Dermatology

Question 1

Haemangioma of infancy:

What is it? What is its course?

Answer 1

1Most common benign soft tissue tumour.

Occurs within first 1-2 weeks, increases in size over 3-9months, regresses over time
50% by 5 yrs of age
90% by 9 yrs of age

Question 2

Haemangioma of infancy:

How often does it occur?

Answer 2

Occurs in 1-2% of newborns

Question 3

Haemangioma of infancy:

What are the risk factors?

Answer 3

Prematurity, multiple gestation, pre eclampsia, females to males 3:1, caucasian, advanced maternal age, placenta previa

Question 4

Haemangioma of infancy:

Complications

Answer 4

Ulceration, bleeding, pain
Interference of function: Amblyopia, Airway, Oral
Cosmetic disfigurement

Question 5

Haemangioma of infancy:

Which types may suggest underlying problems?

Answer 5

Spinal (spina bifida, urogenital issues)
Mandibular (Associated with laryngeal haemangioma and PHACE syndrome)
Disseminated (As ? underlying visceral haemangioma of e.g. Liver)

Question 6

Haemangioma of infancy:

What is PHACES syndrome?

Answer 6

Posterior fossa brain malformations
Haemangiomas; large, segmental facial lesions
Arterial anomalies (e.g. Coarctation of aorta)
Cardiac (heart) anomalies, VSD
Eye abnormalities (e.g. Glaucoma) and Endocrine abnormalities

Question 7

Congenital haemangioma

1. Difference from Haemangioma of Infancy
2. Variants and treatment

Answer 7

1. Fully developed at birth
2. RICH (rapidly involuting congenital haemangioma)
   NICH (non-involuting congenital haemangioma) -
   needs surgical excision

Question 8

Salmon Patch:

1. What is it?
2. Where does it effect?
3. Any complications or associations?
4. What happens to them as child grows?

Answer 8

Vascular malformation

1. Forehead, eye, back of head
2. Nil complications or associations
3. Fade within 1-2 yrs, ones on back of head/neck persist to adulthood

Question 9

Port Wine stain

1. What is it?
2. Does it spontaneously resolve?

Answer 9

1. uncommon vascular malformation
   Well demarcated, non - palpable erythema
2. No, it has proportional growth

Question 10

What is Sturge Weber Syndrome?

Answer 10

Vascular malformation associated with

1. Port wine stain affecting the ophthalmic branch of the trigeminal n.
2. Ipsilateral leptomeningeal vascular malformation resulting in Epilepsy, headaches, intellectual impairment
3. Choroid malformations of the eye - causing glaucoma

Question 11

What are epidermal skin lesions?

Answer 11

Follow the lines of Blaschko

Question 12

What are the types of pigmented lesions and their associations?

Answer 12

Hyper pigmented macules (>5 cafe au last associated with neurofibromatosis)
Hypo pigmented macules (associated with tuberous sclerosis)
Congenital Melanocytic navevi (giant ones increased risk of melanoma)

Question 13

Herpes Zoster in children vs adults presentation

Answer 13

In children:

• Not as painful
• less post herpetic neuralgia
• unnecessary to treat with antiviral
• Not associated with immunosuppression as in adults
• common to see >1 dermatome involved
• can get chicken pox like lesions on the rest of the body