Dermatology Flashcards
What are the symptoms of atopic eczema?
Itchy, erythematous rash.
Where does atopic eczema typically appear in infants?
Face and trunk.
Where does atopic eczema typically appear in young children?
Extensor surfaces.
Where does atopic eczema typically appear in older children and adults?
Flexor surfaces, creases of face and neck.
What are the general management steps for atopic eczema?
Avoid irritants, use emollients, topical steroids (liberal use), wet wrapping.
What is the first-line treatment for mild eczema?
Emollients + mild topical corticosteroids (hydrocortisone 1%).
What is added to the treatment for moderate eczema?
Moderate corticosteroids (betamethasone 0.025% or clobetasone 0.05%), topical tacrolimus, bandages.
What is added to the treatment for severe eczema?
Potent corticosteroids (betamethasone 0.1%)
wet wrapping
phototherapy, systemic therapy.
What causes infected eczema?
Staph aureus
How does infected eczema present
Oozing
swollen
sore skin with yellow crust
treated for infected eczema
oral flucloxacillin
Investigation for infected eczema
skin swab and culture
How does eczema herpeticum present
Fever
widespread blisters
punched out lesions around face
How can eczema herpeticum be differentiated from secondary bacteria infection?
Rapid onset and quick spread
high fever, systemic symptoms
What is the management for eczema herpeticum?
Admit!
oral aciclovir
When would you admit for eczema?
Severe eczema not responding to treatment in 1 week
bacterially infected eczema not responding to treatment
2 week referral
When to make a non urgent referral regarding children and skin
Facial eczema not responding to treatment
suspected contact allergic dermatitis
significant social impact
recurrent infections
What virus causes Hand, Foot, and Mouth Disease?
Coxsackie virus.
What are the key symptoms of Hand, Foot, and Mouth Disease?
Mild systemic upset (sore throat, fever), oral ulcers, vesicles on palms and soles.
What is the management of Hand, Foot, and Mouth Disease?
Symptomatic treatment, no school exclusion needed.
What virus causes Roseola Infantum?
Human herpes virus 6.
What is the typical age range for Roseola Infantum?
6-24 months old.
What are the key symptoms of Roseola Infantum?
: Several days of high fever followed by a blanching rose-pink macular rash, starting on the trun
What is the management of Roseola Infantum?
Supportive (antipyretics), monitor for febrile convulsions, no school exclusion required.
What bacteria causes Scarlet Fever?
Group A Streptococcus (Streptococcus pyogenes).
What is the typical age for Scarlet Fever?
Around 4 years old.
What are the key symptoms of Scarlet Fever?
Fever, sore throat, strawberry tongue, sandpaper rash.
What is the treatment for Scarlet Fever?
Oral penicillin for 10 days (azithromycin if allergic).
What is the school exclusion period for Scarlet Fever?
24 hours after starting ABX
What are the complications of Scarlet Fever?
Otitis media (most common).
Rheumatic fever (20 days after infection).
Acute glomerulonephritis (20 days after infection).
What bacteria causes impetigo?
Staphylococcus aureus.
What are the key symptoms of impetigo?
Golden, crusted skin lesions around the mouth, very contagious
What is the first-line treatment for localised non-bullous impetigo?
Hydrogen peroxide 1% cream.
What is the treatment for widespread non-bullous impetigo?
Topical fusidic acid.
What is the treatment for widespread/bullous/systemically unwell impetigo?
Oral flucloxacillin
When can children return to school after impetigo?
When lesions are crusted and healed OR 48 hours after starting antibiotics.
What is seborrhoeic dermatitis commonly known as in infants?
Cradle cap
What is the typical presentation of seborrhoeic dermatitis?
Greasy, yellow scales on the scalp, may affect face, ears, and neck.
What yeast is associated with seborrhoeic dermatitis?
Malassezia yeasts.
What is the management of seborrhoeic dermatitis?
1st : baby shampoo, petroleum, ointment
2nd : topical imidazole cream
3rd : mild topical steroid (hydrocortisone 1%)
How long does seborrhoeic dermatitis typically last?
Resolves within 8 months
What type of dermatitis causes nappy rash?
Contact dermatitis.
How does irritant nappy rash present?
Well-demarcated erythema, spares skin folds.
How does Candida nappy rash present?
Satellite lesions
pustules
involves flexures
What is the first-line treatment for mild nappy rash?
Zinc barrier cream
What is the treatment for moderate nappy rash with discomfort?
Hydrocortisone 1% cream (max 7 days).
What is the treatment for Candida nappy rash?
Topical imidazole cream, avoid barrier creams.
What is the treatment for bacterial nappy rash?
Oral flucloxacillin for 7 days.
What are milia?
White pimples from retention of keratin/sebum
What percentage of newborns are affected by milia?
up to 50%
What is the treatment for milia?
Self limiting
What causes ringworm
Dermatophyte fungi
What is a key feature of tinea infections
ringed apperance
what is a kerion
severe inflamed ringworm patch
What is the treatment for mild tinea infections?
Topical antifungals (terbinafine, clotrimazole).
What is the treatment for severe tinea infections?
Oral terbinafine (1st line), oral itraconazole (2nd line).
What is the treatment for tinea capitis (scalp)?
Oral antifungal (terbinafine).
What is the most common cause of neck lumps in children?
Lymphadenitis
What are red-flag symptoms of neck lumps?
Sepsis
poor feeding
rpaid growth
stridor
voice change
What is a thyroglossal cyst
midline congenital mass that moves with swallowing
What is a branchial cleft abnormality?
Lateral congenital mass.
How does lymphadenitis present?
Multiple small, tender lumps, transient enlargement.
