Dermatology Flashcards

1
Q

What are the five most common organisms of red rash in paediatric patients?

A

Really Red Munchkins Scare Parents

R: Rubella – fever + 3 day descending rash

R: Roseola – macular rash starting at high fever resolution; starts on trunk

M: Measles – 4Cs: cough, conjunctivitis, corzya and Koplik spots

S: Scarlet Fever – S. pyogenes sandpaper-like rash with strawberry tongue within first 2 days; desquamation on palms and soles afterwards

P: Parvovirus B19 – “slapped-cheek” lacy rash following fever

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2
Q

What are some common infections in paediatric patients associated with rashes?

A

Really Sick Children Must Take No Exercise

R: Rubella (D1)
S: Scarlet fever (D2)
C: Chickenpox (D3)
M: Measles (D4) + Koplik spots one day before rash
T: Typhus, Rickettsia (D5)
N: Nothing
E: Enteric fever/Salmonella/Typhoid (D7) >> Number of days after fever onset that a rash appears

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3
Q

What are 3 organisms that cause rash specific to palm and soles?

A

You drive CARS with your palms and soles.

CA: Coxsackie virus A
R: Rickettsia rickettsii
S: Syphilis (secondary)

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4
Q

What is this lesion? What disease is it related with?

A

Erythema marginatum

  • Asosciated with rheumatic fever
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5
Q

What are the presenting features of measles?

A

Prodrome of the three Cs:

  • Cough
  • Coryza
  • Conjunctivitis

Rash

  • ~4 days after start of symptoms
  • Erythematous maculopapular rash
  • Starts at the hairline and spreads down
  • Sparing palms and soles
  • Koplik spots in the mucosa ~1 day before rash
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6
Q

What are the presenting features for roseola (6th disease) by HHV-6?

A

High-grade fever with irritabilty and lymphadenopathy

Rash once fever subsides

  • Blanching, pink maculopapular
  • Starts at the neck and the trunk
  • Spreads to the face and extremities
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7
Q

What is this lesion? What is it associated with?

A

Erythema multiforme
>> Fixed lesions for at least 7 days
>> Target lesions with damaged skin in the central zone
>> All lesions appear within 72 hours

  • Infections: HSV, Orf virus, hisioplasmosis
  • Drug reactions
  • Non-Hodgkin lymphoma
  • Connective tissue disorders
  • Vasculitides

>> Severe major erythema multiforme: think toxic epidermal necrolysis

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8
Q

What are the possible causes of generalized itching?

A
  • Anemia
  • Iron deficiency
  • Polycythemia rubra vera
  • Lymphoma
  • Hepatic failure
  • Thyroid disease
  • Drugs

>> Unbearable generalized itching: think malignancy

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9
Q

What is a bulla?

A

Vesicle (papule that contains clear fluid) >0.5cm

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10
Q

What is a macule?

A

Flat circumscribed discolouration (think cafe-au-lait spots)

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11
Q

What is a papule?

A

Elevated solid lesion <0.5cm

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12
Q

What is excoriation?

A

Linear erosion induced by scratching

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13
Q

What are the differences between erosion and ulcer?

A

Erosion: partial local loss of epidermis; heals without scar

Ulcer

  • FULL thickness focal loss of epidermis and dermis
  • Heals with scar
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14
Q

What is the difference between erythema and purpura?

A

Erythema: blanchable

Purpura: nonblanchable

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15
Q

How does one differentiate between diaper rash and Candida napkin dermatitis?

A

Candida

  • Sharp margin with scaling
  • Satellite lesions
  • Involvement of intertriginous areas

>> Check oral cavity for oral flush

>> Treat with topical anti-fungal

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16
Q

What is this lesion?

A

Infantile seborrhoeic dermatitis

  • Mainly affects:
    >> Scalp
    >> Face
    >> Flexural areas
  • Cradle cap: yellow or white greasy scales
  • Starts from 2-3 weeks and clears in a few weeks

>> Can also occur in adults

17
Q

What is this lesion? How would one describe it?

A

Eczema/Atopic dermatitis

Some characteristics of eczema

  • Erythema
  • Oozing
  • Excoriations
  • Crusting
  • Papulations
  • Hyperlinearity due to thickened skin
18
Q

What is the management for atopic dermatitis/eczema?

A
  • Emollients
  • Topical steroids
  • Immunomodulating agents: topical VS. systemic
  • Food/allergen avoideance

>> 90% onset before 5 years
>> Remission by age 15 in 90%

19
Q

What is this lesion?

A

Eczema Herpeticum

>> PAINFUL!!!!

Management

  • Admit
  • Consult ophthalmologist
20
Q

What is this lesion? What are the possible treatments?

A

Molluscum contagiosum

Management

  • Cryotherapy
  • Laser ablation
  • Topical antivirals
21
Q

What is this lesion? What is the treatment?

A

Scabies: highly contagious and pruritic

  • Topical application of insecticides: lindane, sulphur
  • Apply below the neck for older children
  • Apply the whole body for infants and toddlers
  • Treat all household members
22
Q

What is this condition? What are the possible causes?

A

Stevens-Johnson syndrome
- Variable skin rash plus at least 2 mucosal lesions
>> Purulent conjunctivitis
>> Lip lesions
>> Perianal/urethral lesions
>> Look for blood in urine and stool
- Look for erythema multiforme
- Erythematous macules rapidly evolve into bullae, skin necrosis and denundation

Causes

  • Drugs: NSAIDs, sulfonamides, anti-convulsants, penicillins, tetracyclines etc.
  • Infections: HSV, mycoplasma etc.
23
Q

What is this lesion?

A

Toxic epidermal necrolysis

  • Detachment of the epidermis from the dermis all over the body
  • Usually related to drug reactions
  • Life-threatening
  • Associated with Stevens-Johnson Syndrome
24
Q

What are fixed drug eruptions?

A

A type of drug reaction that recur at the same site with each exposure of one particular drug

Possible drugs include:

  • Aspirin
  • Antibiotics: penicillin, tetracyclines and sulfonamides
  • Anti-convulsants
25
Q

If a non-palpable rash erupts after varicella infection, what are the differential diagnoses?

A
  • Immune thrombocytopenic purpura (ITP)
  • Henoch-Schonlein purpura (HSP)

>> CBC to rule out ITP

26
Q

What is this lesion? What is the management for this lesion?

A

Hemangioma

Natural history
- Onset at first week of life
- Growth fastest at 6 months of life
- Involution begins at 12 months of life
- Complete involution
>> 50% by age 5 years
>> 70% by age 7 years
>> 100% by age 12 years

  1. Conservative: usually fades in a few years
  2. Propranolol: if it causes functional disability

Note: Hemangiomas VS. tufted angiomas
>> Tufted angiomas rarely self-involute