Dermatology Flashcards
What rash is common in post-mature infants?
Erthema toxicum
Which infants are most at risk of erythema toxicum?
Those that are post-mature
What does an erythema toxicum rash look like?
White pinpoint papules at the centre of an erythematous base
What tend to be the causative organisms of hand, foot and mouth disease?
- Coxsackie A16
2. Enterovirus 71
How is hand, foot and mouth disease managed?
- Push fluids - keep hydrated
- Analgesia
- No need for school exclusion
- Reassurance that not related to disease in cattle
What is the causative organism of roseola infantum?
HHV6
What comes first in roseola infantum - fever or rash?
FEVER (always first, THEN rash)
What are the complications of roseola infantum?
Aseptic meningitis
Hepatitis
How is chicken pox spread?
Via the respiratory route
What is the incubation of chicken pox?
10-21 days
When is the infectious period with chicken pox?
4 days prior to, and 5 days after the rash first appears
When do you keep a child off school until with chicken pox?
Until the vesicles have crusted over
What do you give exposed immunocompromised patients and newborns for prophylaxis?
VZIG (1 dose)
What do you give immunocompromised patients and newborns if chicken pox has already developed?
IV acyclovir
What are the complications of chicken pox?
Secondary bacterial infection of lesions
RARE - pneumonia; encephalitis; disseminated hemorrhagic chicken pox
V RARE - arthritis/nephritis/pancreatitis
What is the causative organism of scarlet fever?
Group A strep
In which condition does the rash feel like ‘sandpaper’?
Scarlet fever
What is strawberry tongue, and in which condition do you see it?
= a white coat on the tongue through which red papillae may be seen
Seen in scarlet fever
What is the management of scarlet fever?
Oral penicillin V (azithromycin if penicillin allergic)
When can children return to school with scarlet fever?
24 hours after starting antibiotics
What are the complications of scarlet fever?
- Otitis media
- Rheumatic fever
- Acute glomerulonephritis
What is the causative organism in measles?
RNA paramyxovirus
Where does the rash start in measles?
Behind the ears
What are Koplik spots, and when do they come on?
‘Grains of salt’ in the buccal mucosa, tend to come on before the rash
How is measles Dx?
IgM antibodies (a few days post-rash onset)
What very rare complication of measles might occur 5-10 years post-illness?
Subacute sclerosing pan-encephalitis
What is scabies an infestation of?
Sarcoptes scabei mite
When is itching in scabies worse?
In the warm and at night
What is the treatment for scabies?
Permethrin 5% all over body, washed off after 8-12 hours, re-application 1 week later. All members of household treated
How does SSSS differ from TENS?
No mucosal involvement
What is seen under the microscope in SSSS vs. TENS?
SSSS = characteristic horny layer TENS = full-thickness necrotic epidermis
How should SSSS be managed?
Flucloxacillin
What are the 3 types of neonatal herpes simplex?
- SEM herpes - skin, eyes, mouth
- DIS herpes - disseminated herpes, affecting internal organs, esp. the liver
- CNS herpes
What tend to be the causative organisms in impetigo?
- S.aureus
2. Streptococcus pyogenes
How does SJS and TENS differ?
SJS = <10% BSA TENS = >30% BSA
How is SJS Dx?
Clinically - severe mucosal ulceration involving at least 2 mucosal surfaces ( e..g lip, oral cavity, nasal, conjunctiva, urethra, vagina, GI tract or resp tract)
What drugs can cause SJS/TENS?
- Sulphonamides
- NSAIDs
- Antibiotics
- AEDs
- Barbiturates
- Allopurinol
- Tetracyclines
What infections can cause SJS/TENS?
- AIDS
- HSV
- EBV
- Influenza
- Typhoid
- Group A strep
- Dermatophyte
If it is a drug cause, when do SJS/TENS tend to present?
2-3 weeks after starting said drug (i.e. a delayed reaction)
What proportion of children with atopic eczema have Sx resolution by 12?
50%
What proportion of children with atopic eczema have Sx resolution by 16?
75%
What proportion of children with atopic eczema will go on to develop asthma?
1/3rd
What tends to cause guttate psoriasis?
Strep/viral sore throat, or ear infection
Over what period does guttate psoriasis tend to resolve?
Over 3-4 months
What is the mild topical steroid?
Hydrocortisone
What are the moderate topical steroids?
Eumovate
Modrasone
What are the potent topical steroids?
Betnovate
Synalar
Elocon
What is the very potent topical steroid?
Dermovate
