Dermatology Flashcards
What are the clinical features/management of bullous impetigo?
Severe blistering form of impetigo (Caused by Staph Aureus)
Treated with systemic antibiotics (Flucloxacillin)
What are the clinical features of albinism?
Autosomal recessive condition (Ocular albinism is x-linked)
Defect in biosynthesis and distribution of melanin
Failure to develop a fixation reflex
Pendular nystagmus
Photophobia
Severe visual impairement
Pale skin prone to sunburn and skin cancer
What are the clinical features of nappy rashes?
Causes:
• Contact dermatitis - Due to irritant effect of urine. Erythematous rash with a scalded appearance, typically affects extensor surfaces
• Seborrhoeic dermatitis - Erythematous rash with flakes. Also present on scalp
• Candida infection - Erythematous rash affecting flexures with satellite lesions
• Atopic eczema
What is the management of nappy rashes?
As contact dermatitis is most common cause, the easiest solution is self-management:
• Use high absorbency nappies
• Leave nappy off for as long as possible to help skin dry
If mild, may apply topical emollient
More severe cases will require topical steroids (Hydrocortisone cream)
Candida related rashes require topical antifungals (Imidazole cream)
If rash persists and bacterial infection suspected, prescribe oral antibiotics (oral flucloxacillin)
What are the clinical features of seborrhoeic dermatitis?
Appears in first 3 years of life
Starts on scalp as erythematous scaly eruption
Scales form a thick yellow layer
Rash may spread to face and flexures
RASH IS NOT ITCHY AND DOESN’T BOTHER CHILD
What is the management of seborrhoeic dermatitis?
Regularly wash scalp with baby shampoo followed by gently brushing to loosen scales. Scales may be softened with baby oil first
If conservative fails and no improvement over weeks, prescribe topical imidazole cream
What is the management of eczema?
Mild eczema (Areas of dry skin and infrequent itching):
• Generous amount of emollients
• Mild corticosteroids (hydrocortisone) for red skin
Moderate eczema (Frequent itchiness and redness):
• Generous amount of emollients
• Moderate corticosteroid (betamethasone valerate)
• If itching/urticaria is severe, prescribe 1 month trial of anti-histamine (cetirizine)
Severe eczema (Widespread dry skin, incessant itching, localised skin thickening):
• Generous amounts of emollient
• Potent topical corticosteroid (higher dose betamethasone)
• Consider oral corticosteroid if causes psychological distress
• Antihistamine (cetirizine)
Infected eczema:
• Swab infected area
• Flucloxacillin
Eczema herpeticum:
• Systemic aciclovir
What are the clinical features of viral warts?
Caused by HPV
Usually found on fingers and soles of feet (Verrucae)
Most will disappear spontaneously over a few months
What is the management of viral warts?
Should only be treated if causing pain or cosmetic problems
* Daily administration of salicylic acid/lactic acid/glutaraldehyde * In older children, may use cryotherapy, though this is painful
What are the clinical features of molluscum contagiosum?
Caused by pox virus
Presents with pearly papules with central umbilication
Self resolve within 18 months
What are the features of ringworm?
Ring shaped erythematous skin lesion
If pustular, known as a kerion
Tinea capitis may cause patchy alopecia
What is the management of ringworm?
Investigation:
Skin scraping - Fungal hyphae seen under microscope
Treatment:
Mild = Topical antifungal
Severe/tinea capitis = Systemic antifungal
What are the clinical features of scabies?
Severe itching 2-6 weeks after infection, worse in warm conditions and at night
Infants/Young children = Palms, soles, trunk
Older children = Between toes/fingers/ axillae, genitalia
Burrows are pathognomonic of scabies
What is the management of scabies?
Topical insecticide (Permethrin cream)
• Applied to whole body
• Washed off after 12 hours
• Applied again 1 week later
What is the management of pediculosis?
Head lice infestation
Dimeticone lotion left on head overnight
Wash next day with shampoo
Repeat a week later
Fine tooth comb may help too
