Final: Eyelids 1

Question 1

Molluscum Contagiosum

Answer 1

-Viral Infection (poxvirus) off the epidermis
-Transmitted through skin to skin contact or contact with fomites.
-Most commonly seen in infants/children.
-If seen in adults, maybe immunocompromised.
(+) bumps on skin (papules), maybe itch
(-) redness
-Can develop into viral conjunctivitis

Management:
-Self limiting 6-12 months (antivirals don’t work)
manage symptoms (cold compress, chemical)

Question 2

Impetigo

Answer 2

-Bacterial infection ( most commonly staph or strep) of the epidermis.
-More commonly in infants/children.
(+) bumps (macule), redness, itchy, skin rash, possibly painful
-Can blister (ruptured blister is honey colored and can scar)
-Highly contagious
-Most commonly affects arms, legs, nose and mouth
-Most common bacterial skin infection in children

Management:
-Topical antibiotic, usually ointment
-Oral antibiotic in addition to topical
-Discuss hand washing, avoid eye rubbing.

Question 3

What is the most common bacterial skin infection in children?

Answer 3

Impetigo

Question 4

Hordeolum

Answer 4

-Acute bacterial infection (staph) of the sebaceous gland with retention of oils and inflammatory debris
-External Hordeolum: Zeis gland
-Internal Hordeolum: Meibomian gland
(+) swelling, redness, pain, discharge from bump
-Can result in pre-septal cellulitis or orbital cellulitis
-May develop into a chalazion

Management:
-Oral antibiotic x 10-14 days (augmenting 500 mg BID, Reflex 500mg BID, Bactrim DS BID
-Warm compress with massage BID w 5-10 minutes of heat
-Lid hygiene

Question 5

Pre-Septal Cellulitis

Answer 5

-Infection (staph, strep, Haemophilus, less commonly herpes, zoster) of the tissue anterior to the orbital septum.
(+) Larger eyelid swelling, redness, pain, possibly low grade fever
-Eyeball looks normal, EOMs function properly, just pain and swelling around the eye
-Can become orbital cellulitis

Management:
Oral anti