Dermatology + allergy

Question 1

what rashes/patches are seen on neonates?

Answer 1

Salmon patch
Haemangioma
Port wine stain
Erythema toxicity neonatorum
Cafe au lait spots
Milia

Question 2

what is a salmon patch?
when does it fade?

Answer 2

Flat face mark
fades in months

Question 3

what is a haemangioma?
what is it associated with?

Answer 3

Strawberry naevus - self limiting
Sturge weber syndrome

Question 4

what is port wine stain?

Answer 4

permanent red flat face mark

Question 5

what is erythema toxicity neonatorum?

Answer 5

eczema like neonatal skin
self limiting

Question 6

what are cafe au lai spots?
what does it mean If there are >5?

Answer 6

flat light brown patches
>5 = NFM

Question 7

What are milia?

Answer 7

sebaceous plugs
sweat glands plugged by sebum

Question 8

what is eczema?
pathophysiology?
RF?

Answer 8

Atopic dermatitis
T1 Hypersensitivity reaction - defect in skin barrier - inflammation
<4y (70%)

RF - Atopy, Phx, Fhx

Question 9

what are the types of eczema and MC?

Answer 9

mc = atopic
Irritant
Allergic
Seborrhoeic (hypo pigmented fungal - parkinsons)
Discoid (very itchy circular lesion)

Question 10

Sx of eczema?
Severity score?

Answer 10

Pruritus
Dry flaky skin
Lichenification (hyperpigmented + thicker skin)

EASI (Eczema area + severity index)

Question 11

where is eczema found in infants vs older kids?

Answer 11

Infants = face + extensors

Older = neck creases + flexors

Question 12

Tx of eczema?

Answer 12

1. Emollient + mild corticosteroid
2. Emollient + moderate corticosteroid + antihistamine
3. Emollient + potent corticosteroid + antihistamine
   +/- PO steroid (must be 5+ y)
   (if given, monitor growth)

Question 13

complication of eczema?

Answer 13

Superinfection (S.aureus)

Eczema herpeticum (HSV superinfection; inpatients and IV Acyclovir)

Dehydration

sleep difficulty

Question 14

what is psoriasis?
what genetically predisposes people to psoriases?

Answer 14

T cell mediated - silver/white scales

HLA B13, 17, 27

Question 15

Sx of psoriasis?

Answer 15

Scaly white plaques

+ve Koebner phenomenon (worse with friction) - formation of skin lesions where typically not experienced

+ve Auspitz sign (scratch = capillary bed bleed)

+ Nail changes (50%) - oncholysis, nail dystrophy

Question 16

where does psoriasis usually affect?

Answer 16

On extensors
behind ears
on scalp

Question 17

Types of psoriasis?
MC?

Answer 17

Chronic plaque (85%)
Gutate (15%) - teardrop lesions post S.Pyogenes infection

Question 18

what does psoriasis increase risk of?

Answer 18

CVD
Psoriatic arthritis

Question 19

Tx for psoriasis?

Answer 19

1. Emolient / topical steroid + Vit D
2. UV B
3. DMARD (Methotrexate - infliximab, ustekinumab)

Question 20

Allergy Sx?

Answer 20

URF
Urticaria (hives)
Rhinorrhoea
Flushing

Question 21

what is anaphylaxis?
Sx?
Dx?

Answer 21

Life threatening allergic reaction

Sx: central cyanosis, resp distress (stridor + T1 resp failure)

Dx: High mast cell tryptase

Question 22

Tx for anaphylaxis?

Answer 22

IM Adrenaline

1-5y = 150 mcg
5-12y = 300 mcg
12+y = 500mcg

Question 23

what is hereditary angioedema?
Tx?

Answer 23

macularpapular rash +/- upper airway obstruction
No URF

Tx: IV C1 esterase inhibitor