dermatology Flashcards
define eczema (dermatitis)
itchy, dry, inflammatory skin condition
what happens in atopic eczema
genetic barrier dysfunction
atopic march
tendancy to 3 commonly linked conditions; eczema, asthma and hayfever
atopy
overactive immune response to environmental stimuli
distribution of eczema in infancy
typically starts on the face/ neck, can spread more generally
distribution of eczema in older children
flexural pattern predominated (antecubital fosse, popliteal fosse, wrists, hands, ankles)
describe the loss of barrier function in atopic eczema
- loss of water
- irritants may penetrate
- allergens may penetrate
what are childhood eczema flares associated with
- infections/ viral illness
- central heating/ cold air
- pets
- teething
- stress
where does seborrheoic dermatitis usually affect
scalp and face
management of seborrheoic dermatitis
emollients
antifungal creams
anti fungal shampoos
mild topical steroids
presentation discoid eczema
scattered annular/ circular patches itchy eczema
describe pomphylx eczema
- hand and foot eczema
- characterised by vesicles
- can be intensely itchy
cause of irritant eczema
repeated contact with irritant (repeated contact/ water and soaps/ touching irritant foods/ chemical irritants)
eczema treatments
- emollients
- topical steroids
- calcineurin inhibitors
- UVB light therapy
- immunosuppressive medication
example of mild corticosteroid
hydrocortisone
example moderate corticosteroid
eumovate
example potent corticosteroid
betnovate
example very potent corticosteroid
dermovate
how to use topical steroids
- once daily for 1-2 weeks
- if improvement then use alternate days for longer
- if stubborn use twice weekly in these areas
unit for steroid cream
finger tip
presentation impetigo
- superficial bacterial skin infection
- pustules and honey coloured crust erosions
management of impetigo
topical antibiotic - fucidin
oral antibiotic. - flucloxacillin
describe molluscum contagiosum
- common benign self limiting infection
- molluscipox virus
- transmission to close direct contacts
- pearly papule, umbilrbated centre
- can take up to 24 months to clear
management molluscum contagiosum
5% potassium hydroxide
describe viral warts
- often skin coloured
- common non-cancerous growths of skin caused by HPV infection
- transmitted via skin contact
management viral warts
- salicylic acid and paring
- cryotherapy
define viral exanthems
ruptive skin rash that is often related to a viral infection
conditions that result in viral exanthems
- chicken pox
- measles
- rubella
- roseola
- erythema infectiosum
virus responsible for chicken pox
varicella-zoster
presentation chick pox
- red papules progressing to vesicles often starting on trunk
- itchy
- associated viral symptoms
when is chicken pox contagious
from 1-2 days before rash appears until lesions have crusted
presentation parvovirus (slapped cheek)
- erythematous rash cheeks initially then lace like network rash over trunk and limbs
- usually self-limiting
- virus targets red cells in bone marrow
rare complications parvovirus
- aplastic crisis
- risk to pregnant women (spontaneous miscarriage/ intrauterine death)
virus causing hand foot and mouth disease
coxsackie virus A16
presentation hand foot and mouth disease
blisters on the ….
brace yourself….
this is a shocker are you ready….
HANDS FEET and MOUTH
also viral symptoms
management hand foot and mouth
treatment supportive
presentation of eczema herpeticum
- unwell child
- eczema history
- monomorphic punched out lesions
management of eczema herpeticum
- withheld steroids for 24hrs
- aciclovir oral or IV
- ophthalmology review if near eye
presentation of orofacial granulomatosis
- lip swelling and fissuring
- oral mucosal lesions
- ulcers and tags
- cobblestone appearance
clinical features erythema nodosum
- painful, erythematous subcutaneous nodules
- normally over shins
- slow resolution, like bruise
causes erythema nodosum
- infections (step, URTI)
- IBD
- sarcoidosis
- drugs (OCP, penicillin)
- mycobacterial infections
- idiopathic
define dermatitis herpetiformis
rare but persistent immunobullous disease that has been linked to coeliac disease
clinical presentation dermatitis herpetiformis
- itchy blisters that can appear as clusters
- often symmetry
- scalp, shoulders, buttocks, elbows, knees
management of suspected dermatitis herpetiformis
- coeliac screening
- skin biopsy
management dermatitis herpetiformis
- gluten free diet
- emollients
- topical steroids
- dapsone
presentation urticaria
- wheals/ hives
- associated angioedema (10%)
- areas of rash can last few minutes –> 24 hours
define acute urticaria
<6weeks
causes urticaria
- viral/ bacterial infection
- food/ drug allergy
- NSAIDs
- opiates
- vaccinations
treatment urticaria
- treat cause
- antihistamines
