Dermatology paeds Flashcards
what causes eczema
Eczema is an atopic dermatitis caused by a disturbed epidermal barrier leading to
increased water loss and infiltration of external contents and irritants
these irritants then cause and immune and inflammatory response
further damage to the epidermal barrier and exacerbations of symptoms occur
what is the presentation of Eczema
itching
erythetematous skin
weeping and crusted skin
lichenification of skin
regional lymphadenopathy
usually on flexion and friction surfaces
if a child younger than 2m comes in and the parents are ?eczema what is the actual diagnosis
seborrheic dermatitis
what is seborrhic dermatitis
a skin irritation afecting the seborrhic regions of skin
affecting face and trunk
what are complications of eczema
infections of staph, strep, HSV
why are staphylococcal infections particularly serious in children with Eczema
inflammatory response of Eczema causes the skin to become acidic
this is ideal for staph which then releases supertoxins and causes severe exacerbations of Eczema
describe the management of Eczema
lifestyle advice
emmolients - twie daily, either parafins or ointements
corticosteroids - hydrocortisone
immunomodulators - tacrolimus or pimercolimus
plus:
occlusive bandages which can have zinc or steroids
antibiotics/antivirals
psychological support
what is stephen-johnsons syndrome
a severe skin reaction which occurs with toxic epidermal necrosis
is a less sevreform of TEN’s
what is the diagnostic difference between stephen-johnsons syndrome and TENs
SJS <10% skin involvement
TEN> 30% skin involvement
what causes stephen-johnsons syndrome
abnormal immune reaction to drugs or infections
drugs typically include anticonvulstants or antibiotics
what is the presentation of stephen-johnsons syndrome
onset is: 1week post abx or 3w post anticonvulstants
ferer
sore thraot
skin lesions
conjunctivitis
burning eyes (more so in TEN)
painful mouth
burning skin
describe the skin lesions of stephen-johnsons syndrome / TEN
ulcerations at mucosa
erythetematous macules and flaccid blisters on skin
how do you diagnose stephen-johnsons syndrome
clinical diagnosis and exclusion of staphylococcal infection (which causes scalded skin syndrome)
how do you manage stephen-johnsons syndrome
STOP MEDS
iv fluids
enteric feeds
analgesia
opthalmology input
abx if theres a secondary infection
what is urticaria
raised red oedematous welts often itchy and are Sx of allergic reactions.
Can be acute or chronic
what is angioendema
eye swelling
what is the diagnostic criteria for a skin reaction to be acute
under 6 weeks reaction
linked to exposure to allergen or viral infection
what is the diagnostic criteria for a skin reaction to be chronic
over 6 weeks
no link to exposure ie non allergic origin
what is the pathophysiogy or urticaria
local increase in permeability of cappilaries and venules
what are causes of chronic uricaria
cold
heat
sun
aquagenic
cholinergic
what is the name of a mark presenting like:
flat red/pink patches on eyelids neck and forehead
salmon patch/stork mark
what kind of birth mark is a salmon patch/stork mark
vascular
what is the management of salmn patch/stork mark
dissapear on their own mostly within months
but
on forehead and neck can take around 4y
what is the name of a mark presenting like:
raised mark on skin which is red or purple
a vascular mark
called strawberry mark / infantile haemangioma
what is the management of aninfantile haemangioma
increase rapidly in size at 6 m
but then dissapear around 7 years
suregry in affecting vision or feeding
what is the name of a mark presenting like:
flat red/purple marks
can be mm-cm
unilateral
port wine stains
what causes port wine stains
capillary malformations
describe the course of port wine stains
colour deepends with age and hormonal changes and do not dissapea
what is the name of a mark presenting like:
flat light brown patches
cafe au lait spots
what does 6+ cafe au lait spots by the age of two indicate
neurofibromatosis
what is the name of a mark presenting like:
blue grey bruise like presenting at birth
on L back/buttock
mongolian spots
what is the course of mongolian spots
usually dissapear around 4y
what is the name of a mark presenting like:
relatively large black or brown mole present at birth
congeital melanocytic nevi
what is the course of congenital melanocytic nevi
get smaller w age
what causes congenital melanocytic nevi
overgrowth of pigmented cells (melanocytes)
what is a risk of congenital melanocytic nevi
skin cancer as an increase in number of miles increases your chances of them becoming cancerous
