Dermatology Flashcards
What is eczema?
Itchy dry inflammatory skin disease
What are flares of eczema in childhood associated wth?
Infection/vital illness Central heating, cold hair Pets Teething Stress
What are the endogenous types of eczema?
Atopic Seborrhoeic Discoid Pomphylx Varicose
What causes atopic eczema?
Genetic and immune mediated barrier dysfunction
What is atopy?
Tendency to eczema, asthma and hayfever
What is the pathology of atopic eczema?
Abnormality in flaggrin expression- flaggrin proteins bind keratin filaments together
Loss of water, irritant and allergens can penetrate
What is the presentation of atopic eczema in infancy?
Typically starts on face and neck, cheek most common
Can spread ore generally
What is th presentation of atopic eczema in older children?
Flexural pattern predominates
Facial eczema can recur
What is the presentation of seborrhoeic eczema?
Mainly face and scalp, scaly appearance
In babies under 3 months, usually resolves by 12 months
What is seborrhoeic eczema associated with?
Proliferation of various species of skin commensals in yeast form
What is the treatment of seborrhoeic eczema?
Emollients
Antifungal creams and shampoos
Mild topical steroids
What is the presentation of discoid eczema?
Scattered annular/circular patches of itchy eczema
Can occur in pattern as a part of atopic eczema or separate entity
Who is pomphylx eczema seen in?
Young females
What is the presentation pf pomphylx eczema?
Vesicles affecting palms and or soles
Can be intensely itchy
What is varicose eczema?
Dry, inflamed possibly ulcerated skin caused by venous insufficiency
What is the treatment of varicose eczema?
Emollients
Topical steroids
Compression stockings
What are the exogenous causes of eczema?
Allergic
Irritant
What is allergic eczema?
Sensitisation to allergen causes eczema
What are the most common allergies?
Milk/dairy Soy Peanuts Eggs Wheat Fish
What causes irritant eczema?
Repeated contact with irritant
What is the treatment of eczema?
Emollients Topical steroids Calcineurin inhibitor UVB light therapy Immunosuppression
What are the possible side effects of topical steroids?
Skin thinning with prolonged use
What are the types of topical steroids?
Very potent= dermovate
Potent= betnovate
Moderate= eumovate
Mild= hydrocortisone
What are the common dermatological infections in children?
Impetigo Molluscum contagiosum Viral warts Viral examthans Chicken pox Parovirus Hand, foot and mouth
What is impetigo?
Superficial bacterial skin infection
What is the causative organism of impetigo?
Often staph aureus
What is the appearance of impetigo?
Pustules and honey coloured crusted lesions
What s the treatment of impetigo?
Topica antibacterial
Oral antibiotic
What is molluscs contagiosum?
Common meaning self limiting infection caused by molluscipox virus
What is the appearance of molluscs contagiosum?
Pearly papule
Umbilicated centre
What causes viral warts?
Often HPV
What is transmission of viral warts via?
Direct skin contact
What is the treatment of viral warts?
Cryotheray
Topical paints- e.g. salicylic acid
What causes viral exanthems?
reaction to toxin produced by organism, damage to skin by organism or immune response
What ar the features of viral exanthems?
Fever
Malaise
ehadache
Associated viral illness
What causes the chicken pox?
Varicella zoster
What is the chicken pox?
Highly contagious disease caused by primary infection of varicella zoster
What are the features of the chicken pox?
red papules progressing to vesicles Often starting on trunk Itchy Associated viral symptoms Contagious until crusted over
What is parovirus?
Slap check
Erythematous rash on cheeks initially
Lace like network rash on trunk and limbs
What does parovirus target?
Bone marrow
What is the risk in parovirus?
Risk to pregnant women
What causes hand, foot and mouth?
Enterovirus
What are the features of hand, foot and mouth?
Blisters on hands, feet and in mouth
Viral symptoms
Self limiting
What are the derm manifestations of systemic diseases seen in children?
Orofacial granulomatosis
Erythema nodosum
Dermatitis herpetiformis
Urticaria
What causes orofacial granulomatosis?
Crohn’s
What are the features of orofacial granulomatosis?
Lip swelling and fissuring
Oral mucosal lesions- ulcers and tags, cobblestone appearance
What ar the clinical features of erythema nodosum?
Painful, erythematous subcutaneous nodules
Over shins- sometimes other sites
Slow resolution- 6-8 weeks
What causes erythema nodosum?
Infections- strep, URT IBD Sarcoidosis Drugs Myocbacterial infections Idiopathic
What is dermatitis herpetiformis?
Persistent immunobollous disease linked to coeliac
What are the clinical features of dermatitis herpetiformis?
Itchy blisters, often symmetry
Scalp, shoulders, buttocks, elbows, knees
What is the treatment of dermatitis herpetiformis?
Emollients
GF diet
Topical steroids
Dapsone
What is urticaria associated with?
Angioedema
What ar the causes or urticaria?
Viral or bacterial infection Allergy NSAIDs, opiates Vaccines Chronic= idiopathic
What is the appearance of urticaria?
Wheals, hives
What is the treatment of urticaria?
Consider triggers and withdraw
Antihistamines 3x daily
