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Paediatrics > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is Purpura?

A

Bleeding of superficial vessels

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2
Q

What does purpura look like?

A

Red/purple non-blanching petechiae

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3
Q

What causes purpura?

A

Infection: MENINGITIS, Hib, Chicken Pox, Sepsis, Enterovirus
Other: Clotting disorders (dec platelets, HUS, DIC), thrombocytopenia, vasculitis, trauma, drug reactions, vasomotor straining

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4
Q

How is purpura investigated?

A

Bloods: FBC, CRP, LFT, Clotting (platelets), INR, autoantibody screen
Blood Film & cultures
Urinalysis

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5
Q

How is purpura managed?

A

Treat cause

Platelets: Transfusion

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6
Q

What factors exacerbate eczema?

A 
Infection
Allergen/Irritant
Heat & humidity
Medical changes
Physiological stress
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7
Q

How does eczema present?

A

Early: Erythema, scaling, itching/excoriation, vesicles, weeping, sleep disturbance
Late: Lichenification

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8
Q

At what age is each body part affected with eczema?

A

Infancy: Face, trunk, extensors
Child: Antecubital fossa, knee flexures, neck
Adolescent: Hands, feet, limb flexures

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9
Q

How is mild eczema managed?

A

Emollients TDS

Mild topical steroid: Hydrocortisone BD 3-5days

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10
Q

How is moderate eczema managed?

A

Emollients TDS
Moderate topical steroid: Eumovate 7-14days
Topical calcineurin inhibitor: Tacrolimus/Pimecrolimus
Bandages & dressings

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11
Q

How is severe eczema managed?

A

Emollients TDS
Potent topical steroid: Betnovate/Dermovate 7-14days
Topical calcineurin inhibitor: Tacrolimus/Pimecrolimus
Bandages & dressings
Oral antihistamine: Cetirizine
Phototherapy

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12
Q

How is a diagnosis of atopic eczema made?

A 
Itchy skin PLUS 3 of:
Visible flexural dermatitis
Hx of flexural dermatitis
Hx/FHx of atopy
Hx of dry skin in past 12m
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13
Q

What are the different types of birthmarks? Describe them

A

Salmon patches: Most common, eyelids, forehead, neck, fade after a few months, more noticeable when crying
Haemangioma: Strawberry marks, eyelids, forehead, neck, raised anywhere on body, grow until 6m, gone by 7y, Tx Propanolol (beta blockers)
Capillary Malformations (Port wine): Flat, red/purple, unilateral, rare, face/neck/back, defect in nerve supplying capillaries, hormone sensitive, Tx laser
Cafe au lait: 1-2, >6 see GP, sign of neurofibromatosis
Mongolian blue spot: Gone by 4y, lower back/buttocks
Congenital melanocytic naevi: Moles, overgrowth of pigment cells, most shrink, growth= Ca risk

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14
Q

What are the causes of impetigo?

A

Staph Aureus

Strep Pyogenes

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15
Q

What are the signs & symptoms of impetigo?

A

Highly contagious
Erythematous macules become vesicular/bullous on face/neck/hands
Linked to pre-existing skin lesion e.g eczema
Infective until dry

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16
Q

How is impetigo treated?

A

Topical Fusidic acid: 3-4/day
Oral Fusidic acid: 250mg
12/hrs 5-10days
Avoid School

17
Q

What is Stevens-Johnson Syndrome?

A

Aka Toxic epidermal necrolysis

Immune mediated hypersensitivity disorder

18
Q

What are the signs & symptoms of Stevens-Johnson Syndrome?

A

Widespread blisters/bullae
On top of erythematous, purple macular or haemorrhage skin
Mucus membranes affected (including mouth)
Nikolsky sign: Rubbing skin causes separation at dermoepidermal junction
Fever
Arthralgia
Myalgia
Prostration

19
Q

How is Stevens-Johnson Syndrome treated?

A 
Supportive: Hydration (Crystalloid), airway protection, maintain temp
Emollients
Dressings
Antiseptics: Chlorhexidine
Specialist eye care
Systemic corticosteroids
20
Q

How is Stevens-Johnson Syndrome investigated?

A

Skin biopsy
Bloods: FBC, LFTs, U&E, Glucose, Bicarb, Mg, Phosphate
Serology
Mycoplasma

21
Q

What are the components of the SCORTEN score?

A 
Predict mortality in SJS/TEN
Age >40
Malignancy
HR >120
Epidermal detachment >10%
Serum bicarb <20
Serum urea >10
Serum glucose >14
22
Q

What are the causes of SJS/TEN?

A

Drugs: Allopurinol, Anticonvulsants, sulfonamides, NSAIDs, salicylates, antivirals
Vaccinations
Infection: HSV, EBV, HIV, influenza, hep, enterovirus

23
Q

What are the complications of SJS?

A 
Acute dehydration
ARDS
Infection
GI ulceration, perforation
Shock
Multiorgan failure
DIC
24
Q

What is the management of nappy rash?

A 
Frequent nappy changes
Use nappies w/greatest absorbency
Barrier: Zinc Cream
Expose to air
Severe: 1% Hydrocortisone
Candida: Topical Nystatin 6hrly
Infection: PO Flucloxacillin 7days
25
Q

What is the pathophysiology of nappy rash?

A

Bacterial breakdown of urine
Produces ammonia
Causes contact dermatitis

26
Q

What skin lesions can be seen in TB infection?

A

Erythema Nodosum: Painful, inflamed rash on the lower limbs

Lupus Vulgaris: Nodular, painful, disfiguring lesions predominantly on the face.

Paediatrics (26 decks)

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