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Paediatrics > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What are the causes of nappy rash?

A
  • Irritant dermatitis (inflammation of the skin due to contact with urine and faeces)
  • Candida infection
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2
Q

How can you differentiate between nappy rash caused by irritant dermatitis and candida infection clinically?

A

Irritant dermatitis:
- Rash spares the flexures

Candida infection:
- Rash includes the flexures

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3
Q

Describe the management of nappy rash due to irritant dermatitis

A

Mainly conservative:

  • Leave nappy off as much as possible
  • Change nappy often

Medical:

  • Use a thin layer of barrier cream/ointment before putting on each nappy, e.g. metanium
  • Steroid cream/ointment, e.g. hydrocortisone
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4
Q

Describe the management of nappy rash caused by candida infection

A

Topical antifungal treatment: an imidazole cream (e.g. clotrimazole, miconazole)

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5
Q

When does infantile seborrhoeic dermatitis present?

A

Usually in the first few weeks of life

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6
Q

Describe the clinical presentation of infantile seborrhoeic dermatitis

A
  • Initially appears as erythematous, scaly rash on the scalp
  • Then forms a thick yellow adherent layer (‘cradle cap’)
  • Rash may spread to the face, behind the ears, flexural surfaces (e.g. axillae) and nappy area
  • Does not bother baby
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7
Q

Describe the management of infantile seborrhoeic dermatitis

A

Mild cases (conservative management):

  • Parental reassurance, advise that rash will clear on its own
  • Can use emollient/baby shampoo and gentle brushing to soften and loosen the scales

Moderate/severe cases (i.e. widespread involvement)
- Imidazole cream (e.g. clotrimazole, miconazole)

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8
Q

Describe the aetiology of molloscum contagoisum

A

Poxvirus

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9
Q

Describe the skin lesions found in molloscum contagiosum

A
  • Small, skin-coloured pearly papules with central umbilication
  • Usually widespread
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10
Q

Describe the prognosis of molloscum contagiosum

Is it contagious?

A
  • Self-limiting
  • Treatment not usually recommended
  • It is very contagious (spread directly through close personal contact, and indirectly through towels, flannels etc.)
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11
Q

What are the clinical features of eczema?

A
  • Dry, red, itchy patches of skin
  • Infants: face and trunk
  • Younger children: extensor surfaces
  • Older children a more typical distribution is seen, with flexor surfaces affected and the creases of the face and neck
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12
Q

Describe the management of eczema (maintenance and flares)

A

Maintenance management:
- Emollient, emollient, emollient!

Flares:

  • Emollient
  • Topical steroids (use lowest potency required for shortest time required)
  • Dressings/bandages
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13
Q

What are the potential complications of eczema?

A
  • Eczema herpeticum (viral infection)

- Secondary bacterial infection

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14
Q

Describe the aetiology of eczema herpeticum

A

Viral skin infection caused by HSV1

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15
Q

What are the clinical features of eczema herpeticum?

A
  • Itchy, red rash (eczema) has become vesicular and painful

- Systemic symptoms = fever, lethargy, reduced oral intake

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16
Q

Describe the management of eczema herpeticum

A
  • Potentially life-threatening emergency

- Admission and IV aciclovir

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17
Q

Describe the aetiology and pathophysiology of secondary bacterial infection in eczema

A
  • Staphylococcus aureus

- Breakdown in skin’s protective layer allows an entry point

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18
Q

What are the clinical features of secondary bacterial infection in eczema?

A

Worsening in eczema (increased redness, oozing, crusting of the skin)

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19
Q

Describe the management of secondary bacterial infection in eczema

A

Flucloxacillin (oral or IV, depending on severity)

20
Q

Which organisms cause impetigo?

A

Staphylococcal or streptococcal infection, e.g. Staphylococcus aureus

21
Q

What are the clinical features of impetigo?

A
  • Lesions are usually on the face, around the nose and mouth
  • Initially erythematous macules
  • Then form honey-coloured crusts
22
Q

Describe the management of impetigo

Are children allowed to go to school?

A
  • 1st line: topical hydrogen peroxide; 2nd line: topical fusidic acid
  • Severe cases may require oral antibiotics, e.g. flucloxacillin
  • Highly contagious - children MUST NOT go to nursery or school until the lesions are healed, dry and crusted over
23
Q

Which organisms cause periorbital cellulitis?

A

Staphylococcal or streptococcal infections, e.g. Staphylococcus aureus

24
Q

What are the clinical features of periorbital cellulitis?

A
  • Fever
  • Erythema, tenderness and oedema of the eyelid and skin surrounding the eyelid
  • Almost always unilateral
25
Q

Give some risk factors for periorbital cellulitis

A
  • Preceding paranasal sinus infection

- Preceding dental abscess

26
Q

Describe the management of periorbital cellulitis

A

Immediate IV antibiotics (3rd generation cephalosporin) e.g. ceftriaxone, to prevent posterior spread of infection causing orbital cellulitis

27
Q

Which organism that causes scalded skin syndrome?

A

Staphylococcus aureus (SSSS - Staphylococcal Scalded Skin Syndrome)

28
Q

Describe the pathophysiology of scalded skin syndrome

A

Staphylococcus aureus produces a toxin which causes the epidermis to blister and peel

29
Q

What are the clinical features of scalded skin syndrome?

A
  • Fever

- Painful, blistering, peeling skin

30
Q

Describe the management of scalded skin syndrome

A
  • IV flucloxacillin
  • Analgesia
  • Fluids
31
Q

What is ringworm? What are the clinical features?

How is ringworm classified?

A
  • Fungal infection
  • Itchy, CIRCULAR, erythematous, scaly rash
  • Well-demarcated

Classified according to location:

  • Tinea capitis = ringworm of the scalp
  • Tinea pedis = ringworm of the foot (athlete’s foot)
  • Tinea cruris = ringworm of the groin
  • Tinea corporis = ringworm on the body
32
Q

Describe the management of ringworm

A
  • Topical imidazole creams (e.g. clotrimazole, miconazole)

- Severe cases: add oral antifungal (e.g. fluconazole)

33
Q

Describe the aetiology and pathophsyiology of scabies

A

Caused by mites (Sarcoptes scabiei) which burrow under the skin and lay eggs

34
Q

What are the clinical features of scabies

A
  • Incredibly itchy
  • Small red spots
  • Classical location: starts between fingerwebs then becomes widespread
35
Q

Describe the management of scabies

A

Treat the patient and all household members/close contacts with a topical insecticide (5% permethrin cream)

Wash everything!!!

36
Q

Describe the aetiology of erythema multiforme

A

Triggered by infection (most commonly HSV) or certain drugs…

Drugs:

  • Antibiotics, e.g. penicillin
  • NSAIDs, e.g. ibuprofen
  • Anticonvulsants, e.g. phenytoin, carbamazepine
37
Q

What are the clinical features of erythema multiforme?

A
  • Widespread itchy, erythematous rash

- ‘Bullseye’ or ‘target’ lesions

38
Q

Describe the management of erythema multiforme

A
  • Withdraw offending medication if applicable

- Usually self-resolving

39
Q

Describe the pathophysiology of psoriasis

A

Autoimmune + environmental trigger

40
Q

What are the clinical features of psoriasis?

A
  • Recurrent episodes of dry, flaky, scaly, erythematous patches over extensor surfaces (knees, elbows) and scalp
  • Guttate psoriasis is a common presentation in children - often follows a streptococcal or viral sore throat/ear infection
41
Q

Describe the management of psoriasis in children

A
  • Topical corticosteroids

- Vitamin D analogues (e.g. calcipotriol)

42
Q

What are the most common birth marks in children?

A
  • Salmon patch (stork mark)
  • Infantile haemangioma (strawberry birthmark)
  • Capillary malformation (port wine stain)
  • Cafe-au-lait spots
  • Mongolian blue spots
  • Congenital melanocytic naevi (normal moles)
43
Q

What are the clinical features of a salmon patch birthmark?

Is this type of birthmark common?

What is the prognosis?

A
  • Flat pink/red patches on a baby’s eyelid, forehead or neck at birth
  • Very common - occur in around half of all babies
  • Fade completely in a few months
44
Q

What are the clinical features of infantile haemangioma?

Are they more common in boys or girls?

What is the prognosis?

A
  • Raised red mark on the skin
  • More common in girls
  • Rapidly increase in size up to 6 months, then begin to shrink - usually disappear by 7 years of age
45
Q

What are the clinical features of capillary malformation (port wine stain)?

What is the prognosis?

A
  • Flat red/purple mark

- Permanent

46
Q

What are the clinical features of cafe-au-lait spots?

Can cafe-au-lait spots be a sign of another condition?

A
  • Flat, light-brown patches

- Neurofibromatosis

47
Q

What are the clinical features of Mongolian blue spots?

Which populations are they more common in?

What is the prognosis?

A
  • Flat, dark purple/blue marks
  • Usually appear over the lower back/buttocks
  • More common in darker-skinned populations
  • Usually disappear

Paediatrics (17 decks)

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