DERMATOLOGY Flashcards
What is the skin symptom? Name two conditions in which you can see this
Desquamation
Kawasaki’s disease, post scarlet fever
What is this skin lesion? What is it caused by, give two examples?
Maculopapular rash: flat, red area on the skin that is covered with small confluent bumps.
Measles, drugs
Macular versus papular
Macule — a small patch of skin that is altered in colour, but is not elevated.
Papule — elevated, solid, palpable lesion that is ≤ 1 cm in diameter.
What type of rash is this? What is a classic cause in children?
Vesicular rash
Chickenpox
What type of rash is this? What is it called by?
Urticaria – AKA hives, weals, welts or nettle rash – raised, itchy rash. It may appear on one part of body or be spread across large areas. usually very itchy
What is this rash assuming that it is non-blanching? Give examples of conditions that cause it
Petechial/purpura rash
Petechia are tiny pinpoint purpura
meningococcaemia, ITP, Henoch-Schonlein purpura (HSP), leukaemia
What are the six points you should consider when describing a rash?
- Raised or flat? (Papular or macula)
- Crusty or scaly?
- Colour
- Blanching?
- Size
- Distribution
What is this rash?
Erythema toxicum neonatorum
- commonest rash in newborns
- non-threatening rash in newborns. It appears in 4-70% of newborns within first week of life, typically improves within 1-2 weeks.
- only occurs during newborn period, but may appear slightly later in premature babies.
- small erythematous macules plus or minus central small pustules
What is this rash?
Milia (milk spots) are small white bumps that appear on skin
- very common
- White/yellow
- Usually on nose, cheeks, chin, forehead
- Resolve
What is this rash? What is it caused by?
Miliaria aka sweat rash or prickly heat
- common skin disease caused by blockage and/or inflammation of eccrine sweat ducts
- frequently seen in hot, humid, or tropical climates, in patients in hospital, and in neonatal period
What is this rash? How do you identify? Which other part of the body may also be affected? How do you treat?
Candidal nappy rash
Bright red rash with clearly demarcated edge and satellite lesions beyond border. Inguinal folds usually involved. May have oral thrush
Treat with a nystatin cream and orally if necessary
Which condition is associated with rash pictured and similar nappy rash? How do you treat?
Infantile seborrhoeic eczema/dermatitis (cradle cap)
Erythema and scaling rash affects face, neck, behind ears, axilla, scalp (cradle cap), upper trunk, nappy area and factions
Majority spontaneously resolved within weeks but minority go on to develop atopic eczema
Treatment: avoid detergents i.e. soap, use emolients, mild topical steroid/antifungal cream
What is this rash? What is the typical prognosis? What are the treatment options?
capillary hemangioma (“strawberry” birthmark) is a benign tumour consisting of abnormal overgrowth of tiny blood vessels. may be present at birth or appear within first 6 months
- Enlarge until 2 to 4 years then regress, usually spontaneously resolved with no treatment
- If near important structures such as eyes then oral or topical propranolol can be given to shrink lesions
What is this? What is the prognosis?
Capillary malformation (port wine stain): pink or purple lesion, sharply circumscribed, present from birth
Don’t go away on their own. In absence of successful treatment, hypertrophy may cause problems later in life, such as loss of function (near eye or mouth), bleeding, disfigurement.
What is this condition? Prognosis?
Mongolian blue spots, AKA slate gray nevi → pigmented birthmark
- congenital dermal melanocytosis
- flat and blue-gray
- buttocks or lower back, may be found on arms or legs
- mistaken for bruises
- almost always disappear before adolescence, no Tx needed
What is this condition? How do you treat?
Staphylococcal scalded skin syndrome
Intravenous antibiotics
What is this rash caused by? Explain why the rash develops. Best prevention?
Meningococcal septicaemia
- Neisseria meningitidis, like many other gram-negative blood infections, causes DIC
- DIC causes ischemic tissue damage when upstream thrombi obstruct blood flow and haemorrhage because clotting factors are exhausted
- Small bleeds into skin cause non blanching petechial rash
- vaccine is best prevention
What is this rash caused by?
Chickenpox
Review the difference between varicella-zoster and herpes zoster
A child feeling generally unwell with a fever presents with these signs. What is the cause of this condition? What would you expect the rash to feel like? How do you treat? What are the two main sequelae of this infection?
Scarlet fever
- Group A streptococcus tonsillitis
- Risk of glomerulonephritis and rheumatic fever
- Treat with penicillin
Which condition is associated with Koplik’s spots? How do you expect the skin rash look look in this condition?
Measles
Morbilliform rash (drug rash appearance)
Which infection is characterised by a rash that moves down the body, starting from face? In which patient group is this infection most risky? Explain why
Rubella (German measles)
Pregnancy: severe fetal anomalies if mother develops rubella in first trimester
What is this infection? What is the likely rash that will be seen on the body? What is it caused by?
Slapped cheek syndrome (fifth disease, erythema infectiosum)
- Lacelike rash on body
- Parovirus B19 infection
What is this condition? What’s it caused by? How do you treat?
Impetigo, highly contagious superficial skin infection caused by staphylococcus or streptococcus bacteria
Treat with antibiotics: flucloxacillin or erythromycin
Patient with intensely itchy rash and the following sign has which condition? How to treat?
Scabies
Treat entire household with scabicides and launder bedding
Purpura on buttocks and legs, arthritis and abdominal pain is classic triad of which condition?
this condition is associated with which GI condition? And which renal condition?
Henoch-Schönlein purpura (IgA vasculitis)
- Intussusception
- Nephritis (haematuria, proteinuria, hypertension), rarely renal failure
Cracked lips and strawberry tongue as well as lymphadenopathy and peeling skin at fingers and toes and a fever >5 days not responding to paracetamol are signs of which condition? Treatment? What is a cardiac complication of this condition?
Kawasaki’s disease - form of vasculitis thought to be response to infection
- IVIG and aspirin
- some children can form coronary artery aneurysms
What is the Kawasaki like condition associated with COVID-19 in children?
Paediatric inflammatory multisystem syndrome (PIMS / PIMS-TS)
What is this condition? What is caused by? How is it treated?
Hand, foot and mouth disease
- Coxsackievirus, enterovirus
- supportive treatment
