Dermatology Flashcards
Distribution of infantile eczema?
typically acute onset
over face and extensor regions +/- trunk
Nappy region affected less often
Distribution of childhood vs adolescent eczema
Childhood
Flexor regions particularly affected
rash has polymorphous appearance
Adolescent
Eczema more lichenified + excoriated. flexures, wrists, ankels, upper trunk, head and neck affected
Management of eczem
1) avoid irritants/precipitants
2) rigorous bathing regimes
+ 2) emollients - creams vs ointments - ointment better if skin is dry. As oily as they can tolerate.
3) topical corticosteroids - of varying strength depending on severity
- start off on something like Betnovate 0.025%
- can escalate to eumovate, dermovate
What are the causative organisms of impetigo?
Non-bullous - staph A, strep B
Bullous - almost exclusively Staph A
Management of impetigo
Abx - topical fusidic acid
If rash is more widespread - think about oral Flucloxacillin
Advise to stay off school until either all rashes crusted over, or 48hrs after starting Abx
Management of nappy rash / thrush
Frequent nappy changes - should be 6-12 times/day
Consider barrier cream - metanium
Promote naked time to allow area to air out and dry
What is the SCAR spectrum
SCAR - Severe Cutaneous Adverse Reaction
Erythema Multiforme –> Stevens Johnsons Syndrome –> Toxic Epidermal Necrolysis
Which scoring systems are used in SJS/TEN
ALDEN
SCORTEN
What is erythema nodosum
Dermatological reaction - typically following Streptococcal infection
Red, painful nodules on the lower limb, typically lasting 2-3 weeks
Management of scabies?
Permethrin 5% dermal cream - head to toe coverage
+ treatment of household contacts
Wash all clothes, bed-linen, towels at 50 degrees
Antihistamines for itch
Children can return to school after first treatment
