infatum - caused by HHV-6.

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24
Q

Presentation of Sixth disease.

A

Sudden fever for 5 days;

THEN

Rash:
- mild erythematous macular rash
- not itchy

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25
Q

Management of roseola infantum.

A

Self-limiting (1 week)

No need to keep off nursery if they are well enough to attend.

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26
Q

Complications of roseola infantum.

A
  • febrile convulsions
  • myocarditis
  • thrombocytopenia
  • Gullain-Barre syndrome
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27
Q

What is erythema multiforme?

A

An erythematous rash caused by a hypersensitivity reaction:
- HSV 6 and 11
- mycoplasma pneumonia
- medications

28
Q

Presentation of erythema multiforme.

A

Widespread, itchy, target lesions.

29
Q

Aetiology of chickenpox.

A
  • VAV
30
Q

Presentation of chickenpox.

A

Widespread vesicular rash.

  • fever
  • itch
  • general fatigue / malaise
31
Q

At what point is chickenpox no longer contagious?

A

When the lesions scab over (5-7 days after appearing).

32
Q

Complications of chickenpox.

A
  • bacterial superinfection
  • dehydration
  • conjunctival lesions
  • pneumonia
  • encephalitis
33
Q

Long-term complications of chickenpox.

A

After infection, the virus lays dormant in the sensory dorsal root ganglion cells.

It can reactive as:
- shingles
- Ramsay Hunt syndrome

34
Q

Management of chickenpox in children.

A

Usually a mild self-limiting condition that does not require treatment.

Symptomatic treatment:
- calamine lotion
- clorphenamine
- cut finger nails

Keep child off school until rash blisters over.

35
Q

Aetiology of hand, foot and mouth disease.

A

Coxsackie A virus

36
Q

Presentation of hand, foot and mouth disease.

A

Viral URTI sx.

  • mouth / tongue ulcers
  • blistering on hands and feet
37
Q

Management of hand, foot and mouth disease.

A

Supportive management:
- adequate fluid intake
- simple analgesia

Highly contagious therefore measures to prevent transmission:
- avoid sharing towels and bedding
- washing hands
- careful handing of dirty nappies

38
Q

Complications of hand, foot and mouth disease.

A
  • dehydration
  • bacterial superinfection
  • encephalitis
39
Q

What is molluscum contagiousum?

A

A viral skin infection caused by poxvirus.

40
Q

Features of molluscum contagiosum.

A
  • small, flesh coloured papules
  • central dimple
41
Q

Management of molluscum contagiosum.

A

Resolve themselves without treatment; however this can take up to 18 months.

Avoid sharing towels or other close contact with lesions, to minimise risk of spreading the infection.

42
Q

Complications of molluscum contagiosum.

A

As a result of scratching:
- bacterial superinfection
- scarring
- spreading lesions

43
Q

Aetiology of pityriasis rosea.

A

Unknown - thought to be caused by a virus but no definitive cause has been established.

44
Q

Presentation of Pityriasis rosea.

A

Rash:
- herald patch
- christmas tree lesions over trunk

Other symptoms may be present:
- generalised itch
- low grade pyrexia
- headache
- lethargy

45
Q

Disease course - pityriasis rosea.

A

Resolves without treatment within 3 months.

May leave discolouration of the skin where the lesions were, however these will also resolve within another few months.

46
Q

Management of pityriasis rosea.

A

No treatment - resolves spontaneously without any long term effects.

Not contagious.

Emollients, topical steroids or sedating antihistamines may help with any generalised itch.

47
Q

Pathophysiology of seborrhoeic dermatitis.

A

Malassezia yeast colonisation of the sebaceous glands causes erythema, dermatitis and crusted dry skin.

48
Q

Presentation of infantile seborrhoeic dermatitis.

A

AKA cradle cap.

Crusted and flaky scalp.

49
Q

Management of infantile seborrhoeic dermatitis.

A
  1. Apply baby oil + gently brush scalp
  2. White petroleum jelly overnight
  3. Anti-fungal cream (e.g. clotrimazole, miconazole)
50
Q

Presentation of seborrhoeic dermatitis of the scalp.

A

Flaky itchy skin on the scalp.

More commonly occurs in adolescents and adults rather than children.

51
Q

Management of seborrhoeic dermatitis of the scalp.

A

Ketoconazole shampoo - leave on for 5 minutes then wash off.

Topical steroids may be used if there is severe itching.

52
Q

Management of seborrhoeic dermatitis of the face and body.

A

Topical anti-fungal cream:
- clotrimazole
- miconazole

Localised inflammation may benefit from topical steroids.

53
Q

What is nappy rash?

A

Friction between the skin and nappy, and contact with urine and faeces in a dirty nappy, results in a contact dermatitis.

54
Q

Risk factors for nappy rash.

A
  • delayed changing of nappies
  • irritant soap products
  • poorly absorbent nappies
  • diarrhoea
  • pre-term infants
55
Q

Presentation of nappy rash.

A

Rash appears in patches of exposed skin that comes in contact with the nappies, with sparing of the skin creases:
- sore
- red
- inflammed

56
Q

Management of nappy rash.

A
  • highly absorbent nappies
  • change the nappy and clean skin as soon as possible after wetting or soiling
  • use water or alcohol free products for cleaning the nappy area
  • ensure the nappy area is dry before replacing the nappy
  • maximise time not wearing a nappy
57
Q

Complications of nappy rash.

A
  • candida infection
  • cellulitis
  • erosions
  • ulceration
  • Jacquet’s erosive diaper dermatitis
58
Q

Differentials for a non-blanching rash in children.

A
  • meningococcal septicaemia
  • henoch-schonlein purpura
  • ITP
  • acute leukaemia
  • HUS
  • viral illness
59
Q

Investigating non-blanching rashes.

A
60
Q

Management of non-blanching rashes in children.

A
61
Q

What is erythema nodosum?

A

Red lumps appear across the patient’s shins due to inflammation of the subcutaneous fat.

62
Q

Causes of erythema nodosum.

A
  • IBD
  • sarcoidosis
  • tuberculosis
  • pregnancy
  • streptococcal throat infections
  • lymphoma
  • leukaemia
63
Q

Presentation of erythema nodosum.

A

Red, inflamed, subcutaneous nodules across both shins.

Nodules appear raised and can be painful or tender.

64
Q

Investigating erythema nodosum.

A

Diagnosis is based upon clinical presentation - investigations can help identify the underlying cause:
- CRP and ESR
- throat swab (streptococcal infection)
- CXR
- stool microscopy and culture
- faecal calprotectin (IBD)

65
Q

Management of erythema nodosum.

A

Conservative management with rest and analgesia - steroids may be used to help settle the inflammation.

Treatment of underlying cause is paramount.

66
Q

Pathophysiology of staphylococcal scaled skin syndrome (SSSS).

A

Staphylococcus aureus produced epidermolytic toxins, causing the skin to become damaged and broken down.

67
Q

Presentation of staphylococcal scaled skin syndrome.

A
  1. Patches of erythema
  2. Thin and wrinkled skin
  3. Bullae form

Nikolsky sign - gentle rubbing of the skin causes it to peel away.

Year 4 - Paediatrics (17 decks)

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