Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 paediatrics > paediatric dermatology > Flashcards

paediatric dermatology Flashcards

1
Q

label the skin

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is eczema

A

red, dry itchy skin eruption

flares and settles intermittently

varies in severity - mild, moderate, severe

impact on QOL for whole family

familial tendency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how common is eczema

A

1/5 children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is atopic eczema

A

widespread, diffuse, red scaly eruption

very itchy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pattern of onset of atopic eczema

A

any time in childhood

fluctuates in severity

commmonest pattern is early onset and settles by school age

of prior to 3mths - raises suspicion of cow milk protein allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

triggers for atopic eczema

A

illness

stress

teething

environment - cold air, central heating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what causes atopic eczema

A

barrier defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

eczema - what is a barrier defect

A

increased permeability to irritants and allergens, water loss → dry and itchy, increased risk of irritation and sensitisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

fillagrin and eczema

A

filaggrin mutation identified to predispose to development of eczema → lack of structural integrity and moisturising factor

filaggrin = structural protein which binds keratin fibres together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is a sign of filaggrin deficiency

A

hyperlinearity on the palms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

management of eczema

A

topical steroids - mainstay of treatment, appropriate strength and adequate amounts need to be used

moisturiser (emollient) - itch management, helps to reduce total amount of steroid use over time

soap substitute - soap, shower gel and shampoo can all dry skin and flare eczema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

finger tip units

A

1 FTU = covers surface area of 2 adult hands (use as a guide to treatment)

1 FTU = 0.5g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

finger tip units for 3-6mth old child

A

1 FTU:

  • entire face and neck
  • entire arm and hand
  • entire front of chest and abdo

1.5 FTU:

  • entire leg and foot
  • enture back incl buttocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

finger tip units for 1-2y/o child

A

1.5FTU:

  • entire face and neck
  • entire arm and hand

2 FTU:

  • entire leg and foot
  • entire front of chest and abdo

3 FTU:

  • entire back incl buttocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

FTU for 3-5y/o child

A
  1. 5 FTU:
    * entire face and neck

2 FTU:

  • entire arm and hand

3 FTU:

  • entire leg and foot
  • entire front of chest and abdo
  1. 5 FTU:
    * entire back incl buttocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

FTU for 6-10y/o child

A

2FTU:

  • entire face and neck
    2. 5 FTU:
  • entire arm and hand
    3. 5 FTU:
  • entire front of chest and abod
    4. 5 FTU:
  • entire leg and foot

5 FTU:

  • entire back incl buttocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how to use steroids on body for eczema treatment

A
  • once daily for 1-2wks to affected areas
  • if improvement step down to alternate days for further week
  • stubborn/persistent areas - can use 2x wkly in these areas
  • if at any point eczema starts flaring, go back to daily applications

use ointment rather than cream - less preservatives, greasier preparations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

topical steroid ladder for eczema

A

vey potent - dermovate, 600x

potent - betnovate, 100x

moderate - eumovate, 25x

mild - hydrocortisone

  • step up potency if not effective enough or severity is increasing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

use of topical steroids on face for eczema

A
  • more sensitive area and need to limit steroid use
  • mild/moderate steroid for 3-5days and then stop and repeat as needed
  • if needing to use regularly (3-5 days >3x/mth) - can introduce tacrolimus (protopic ointment)
    • helps reduce use of streroids on face
    • helps repair skin barrier
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

why do parents avoid topical treatment for eczema

A
  • topical steroid phobia
  • conflicting advice
  • skin thinning in prolonged use - shouldn’t cause skin thinning if used appropriately and with clear instructions

if untreated, eczema can impact on QOL and can lead to faltering growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what happens when topical steroids don’t work in eczema

A

think about triggers - allergy, contact allergy, photoaggravation

steroid sparing agents - protopic ointment or Elidel cream

phototherapy UVB

immunosuppression - methotrexate, ciclosporin, mycogenalate, mofetil, azathioprine

biologics - dupilomab (IL4 inhibitor)

JAK inhibitors etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

emollients for eczema

A

the right moisturiser is the one parents are happy to use

ideally lighter emollient for during the day and greasier preparation to use at night

viscous garments can be used alongside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when to suspect food allergy

A

young onset of eczema - milk as a trigger

immediate reactions (type 1) - lip swelling, facial redness/itching, anaphylactoid symptoms

late reactions (type IV hypersensitivity) - worsening of eczema 24/48hrs after ingestion, GI problems, FTT, severe eczema unresponsive to treatment, severe generalised itching (even when the skin appears clear)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

testing for food allergy and related eczema

A

no specific test

remove suspected agent from diet for 4-6wks

rechallenge to see if symptoms reappear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is discoid eczema

A

scattered annular/circular patches of itchy eczema

can occur in this pattern as part of atopic eczema or in isolation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

treatment of discoid eczema

A

stubborn to treat - often re-appears in the same area

requires potent topical steroid, often in combination w/ antibacterial component e.g. betnovate C ointment

  • apply for 14 days until area settles then wean down
  • problematic areas - 2x/wk maintenance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is seborrheoic dermatitis

A

mainly scalp and face

often babies <3mths, usually resolves by 12mths

associated cradle cap in infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

organisms in seborrheoic dermatitis

A

associated w/ proliferation of various species of the skin commensal Malassezia in its yeast form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

treatment of seborrheoic dermatitis

A

emollients - to loose scale

daktocort ointment

protopic ointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is impetigo

A

common acute superficial bacterial skin infection

staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

features of impetigo

A

pustules and honey coloured crusted erosions

typically around mouth and nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

treatment of impetigo

A

topical antibacterial - fucidin

oral abx - flucloxacillin (non-responsive. not improving, systemically unwell)

separate towels and face cloths for rest of family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is molluscum contagiosum

A

common benign self limiting infection

molluscipox virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

features of molluscum contagiousum

A

2wk-6mth incubation

transmission to close direct contacts

pearly papules, umbilicated centre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

management of molluscum contagiosum

A

can take up to 24mths to clear

reassurance

5% potassium hydroxide - causes irritation and directs body towards virus to help clear up, just need to treat up 1-2 areas and rest should speed up recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are viral warts

A

benign self limiting condition

common non-cancerous growth of skin caused by HPV infection

common on hands and feet

transmitted by direct skin contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

treatment of viral warts

A

no treatment

stimulate own immune system to respond

  • topical treatments e.g. salicylic acid and paring
  • cryotherapy
  • oral zinc

90% resolve in 24mths

38
Q

what is viral exanthems

A

common

child has associated viral illness - fever, malaise, headache

either a reaction to toxin produced by the organism, damage to the skin by the organism or an immune response

chicken pox, measles, rubella, roseola (HSV 6), erythema infectiosum (parovirus B19, slapped cheek)

39
Q

what causes chicken pox

A

1y infection w/ varicella zoster virus

highly contgious

40
Q

immunity to chicken pox

A

one infection is thought to confer lifelong immunity

immunocompromised individuals are susceptible to the virus at all times

41
Q

features of chicken pox

A

red papules progressing to vesicles

often starts on the trunk

itchy

associated w/ viral symptoms

42
Q

what condition is this

A

atopic eczema

43
Q

what condition is this

A

discoid eczema

44
Q

what condition is this

A

seborrheoic dermatitis

45
Q

what condition is this

A

impetigo

46
Q

what condition is this

A

molluscum contagiosum

47
Q

what condition is this

A

viral warts

48
Q

vwhat condition is this

A

viral exanthems

49
Q

what condition is this

A

chicken pox

50
Q

timeline for chicken pox

A

incubation period 10-21 days

contagious 1-2 days before rash appears and until lesions have crusted

self limiting

51
Q

management of chicken pox

A

self limiting

infection control - nursery

rarely associated pneumonia, encephalitis

52
Q

slapped cheek causative organism

A

parvovirus

slapped cheek aka fifth disease, erythema infectiosum

53
Q

features of slapped cheek

A

incubation 7-10 days

viral symptoms

erythematous rash - cheeks initially, lace like network rash (trunk and limbs)

can take 6wks to completely fade

usually a mild self limiting illness

54
Q

where to the parvovirus cells target

A

red cells in bone marrow

55
Q

rare complications from slapped cheek

A

aplastic crisis (if haemolytic disorders)

risk to pregnant women - spontaneous abortion, intrauterine death, hydrops fetalis

56
Q

what condition is this

A

slapped cheek

57
Q

what causes hand foot and mouth

A

enterovirus - coxsackie virus A16, can also be due to enterovirus 17 and other coxsackivirus types

58
Q

features of hand foot and mouth

A

blisters on the hands, feet and in the mouth

viral symptoms

59
Q

epidemics of hand foot and mouth

A

late summer or autumn months

60
Q

treatment of hand foot and mouth

A

self limiting

supportive treatment

61
Q

what condition is this

A

hand foot and mouth

62
Q

features of eczema coxsackium

A

associated viral symptoms

hx of eczema

flared sites picks out areas of eczema

self limiting and children are relatively well

63
Q

what condition is this

A

eczema cosackium

64
Q

treatment for eczema coxsackium

A

self limiting

swab from lesions

treat w/ aciclovir if unsure and to err on the side of caution

65
Q

features of eczema herpeticum

A

unwell child

hx of eczema

monomorphic punched out lesions

66
Q

what condition is this

A

eczema herpeticum

67
Q

treatent for eczema herpeticum

A

withold steroids for 24hrs to prevent areas spreading further

aciclovir - oral/IV

50:50 as emollient

analgesia

ophthalmology review if near eye

68
Q

features of orofacial granulomatosis

A

lip swelling and fissuring

oral mucosal lesions - ulcers and tags, cobblestone appearance

69
Q

management of orofacial granulomatosis

A

consider crohn’s disease - check faecal calprotectin if GI symptoms

consider patch testing - benzoate and cinnamate free diet

70
Q

what condition is this

A

orofacial granulomatosis

71
Q

features of erythema nodosum

A

painful, erythematous subcutaneous nodules

located over shins, sometimes other sites

slow resolution, like bruise

6-8wks duration before fading and settling

72
Q

causes of erythema nodosum

A

infections - streptococcus, URTI, mycobacterial

IBD

sarcoidosis

drugs - OCP, sulphonamides penicillin

idiopathic

73
Q

what condition is this

A

erythema nodosum

74
Q

treatment of erythema nodosum

A

NSAIDs

identify and treat cause

sometimes topical steroid - less helpful with deeper inflamamtion

75
Q

what is dermatitis herpetiformis

A

rare but persistent immunobullous disease linked to coeliac

76
Q

features of dermatitis herpetiformis

A

itchy blisters, can appear in clusters

often symmetry

scalp, shoulders, buttocks, elbows and knees

77
Q

management of dermatitis herpetiformis

A

detailed hx

coeliac screening w/ TTG

skin biopsy

emollients, gluten free diet, topical steroids, dapsone

78
Q

what condition is this

A

dermatitis herpetiformis

79
Q

what is urticaria

A

wheals/hives

associated angioedema - 10% - important to differentiate from allergy (urticaria - lack of systemic symptoms)

areas of rash can last from a few mins -24hrs

80
Q

timing of urticaria

A

acute <6wks

chronic >6wks

81
Q

causes of urticaria

A

viral infection, bacterial infection

food/drug allergy

NSAIDs, opiates

vaccinations

chronic - idiopathic

82
Q

what condition is this

A

urticaria

83
Q

treatment of urticaria

A

consider possible triggers incl. medications and withdraw

antihistamines: non-sedating

  • off licence doses (3-4x standard)
  • newer generation e.g desloratadine

add on treatments: ranitidine, montelukast

for prolonged problems despite high dose anti-histamine: omalizumab, ciclosporin

84
Q

what is infantile haemangioma

A

very common vascular birth mark

not present at birth

proliferative phase between 6wks-8mths

then starts to involute

can be superficial or deep

85
Q

when are infantile haemangiomas more common

A

premature

low birth weight

females

FHx

86
Q

treatment for infantile haemangioma

A

no treatment is needed as will resolve

beta blockers can speed up the process of involution

  • topical - timolol 0.5% gel forming solution tds
  • oral - propanolol solution

when to treat:

  • rapidly enlarging
  • central face or cosmetically sensitive site
  • ulcerating: buttocks, genitals, posterior shoulder
86
Q

treatment for infantile haemangioma

A

no treatment is needed as will resolve

beta blockers can speed up the process of involution

  • topical - timolol 0.5% gel forming solution tds
  • oral - propanolol solution

when to treat:

  • rapidly enlarging
  • central face or cosmetically sensitive site
  • ulcerating: buttocks, genitals, posterior shoulder
87
Q

what condition is this

A

infantile haemangioma

88
Q

what condition is this

A

PHACES

89
Q

what is PHACES

A

pituitary fossa abnormality

haemangioma

arterial anomalies

cardiac anomalies or coarctation of the aorta

eyes

sternal cleft

90
Q

management of PHACES

A

low dose propanolol can result in good improvement of segmental haemangioma

MDT approach required

Y3 paediatrics (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions