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Paediatrics > Paediatric dermatology > Flashcards

Paediatric dermatology Flashcards

1
Q

Eczema

A
  • Red, dry, itchy skin eruption
  • Flares and settles intermittently
  • Familial pattern
  • Different pathogens associated
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2
Q

Atopc eczema

A
  • Most common type
  • Widespread diffuse eruption
  • Onset → anytime during childhood
  • Fluctuates in severity
  • Triggers
    • Illness
    • Stress
    • Teething
    • Environment → cold air, central heating
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3
Q

Pathophysiology of eczema

A
  • Increased water loss
  • Permeability of irritants and allergens
  • Filaggrin mutation predisposition → protein that binds keratin fibres together
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4
Q

Management of eczema

A
  • Topical steroids
  • Moisturisers and emollients → helps symptomatically with itch and reduces steroid use
  • Soap substitute for washing
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5
Q

Types of topical steroids

A
  • Mild → hydrocortisone
  • Moderate → eumovate
  • Potent → betnovate
  • Vert potent → dermovate
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6
Q

What are the problems of topical steroid

A
  • Steroid phobia
  • Conflicting advice
  • Skin thinning in prolonged use
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7
Q

Alternative management of eczema

A
  • Treatment of triggers → allergy, contact allergy, photo aggravation
  • Steroid sparing agent → Protopic ointment
  • Phototherapy UVB
  • Immunosuppression → methotrexate, ciclosporin, mycofenalate, azathioprine
  • Biologics
  • JAK inhibitor?
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8
Q

When to suspect food allergy

A
  • Immediate reaction (type 1 hypersensitivity) → lip swelling, facial itching, anaphylactoid symptoms
  • Late reaction (type 4 hypersensitivity)
    • Worsening eczema 24/48h after ingestion
    • GI problems
    • Failure to thrive
    • Severe eczema
    • Severe generalised itch → even when skin is clear
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9
Q

Discoid eczema

A
  • Scattered annular/ circular patches of itchy eczema
  • Pattern as part of atopic eczema or isolated
  • Stubborn to treat
  • Requires potent topical steroids and antibacterial component
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10
Q

Seborrhoeic dermatitis

A
  • Mainly scalp and fate
  • Associated with proliferation of skin commensal
  • Associated with cradle cap
  • Treatment
    • Emollients → loosen scales
    • Daktocort ointment
    • Protopic ointment
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11
Q

Impetigo

A
  • Common
  • Acute superficial bacterial infection
  • Pustules and honey-coloured crusted erosion
  • Staph aureus
  • Treatment
    • Topical antibacterial (fucidin)
    • Oral antibiotic (flucloxacillin)
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12
Q

Molluscum contagiosum

A
  • Self-limiting and common
  • 2 weeks to 6 month incubation
  • Transmission via close contact
  • Pearly papule, umbilicate centre
  • 24 months to clear
  • 5% potassium hydroxide → last resort
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13
Q

Viral warts

A
  • Benign and self-limiting
  • Non-cancerous growth caused by HPV infection
  • Transmitted by direct skin contact
  • Treatment → stimulate own immune system
    • Cryotherapy
    • Oral zinc
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14
Q

Viral exanthema

A
  • Reaction to toxin produced by organism, damage to skin by organism or immune response
  • Causes fever, malaise and headache
  • Viruses: chicken pox, measles, rubella, roseola, erythema infectiosum
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14
Q

Viral exanthema

A
  • Reaction to toxin produced by organism, damage to skin by organism or immune response
  • Causes fever, malaise and headache
  • Viruses: chicken pox, measles, rubella, roseola, erythema infectiosum
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15
Q

Chicken pox

A
  • Varicella zoster infection
  • Highly infectious
  • Infection causes lifelong immunity
  • Immunocompromised susceptible to virus all the time
  • Red papules (small bumps) → vesicles (blisters
  • Causes itch and viral symptoms
  • 1-2 days contagious before e rash
  • Self-limiting
16
Q

Parvovirus

A
  • Slapped check
  • Erythema infectiosum
  • Incubation 7-10 days
  • Viral symptoms
  • Erythematous rash initially, lace-like network rash
  • Mild and self-limiting
  • Virus targets red cells in bone marrow
  • Rare → aplastic crisis
17
Q

Hand foot and mouth

A
  • Enterovirus
  • Usually coxsakie virus A16
  • Blisters on hand, feet and mouth
  • Viral symptoms
  • Late summer and autumn prevalence
  • Self-limiting with supportive treatment
18
Q

Eczema coxackium

A
  • Associated with Cocksackie virus
  • Associated viral symptoms
  • History of eczema
  • F
19
Q

Orofacial granulomatosis

A
  • Lip swelling and fissuring
  • Oral mucosal lesions → ulcers and tags, cobblestone appearance
  • Associated with Crohn’s disease
  • Check faecal calprotectin if GI
  • Patch testing
  • Benzoate and cinnamate free diet
20
Q

Clinical features of erythema nodosum

A
  • Painful, erythematous subcutaneous nodules
  • Over shins and other sites
  • Slow resolution, like bruises
  • 6-8 weeks
21
Q

Causes of erythema nodosum

A
  • Infection → streptococcus and URTI
  • Inflammatory bowel disease
  • Sarcoidosis
  • Drugs → OCP, sulphonamide, penicillin
  • Mycobacterial infection
  • Idiopathic
22
Q

Dermatitis herpetiformis

A
  • Rare but persistent immunobullous disease
  • Linked to coeliac disease
  • Often symmetrical
  • Scalp, shoulder, buttocks, elbow and knees
  • Coeliac screen
  • Skin biopsy
  • Treatment → emollients, gluten free diet, topical steroids, dapsone (antibiotic)
23
Q

Urticaria

A
  • Wheals/ hives
  • Associated angioedema
  • Lasts a few months to 24 hours
  • Acute < 6 weeks
  • Chronic > 6 weeks
  • Causes
    • Viral infection
    • Bacterial infection
    • Food and drug allergy
    • NSAIDs, opiates
  • Chronic → idiopathic
24
Q

Treatment of urticaria

A
  • Identify and withdraw triggers
  • Antihistamines
    • Ranitidine
    • Montelukast
    • Ciclopsin
    • Omalizumab
25
Q

Treatment of urticaria

A
  • Identify and withdraw triggers
  • Antihistamines
    • Ranitidine
    • Montelukast
    • Ciclopsin
    • Omalizumab
26
Q

Infantile haemangioma

A
  • Strawberry spot
  • Benign
  • Very common vascular birth
  • Not present at birth
  • Proliferation between 6 weeks to 8 months
  • Starts to involute
  • Can be superficial or deep
26
Q

Infantile haemangioma

A
  • Strawberry spot
  • Very common vascular birth
  • Not present at birth
  • Proliferation between 6 weeks to 8 months
  • Starts to involute
  • Can be superficial or deep
27
Q

Treatment of infertile haemangioma

A
  • No treatment → resolves
  • Beta blockers to speed up involution
    • Topical timolol
    • Orla propanolol
  • Particularly for rapidly enlarging, cosmetic sensitive areas and ulcerating sites

Paediatrics (10 decks)

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