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Y5 Paediatrics > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the skin of a newborn coated with

A

Vernix caseosa

Chalky white greasy coat

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2
Q

What is impetigo

A

Yellow gold crust around nose and mouth

Due to staph aureus

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3
Q

How do you treat impetigo

A

Topical fluclox

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4
Q

What is bullous impetigo

A

uncommon blistering form of impetigo

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5
Q

How do you treat bullous impetigo

A

Systemic antibiotics (oral fluclox)

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6
Q

What are melanocytic naevi

A

moles

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7
Q

What causes albinism

A

defect in biosynthesis and distribution of melanin

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8
Q

WHat are characteristics of albinism

A
  • failure to develop fixation reflex due to lack of pigment in iris, retina, eyelids, eyebrows
  • pendular nystagmus
  • photophobia
  • visual impairment
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9
Q

What are children with albinism prone to, so what must you give

A

Skin cancer and sunburn

So give high fa ctor sun creM

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10
Q

What is epidemiolysis bullosa

A 
GENETIC CONDITION (AR/AD) 
Blistering of skin and mucopus membranes occurring spontaneously / flllowing mild trauma
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11
Q

What is a colloidon baby

A

rare manifestation of inherited ichthyoses (dry scaly skin)

Skin is taut, shiny, parchment like
Membranes become fissured and separate within a few weeks
Risk of dehydration

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12
Q

What do you give to manage colloidon baby

A

emollients

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13
Q

What are common causes of naappy rashes

A

Common causes of nappy rashes:

  • irritant contact dermatitis
  • infantile seborrhoeic dermatitis
  • candida infection
  • atopic eczema
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14
Q

Why does irritant dermatitis occur as nappy rash

A

If nappy is not changed frequently enough

Due to irritant effect of urine on skin

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15
Q

How does irritant dermatitis present

A

SPARED FLEXURES

Rash is erythematous, scalded appearance

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16
Q

How do you manage irritant dermatitis

A

protective emollient

Topical steroids

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17
Q

What does a candida nappy rash look like

A

Includes flexures

Can cause satellite lesions

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18
Q

How do you manage candida naappy rash

A

topical antifungal (imidazole cream e.g. clotrimazole)

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19
Q

How do you manage nappy rash if it persists / swab is bacterial infection?=

A

ORAL FLUCLOX 7 days

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20
Q

When does infantile seborrhoeic dermatitis present

A

First three moths of life

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21
Q

What does infantile seborrhoeic dermatitis present as

A

Erythematous scaly eruption on scalp
NOT itchy
May involve flexures (neck, axillae, nappy area)

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22
Q

What is a cradle cap

A

Thick yellow adherent layer to head

Occurs in infantile seborrhoeic dermatitis

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23
Q

What risk is associated ith infantile seborrhoeic dermatitis

A

later development of ECZEMA

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24
Q

How do you manage infantile seborrhoeic dermatitis

A

reassure parents
resolves spontaneously over weeks / months
Regular washing with baby shampoo + brushing with soft brush to remove scales

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25
Q

What can you give if cradle cap / infantile seborrhoeic dermatitis is not resolving conservatively

A

could be due to inflammatory reaction to yeast > give topical imidazole cream (clotrimazole)

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26
Q

What is the pathophysiology of atopic eczem

A

BARRIER DEFECT OF EPIDERMIS

+

IMMUNE DYSREG OF TH2

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27
Q

How do you diagnose atopic eczema?

A

clinical
skinprick for T1 hypersensitivity
Elevated plasma IgE

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28
Q

What are clinical features of eczema

A

ITCHING > scratching, exacerbation of rsh, weepy ad pustular if infected

Dry skin
Lichenification, pigmentation

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29
Q

How does distribution of eczema change with age

A

In children: cheeks, scalp, extensor surface

in adults: flexor surfaces

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30
Q

What are complications of eczema

A 
overlying infection (bacterial) 
overlying infection from eczema >eczema herpeticum
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31
Q

What wueestionnaire can you use to assess psych impact of eczema on child?

A

Children’s Dermatology Life Quality Index Questionnaire

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32
Q

What is mild eczema

A

dry skin, infrequent itching

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33
Q

What is moderate eczema

A

dry skin, frequent itching, redness . possible excoriations and localised skin thickening

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34
Q

what is severe eczema

A

widespread areas of dry skin, incessant itching …

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35
Q

what does infected eczema look like

A

weeping, crusting, pustules with fevwr and maaise

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36
Q

How do you manage eczema conservatively

A

emollients

avoid soap

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37
Q

how do you manage eczema topically

A

corticosteroids (e.g. 1% hydrocortisone)
antihistamine (chlorphenamine)
retinoids
calcineurin inhibitors (tacrolimus)

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38
Q

What non drug management can you give for eeczema

A

phototherapy (narrowband UVB)

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39
Q

How do you manage mild eczema

A 
emollients 
mild corticosteroids (e.g. 1% hydrocortisone)
40
Q

how do you manage moderate eczema

A

emollient

potent steoid e.g. betamethasone valerate 0.025%

41
Q

how do you manage severe eczema

A

emollient

more potent steroid e.g. bethamethasone valerate 0.1%

42
Q

How do you manage infected eczema

A

SWAB infected skin

FLucloxacillin (erythromycin if allergic)

43
Q

How do you treat eczema herpeticum

A

IV acyclovir

44
Q

What causes virala warts

A

HPV

45
Q

Where are viral warts usually found in children

A

fingers, soles. called VERRUCAE

46
Q

When do verrucaes need to be treated

A

if painful / cosmetic problems

otherwise should disappear spontaneously

47
Q

How can you remove verrucae

A

daily salicylic acid, lactic acid

Cryotherapy with liquid nitrogen (painful)

48
Q

how do you manage molluscum

A

No treatment if child is immunocompetent

Should resolve independently within 18 months

49
Q

What is ringworm

A

DERMATOPHYTE

invcades keratinous structure e.g. skin, nails, hair

50
Q

Why are dermatophytes caled ringworm

A

due to annular appearance of skin lesion

51
Q

what is a kerion

A

inflamed pustular ringworm patch

52
Q

How does tinea capitis present

A

scaling, patchy alopecia with broken hairs

53
Q

how do you investigiate tinnea capitis

A

exam under UV light (Wood’s); green/yellow fluorescence of infected hairs
microscopy of skin scraping
culture

54
Q

What is management for ringworm

A

topical / systemic antifungal based on severity

e.g. terbinafine, itraconazole

55
Q

How is ringworm passed on

A

through cat/dog

56
Q

What is the cause of scabies

A

sarcoptes scabei

57
Q

What are symptoms of scabies

A

severe itching
worse in warm conditions/at night
burrows, papules, vescicles

58
Q

What is scabies dx based on

A

CLINICAL

may use microscopy exam of skin scraping to identify mite, eggs

59
Q

What is management of scabiees

A

Topical PERMETHRIN 5% cream (or malathion 0.5%)
Applied to whole body
Wash off after 8-12 hours
Second application after 1 week

Also treat members of household and other close contact

60
Q

How do you treat post scabetic itch

A

crotamiton 10% cream

61
Q

what is pediculosis

A

head lice infestation

with pediculosis capitis

62
Q

How do you treat pediculosis

A

DIMETICONE 4% lotion

OR

MALATHION 0.5%

63
Q

What does psoriasis present as

A

scaly plaques on extensor surface

p

64
Q

When does psoriasis present

A

AFTER AGE OF 2 YEARS OLD

65
Q

When does guttate psoriasis presents

A

After sore throat / ear infection

66
Q

Describe guttate psoriasis lesion

A

small, raindrop like
oval/round erythematous scaly patches
on trunk / back / upper limbs
Resolves over 3-4 months

67
Q

How do you treat guttate psoriasis

A

coal tar preparation
Calcipotriol (vit D agonist)
Phototherapy
Methotrexte

68
Q

What is PITYRIASIS ROSEA

A

acute, benign, self limiting

viral origin

69
Q

what is clinical appeearance of PITYRIASIS ROSEA

A

begins with herald patch (single round/oval scaly macule), 2-5cm diameter
after few days, several small dull pink macules also develop
Rash follows line of ribs posteriorly: FIR TREE MAATTERN

70
Q

Is PITYRIASIS ROSEA itchy

A

occasionalaly

71
Q

how do you treat PITYRIASIS ROSEA

A

no treatment required

resolves within 4-6 weeks

72
Q

What is alopecia areeata

A

common form of hair loss in children

regrowth aftrr 6-12 months

73
Q

how does alopecia areata present

A

hairlss smooth areas of non inflamed skin on scalp

Remnants of broken off hair (exclamation mark hairs)

74
Q

Describe granuloma annulare

A

Ringed lesion with raised flesh coloured non scaling edge

75
Q

How is granuloma annulare different to ringworm

A

NON SCALING

76
Q

How do you manage mild-moderatee acne vulgaris

A

Emollient, cleanser with non-comedogenic preparation

  1. Benzoyl peroxide
    • clindamycin
  3. Topical retinoid e.g. Adapalene
  4. Azelaic acid
77
Q

How do you manage moderate acne vulgaris not responding to topical tx

A

Consider oral anttibiotic e.g. Lymecycline / Doxyxycline, max 3 months

Co-prescribe topical retinoid or benzoyl peeroxide to prevent antibioptic resistancee

78
Q

What do you give to acne vulgaris if not responding to antibiotics

A

Isotrenitoin (Raccutanne)

79
Q

How often do you review for acne vulgaris

A

8-12 weeks

80
Q

Describe erythema nodosum

A

Tender erythematous nodules over legs

81
Q

What are triggers of erythema nodosum

A

Strep infection
TB
IBD
Drug reaction

82
Q

Descrive erythema multiforme

A

TARGET LESION (3 colours) - central papule surrounded by erythematous ring

83
Q

What are causes of erythema multiforme

A

HSV - omost common!
Mycoplasma pneumoniae
Infection
Drug reaction

84
Q

WHat is Steven Johnson Syndrome

A

Severe bullous form of erythema multiforme invading the MUCOUS MEMBRANE

can present with conjunctivitis and mouth ulceration

85
Q

WHat are triggers for SJS

A

drug sensitivity

86
Q

what is management for urticaria

A

avoid triggers
symptom diary
UAS7 (Urticaria Activity Score) to Assess

tx: non sedating antihistamine
oral corticosteroid if severe

refer if rebound symptoms occur after steroid

87
Q

Explain UAS7 (Urticaria Activity Score)

A

Records the severity of disease over 7 days

<7 in one week: control of disease
>28 in one week: SEVEREw

88
Q

what do you give for acne if not responding to topical therapy=?

A

Antibiotic (lymecycline/doxycycline) for 3 months + topical retinoid / benzoyl peroxide CO-PRESCRIBED

89
Q

What do you do for acne patients if not reponding to two courses of antibiotics / are scarring?

A

refer to dermatology for roaccutane

90
Q

how do you manage uncomplicated cellulitis

A

if uncomplicated: at home with antibiotics
HIGH DOSE FLUCLOX 7 DAYS
arrange review in 48h

91
Q

how does erysipelas present

A

similarly to cellulitis

but with VERY CLEAR demarcated rash

92
Q

how do you mange erysipelas

A

Pen V

93
Q

How do you manage Guttate Psoriasis

A
  • Cold tar preparation
  • Topical emollients (E45)
  • Dithranol
  • Calcipotriol (vitamin D)

ALSO Phototherapy (narrow band UVB 2-3x weekly)

94
Q

How do you manage milia?

A

most clear by themselves

remove if cosmetically displeasing (fine needle, cryotherapy)

95
Q

how do you manage viral warts in children?

A

watchful waiting
daily salicyilc acid/ lactic acid and file it down
cryotherapy with liquid nitrogen

Y5 Paediatrics (30 decks)

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