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Finals > Paediatric dermatology > Flashcards

Paediatric dermatology Flashcards

1
Q

What is the most common cause of a bacterial skin infection in someone with eczema ?

A
  • Staphylococcus aureus
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2
Q

what is eczema herpeticum ?

A
  • Viral skin infection caused by HSV or VZV
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3
Q

How does eczema herpeticum present ?

A
  • Pt who suffers with asthma
  • Develops widespread, painful, vesicular rash
  • Systemic Sx : fever, lethargy, irritability, reduced oral intake
  • Lympadenopathy
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4
Q

How is eczema herpeticum managed ?

A
  • Aciclovir (Oral or IV depending on severity)
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5
Q

What is acne vulgaris characterised by ?

A
  • Obstruction of the pilosebaceous follicle with keratin plugs resulting in comedones, inflammation and pustules
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6
Q

what is the stepwise approach to managing acne

A
  • Topical benzoyl peroxide
  • Topical retinoids (e,g,
  • Topical Abx (e.g. clindamycin)
  • Oral Abx (e.g. lymecycline)
  • Oral contraceptive pill (co-cyprindiol)
  • Severe : oral retinoids (Isotretinoin)
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7
Q

How does oral isotretinoin (roaccutane) work and a key CI?

A
  • Reduces : sebum production, bacterial growth and inflammation.
  • Teratogenic ! Must be stopped for at least 1mnth before getting pregnant.
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8
Q

4 SE of isotretinoin

A
  • Dry skin and lips
  • Photosensitivity of the skin to sunlight
  • Depression, anxiety, aggression and suicidal ideation.
  • Rarely Stevens-Johnson syndrome and toxic epidermal necrolysis
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9
Q

what are the 6 viral exanthemas

A
  • Pathogens that cause an eruptive widespread rash
  1. Measles
  2. Scarlet fever
  3. Rubella
  4. Duke’s disease
  5. Parvovirus B19
  6. Roseola infantum
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10
Q

-> Fever and conjunctivitis, followed by:
-> Greyish white spots of buccal mucosa (Koplik)
-> Rash beginning behind the ears, before spreading to the rest of the body

A

Measles

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11
Q

8 complications of measles

A

Otitis media (Most common)
Pneumonia (Most common cause of death)
Diarrhoea
Dehydration
Encephalitis
Meningitis
Hearing loss
Vision loss

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12
Q

How long should children with measles be isolated for ?

A

Until 4 days after symptoms resolve

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13
Q

what is the cause of scarlet fever?

A
  • Exotoxin produced by streptococcus pyogenes
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14
Q

What is the presentation of scarlet fever ?

A
  • Initial tonsilitis
  • Macular rash with ‘sandpaper’ feel, starting on trunkand spreading outwards.
  • Flushed face
  • Sore throat
  • Strawberry tongue
  • Cervical lymphadenopathy
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15
Q

How is scarlet fever managed

A
  • 10 days of phenoxymethypenicillin (penicillin V)
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16
Q

How long should children with scarlet fever be kept off school ?

A

24 hours after staring antibiotics

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17
Q

Give 3 complications of scarlet fever

A
  • Otitis media: the most common complication
  • Rheumatic fever: typically occurs 20 days after infection
  • Acute glomerulonephritis: typically occurs 10 days after infection
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18
Q

How does rubellapresent

A
  • Prodrome : e.g. low-grade fever
  • Rash: maculopapular, initially on the face before spreading to the whole body, usually fades by the 3-5 day
  • Lymphadenopathy: suboccipital and postauricular
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19
Q

How long should children with Rubella be kept off school

A

5 days after rash appears

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20
Q

How does parvovirus B19 present ?

A
  • Initial fever and coryzal Sx
  • Diffuse bright red rash on both cheeks
  • Raised and itchy rash spreading to trunk and limbs
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21
Q

Give 4 complications of parvovirus B19

A
  • Aplastic anaemia
  • Encephalitis or meningitis
  • Pregnancy complications : fetal death
  • Rarely hepatitis, myocarditis or nephritis
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22
Q

what is the cause of roseola infantum ?

A

Human herpes virus 6 (HHV6)

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23
Q

How does roseola infantum present

A
  • High fever (40) : lasting a few days, followed later by :
  • Maculopapular rash
  • Nagayama spots: papular enanthem on the uvula and soft palate
24
Q

what is the most common complication of roseola infantum ?

A

Febrile convulsions

25
Q

what is erythema multiforme and what is it most commonly caused by ?

A
  • Erythematous rash caused by a hypersensitivity reaction
  • Viral infections and medications
26
Q

What is a characteristic sign of erythema multiforme ?

A

-> Target lesions : red rings within larger red rings with the darkest point at the centre.

27
Q

what is urticaria and 6 acute causes

A
  • Hives (small itchy lumps) caused by release of histamines
  1. Allergies to food, medications or animals
  2. Contact with chemicals, latex or stinging nettles
  3. Medications
  4. Viral infections
  5. Insect bites
  6. Dermatographism (rubbing of the skin)
28
Q

what are 3 chronic causes of urticaria ?

A
  • Chronic idiopathic urticaria : unknown trigger
  • Chronic inducible urticaria : specific trigger
  • Autoimmune urticaria : caused by underlying autoimmune conditions (e.g. SLE)
29
Q

what is the first line management of urticaria ?

A

Non sedating antihistamines (e.g. Fexofenadine)

30
Q

what is the cause of chickenpox?

A

Varicella zoster virus (VZV)

31
Q

what are 6 complications of chickenpox ?

A
  • Bacterial superinfection (Increased risk with NSAIDs)
  • Dehydration
  • Conjunctival lesions
  • Pneumonia
  • Encephalitis (presenting as ataxia)
  • Reactivation : Shingles, Ramsay Hunt syndrome
32
Q

what is the cause of hand, foot and mouth disease ?

A

Coxsackie A virus

33
Q

How does hand, foot and mouth disease present ?

A
  • Mild systemic upset: sore throat, fever
  • Oral ulcers
  • Followed later by vesicles on the palms and soles of the feet
34
Q

What is the cause of molluscum contagiosum ?

A
  • Molluscum contagiosum virus (MCV) -> member of Poxviridae family
35
Q

how does molloscum contagiosum present ?

A
  • Pinkish or pearly white papules with a central umbilication
  • Appear in clusters anywhere on the body (except hands and soles of feet)
36
Q

what advice is given regarding molloscum contagiosum ?

A
  • Usually self resolves within 18mnths
  • Very contagious : avoid sharing towels, clothing etc
37
Q

How does pityriasis rosea present ?

A
  • Usually affects adolescents and young adults
  • No prodrome : minority may give a history of a recent viral infection
  • Herald patch (usually on trunk)
  • Followed by : erythematous, oval, scaly patches. On the torso can be arranged in Christmas tree fashion following the ribs
38
Q

How does seborroeic dermatitis often present in infants?

A
  • Craddle cap : crusted flaky scalp
  • Can also affect the nappy area, face and limb flexures
39
Q

How is seborroeic dermatitis of the scalp managed ?

A

-> Infantile : Baby oil and gently brushing scalp. If not effective = white petroleum jelly overnight to soften crusted areas.
-> Dandruff : Ketoconazole shampoo

40
Q

How is seborreic dermatitis of face and body managed

A
  • 1st line = antifungal (clotrimazole, miconazole).
41
Q

what is ringworm (Tinea) and what is the most common cause

A
  • Fungal infection of the skin
  • Trichophyton
42
Q

what are the different kinds of ringworm ?

A
  • Tinea capitis : ringworm affecting the scalp
  • Tinea pedis : ringworm affecting the feet (athletes foot)
  • Tinea cruris : ringworm of the groin
  • Tinea corporis : ringworm on the body (corporis
  • Onychomycosis : fungal nail infection
43
Q

How is tinea infection managed

A
  • Anti-fungal creams such as clotrimazole and miconazole
  • Anti-fungal shampoo such as ketoconazole for tinea capitis
  • Oral anti-fungal medications such as fluconazole, griseofulvin and itraconazole
44
Q

How are fungal nail infections managed ?

A
  • Amorolfine nail lacquer for 6-12 mnths
45
Q

what signs would point towards a candidal infection, rather than a simple nappy rash ?

A
  • Rash extending into the skin folds
  • Larger red macules
  • Well demarcated scaly border
  • Circular pattern to the rash spreading outwards, similar to ringworm
  • Satellite lesions, which are small similar patches of rash or pustules near the main rash
  • Presence of oral thrush
46
Q

How does scabies present ?

A
  • Intensely itchy small red spots with possible track marks where the mites have burrowed
  • Rash is often between the finger webs
47
Q

How is scabies managed ?

A
  • Permethrin cream
48
Q

How are headlice treated ?

A
  • Dimeticone 4% lotion overnight : repeated 7 days later
  • Fine comb treatment
49
Q

GIve 8 differentials of a non blanching rash

A
  • Meningococcal septicaemia or other bacterial sepsis : presents with a feverish unwell child.
  • Henoch-Schonlein purpura (HSP) : presents as a purpuric rash on the legs and buttocks and may have associated abdominal or joint pain.
  • ITP : develops over several days in an otherwise well child.
  • Acute leukaemias : gradual development of petechiae, potentially with other signs such as anaemia, lymphadenopathy and hepatosplenomegaly.
  • Haemolytic uraemic syndrome (HUS): associated with oliguria (very low urine output) and signs of anaemia. This often presents in a child with recent diarrhoea.
    -Mechanical: Strong coughing, vomiting or breath holding can produce petechiae in a “superior vena cava distribution”, above the neck and most prominently around the eyes.
  • Traumatic: Tight pressure on the skin, for example in non-accidental injury, or occlusion of blood in an area of skin can lead to traumatic petechiae.
  • Viral illness: This is often the explanation when other causes and serious illness are excluded.
50
Q

what is erythema nodosum

A
  • Inflammation of subcutaneous fat
  • Typically affecting the shins
51
Q

Possible underlying causes of erythema nodosum

A
  • Infection : streptococci, TB, brucellosis
  • Systemic disease : sarcoidosis, IBD, Behcet’s
  • Malignancy/lymphoma
  • Drugs : penicillins, sulphonamides, combined oral contraceptive pill
  • Pregnancy
52
Q

what is impetigo ?

A
  • Superficial bacterial skin infection
  • Usually caused by staphylococcus aureus
53
Q

what is non bullous impetigo and how is it managed

A
  • Lesions occur around nose and mouth with ‘golden crusts’
  • Hydrogen peroxide 1% cream
54
Q

what is bullous impetigo and how is it managed ?

A
  • Always caused by staph aureus
  • Fluid filled vesicles that burst to form ‘golden crust’
  • More systemically unwell
55
Q

what is the treatment of pityriasis rosea ?

A

non indicated
Self limiting over 12 wks

56
Q

What is pityriasis versicolor and how does it present ?

A
  • Superficial cutaneous fungal infection
  • Affects the trunk
  • Pink or brown patches
  • Mild itching
57
Q

How is pityriasis versicolor managed ?

A
  • Topical antifungal
  • Ketonazole shampoo

Finals (92 decks)

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