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Phase 3a conditions list flashcards > Paediatric - dermatology > Flashcards

Paediatric - dermatology Flashcards

1
Q

What are some key dermatological conditions in children (9)?

A
  • Eczema
  • Acne vulgaris
  • Uticaria + angioedema
  • Anaphylaxis
  • Birth marks
  • Stephensons-johnson syndrome
  • Nappy rash
  • Allergic rhinitis (not really derm, but anyway…)
  • Infectious rashes
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2
Q

What is acne vulgaris?

A

Chronic inflammation of the pilosebaceous unit

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3
Q

What bacteria is commonly responsible and found in the skin of those with acne?

A

Cutibacterium acnes (people with acne aren’t cute)

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4
Q

What makes up the pilosebaceous unit (2)?

A
  • Hair follicule
  • Sebaceous gland
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5
Q

How is acne vulgaris treated (4)?

A
  • Benzoyl peroxide
  • Topical/ oral retinoids
  • Topical/ oral antibiotics
  • Contraceptive pill (female only)
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6
Q

What is the typical presentation of a patient with acne vulgaris?

A

Erythematous papules/ pustules on face and back

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7
Q

What is an example of an oral retinoid for acne vulgaris?

A

Isotretinoin

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8
Q

When can isotretinoin not be used?

A

During pregnancy (teratogenic)

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9
Q

Example of an oral antibiotic for acne vulgaris?

A

Lymecycline

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10
Q

Example of a topical antibiotic for acne vulgaris?

A

Clindamycin

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11
Q

What is an example of an oral contraceptive used for acne vulgaris?

A

Co-cyprindiol

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12
Q

What is eczema?

A

A group of conditions that cause the skin to become dry, red and itchy

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13
Q

What are the main 2 types of eczema?

A
  • Atopic dermatitis
  • Contact dermatitis
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14
Q

What are the two types of contact dermatitis?

A
  • Allergic contact dermatitis
  • Irritant contact dermatitis
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15
Q

What is the pathophysiology of atopic dermatitis?

A

Defects in the skin barrier allow irritants, microbes to enter –> immune response –> inflammation

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16
Q

What is a key risk factor for eczema?

A

Family history

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17
Q

What age does eczema usually present?

A

Early childhood

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18
Q

Is eczema lifelong?

A

Sometimes (if a child is going to grow out of it they usually have done by age 18)

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19
Q

Where is eczema usually found on the body?

A

Flexor surfaces - inside of elbows and knees and on the face

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20
Q

How is eczema managed (4)?

A
  • Lifestyle changes (e.g. washing with soap less, itching less)
  • Emollients
  • Steroids
  • Specialist treatments (e.g. DMARDs, phototherapy))
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21
Q

What is an example of a mild topical steroid?

A

Hydrocortisone 0.5 - 2.5%

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22
Q

What is an example of a moderate topical steroid?

A

Clobetasone butyrate 0.05%

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23
Q

What is an example of a potent topical steroid?

A

Betamethasone 0.1%

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24
Q

What is an example of a very potent topical steroid?

A

Clobetasol propionate 0.05%

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25
Q

What are some side effects of topical steroids (4)?

A
  • Skin thinning
  • Bruising
  • Tearing
  • Enlarged blood vessels under skin
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26
Q

What areas should topical steroids be used with caution in?

A

Face and genital areas

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27
Q

What is the most common bacteria to infect the skin of those with eczema?

A

Staph aureus

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28
Q

How is staph aureus skin infection treated?

A

Flucloxacillin

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29
Q

What can exacerbate symptoms of eczema?

A

Frequent washing of skin with soap and water

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30
Q

What is eczema herpeticum?

A

Viral skin infection

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31
Q

What are some risk factors for eczema herpeticum?

A
  • Eczema/ other skin condition sufferer
  • Patient/ close contact with a coldsore
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32
Q

What is the most and second most common cause of eczema herpeticum?

A
  1. HSV-1
  2. VZV
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33
Q

What sort of rash does eczema herpeticum cause?

A

Widespread, painful, vesicular, erythematous rash
After vesicles burst they leave small punched out ulcers

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34
Q

What are the signs/ symptoms of eczema herpeticum (3)?

A
  • Rash
  • Systemic symtoms e.g. fever, lethargy, irritability
  • Lymphadenopathy
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35
Q

How is eczema herpeticum treated?

A

Acyclovir (may need to be IV)
admission if severe

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36
Q

What is a complication of eczema herpeticum?

A

Bacterial superinfection

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37
Q

What is the medical term for hives?

A

Urticaria

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38
Q

What is the pathophysiology of urticaria?

A

The release of histamine and other pro-inflammatory chemicals by mast cells under the skin causing inflammation + oedema

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39
Q

What are the two types of urticaria?

A
  • Acute
  • Chronic
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40
Q

What are some causes of acute urticaria (5)?

A
  • Allergies (food/ meds/ animals)
  • Contact with chemicals/ latex/ stinging nettles
  • Infections (viral)
  • Insect bites
  • Rubbing skin
    all of these can cause mast cells to release histamine
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41
Q

What are the 3 subclassifications of chronic urticaria?

A
  • Chronic idiopathic urticaria - no identifiable cause
  • Chronic inducible urticaria - identifiable triggers (e.g. sunlight, temp change, emotions)
  • Autoimmune urticaria - underlying autoimmune condition (e.g. SLE)
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42
Q

What other symptoms can occur with urticaria (3)?

A
  • Itching
  • Fatigue
  • General unwell feeling (due to inflammation)
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43
Q

How is urticaria managed?

A
  • Antihistamine
  • Steroids (for flares)
  • Specialist drugs
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44
Q

What is the antihistamine of choice for urticaria?

A

Fexofenadine

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45
Q

What specialist drugs can be used?

A
  • Anti-leukotrienes (e.g. montelukast)
  • Omalizumab (targets IgE)
  • Ciclosporin (anti-inflammatory)
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46
Q

What other symptoms may also occur with urticaria (2)?

A
  • Angioedema
  • Flushing of the skin
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47
Q

What is angioedema?

A

Sudden swelling of a body part

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48
Q

What part of the body is often affected by angioedema?

A

Tongue

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49
Q

What are the top 3 causes of angioedema?

A
  • Allergy
  • ACE inhibitors
  • Hereditary angioedema (C1 esterase inhibitor deficiency)
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50
Q

What is allergic rhinitis?

A

Allergic inflammatory response in the nasal mucosa and eyes

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51
Q

What type hypersensitivity is allergic rhinitis?

A

Type 1 hypersensitivity

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52
Q

What are the 3 types of allergic rhinitis?

A
  • Seasonal e.g. hay fever
  • Perennial e.g. house dust mite allergy
  • Occupational - associated with work/ school environment
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53
Q

What are the main signs/ symptoms of allergic rhinitis (4)?

A
  • Runny, blocked nose
  • Sneezing
  • Itchy eyes + nose
  • Red swollen eyes
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54
Q

What other medical conditions is allergic rhinitis associated with (2)?

A
  • Eczema
  • Asthma
    these three make the atopic triad
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55
Q

What are some tiggers for allergic rhinitis (4)?

A
  • Tree pollen/ grass
  • House dust mites
  • Pets
  • Mould
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56
Q

How is allergic rhinitis managed (3)?

A
  • Oral antihistamines
  • Nasal corticosteroids
  • Nasal antihistamines
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57
Q

What are 3 examples of non-sedating antihistamines?

A
  • Cetirizine
  • Loratadine
  • Fexofenadine
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58
Q

What are 2 examples of sedating antihistamines?

A
  • Chlorphenamine
  • Promethazine
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59
Q

What is an example of a nasal steroid spray?

A

Mometasone

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60
Q

What is the pathophysiology of anaphylaxis?

A

Upon second exposure to an irritant, IgE causes degranulation of mast cells –> histamine + other pro inflammatory chemicals released

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61
Q

What type of hypersensitivity is anaphylaxis?

A

Type 1 hypersensitivity

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62
Q

What differentiates anaphylaxis from other forms of allergies?

A

Compromise of airway, breathing or circulation

63
Q

What are the signs/ symptoms of anaphylaxis (9)?

A
  • Urticaria
  • Itching
  • Angioedema - particularly lips + eyes
  • Abdo pain
  • SOB
  • Wheeze/ stridor
  • Tachycardia
  • Lightheaded
  • Collapse
64
Q

How is anaphylaxis managed (4)?

A
  • A-E assessment
  • Adrenaline IM (again after 5 min)
  • Antihistamine
  • Steroids (IV hydrocortisone)
65
Q

How should patients be managed after the initial acute anaphylaxis (3)?

A
  • Admitted for observations in case of a biphasic reaction
  • Measure serum tryptase within 6 hours
  • Patient education + give epi pen
66
Q

What is tryptase and why is it measured?

A

It is released when mast cells degranulate
tryptase stays in blood for 6 hours so must be measured within this time period

67
Q

Where should an epi pen be administered?

A

Upper outer thigh

68
Q

What are the two categories of birth marks?

A
  • Vascular birth marks
  • Pigmented birth marks
69
Q

What are 3 types of vascular birth marks?

A
  • Salmon patches (nevus simplex) - pink/ red marks, often on forehead
  • Haemangioma - raised bright red areas (purple if under skin)
  • Port wine stains (nevus flammeus) - red, purple, dark patches/ marks on face
    the first two tend to fade and port wine stains can get darker if not treated
70
Q

Which one of the vascular birth marks can raise further health concerns?

A

Port wine stains can be associated with other weird health problems

71
Q

What are the 3 main types of pigmented birth marks?

A
  • Blue grey spots (mongolian birth spots)
  • Cafe au lait spots (light brown patches found anywhere)
  • Congenital melanocytic nevi (moles)
72
Q

Where are blue grey spots often found and why can this sometimes be concerning?

A

Found on lower back/ buttocks
Can be concerning because it can mimic injuries seen in abuse

73
Q

What is a risk of congenital melanocytic nevi?

A

Have a higher chance of developing into moles, depending on the size of the lesion

74
Q

What is a severe skin reaction that can follow medication use or infection?

A

Stephens-johnson syndrome

75
Q

What is a more severe form of Stephens-johnson syndrome?

A

Toxic epidermal necrolysis (TEN)

76
Q

What is the difference between SJS and TEN?

A
  • SJS affects < 10% skin surface
  • TEN affects > 30% skin surface
    between 10-30% of skin is an intermediate form
77
Q

What happens in the skin in stephens-johnson syndrome?

A

Autoimmune disorder where a disproportionate immune response causes epidermal necrosis resulting in blistering and shedding of the skin

78
Q

What type hypersensitivity is SJS and TEN?

A

Type 4 hypersensitivity

79
Q

What may predispose a person to SJS?

A

Certain HLA genes

80
Q

What are the signs/ symptoms of SJS (6)?

A

Begins with:
* Fever
* Cough
* Sore throat, mouth, eyes
* Pruritus
* Muscle/ joint aches
Then develop:
* Purple red - blistering rash

81
Q

What are some of the common medications that cause SJS (4)?

A
  • NSAIDs
  • Allopurinol
  • Abx
  • Anti-epileptics
82
Q

What are some of the common infections that cause SJS (4)?

A
  • HSV
  • M. pneumoniae
  • CMV
  • HIV
83
Q

How is SJS/TEN managed (4)?

A
  • Supportive care
  • Steroids
  • Immunoglobulins
  • Immunosuppressants
84
Q

What are some complications of SJS/TEN (3)?

A
  • Secondary infection
  • Skin damage
  • Visual complications
85
Q

What is a milder rash that can follow medication use and infections?

A

Erythema multiforme
used to be considered same spectrum as SJS/TEN, however now separate

86
Q

What does an erythema multiforme rash look like?

A

Typically target lesions (like lymes disease)
accompanied with general flu like symptoms

87
Q

What are some common causes of erythema multiforme (2)?

A
  • HSV
  • M. pneumoniae
88
Q

How is erythema multiforme managed?

A

Generally self limiting

89
Q

What condition may cause red lumps to form across a childs shins?

A

Erythema nodosum

90
Q

What are some causes of erythema nodosum (8)?

A
  • Strep throat
  • Gastroenteritis
  • M. pneumoniae
  • TB
  • Medications
  • Sarcoidosis
  • IBD
  • Lymphoma/ leukaemia
    pregnancy in adults
91
Q

What type of condition is erythema nodosum?

A

Type 4 hypersensitivity

92
Q

How is erythema nodosum investigated (5)?

A
  • Inflammatory markers
  • Throat swab
  • CXR
  • Stool microscopy/ culture (for gastroenteritis)
  • Faecal calprotectin
93
Q

What rash in sometimes found in those with coeliacs disease?

A

Dermatitis herpetiformis

94
Q

What is an important cause of rash around the pelvis and genital area in babies?

A

Nappy rash

95
Q

What is nappy rash?

A

Contact dermatitis where the skin comes into contact with the nappy, faeces and urine

96
Q

What age is nappy rash most common?

A

9-12 months
maybe because they start to move more???

97
Q

What are some risk factors for nappy rash (4)?

A
  • Poorly absorbent nappy
  • Delayed changing of nappy
  • Irritant cleaning products
  • Diarrhoea
98
Q

What are some complications of nappy rash?

A
  • Infection
  • Ulceration
99
Q

What are the most common causes of infection from a nappy rash (2)?

A
  • Candida
  • Strep/staph
100
Q

What might suggest a candida infection rather than just a nappy rash (4)?

A
  • Rash in skin folds
  • Well demarcated scaly border
  • Satellite lesions
  • Circular lesions spreading outward
101
Q

How can nappy rash be managed (3)?

A
  • Change nappy frequently
  • Use more absorbent nappies
  • Use genital cleaning products
102
Q

What are some infectious causes of rash in children (14)?

A
  • Chicken pox (VZV)
  • Hand foot and mouth (coxsackie virus)
  • Molluscum contagiosum
  • Ringworm
  • Scabies
  • Head lice
  • Staphylococcal scalded skin syndrome
  • Meningococcal sepsis (+ other bacterial sepsis)
  • Impetigo
  • Rubella
  • Measles
  • Roseola
  • Slapped cheek
  • Scarlet fever
103
Q

What is the pathophysiological cause of non-blanching rashes?

A

Bleeding under the skin from capillaries

104
Q

What two words can be used to describe non-blanching rashes depending on their size?

A
  • Petechiae = small < 3mm
  • Purpura = larger 3-10mm
105
Q

What are some causes of non blanching rashes in children (7)?

A
  • Meningococcal septicaemia
  • Henoch Schonlein purpura
  • Idiopathic thrombocytopenia purpura
  • Haemolytic uraemia syndrome
  • Acute leukaemia
  • Strong coughing/ trauma
  • Viral
106
Q

How should a non-blanching rash be managed in children?

A

Urgent referral to a hospital unless benign cause is clear

107
Q

How should a non-blanching rash be investigated?

A
  • Bloods (FBC, U&E, CRP, coagulation, culture)
  • Lumbar puncture (meningitis)
  • BP
  • Urine dip
108
Q

What is the presentation of molluscum contagiosum virus?

A

Papules with a central dimple that appear in clusters in a local area

109
Q

How is Molluscum contagiosum spread?

A

Direct contact/ sharing towels

110
Q

What causes molluscum contagiosum?

A

Molluscum contagiosum virus

111
Q

How is molluscum contagiosum treated (3)?

A
  • Nothing - body will fight it off on its own
  • Creams e.g. potassium hydroxide
  • Surgery/ cryotherapy
112
Q

What is ringworm?

A

A fungal infection of the skin causing a rash

113
Q

What is the most common cause of ringworm?

A

Trichophyton

114
Q

What is ringworm on the scalp called?

A

Tinea capitis
Wear a cap on your head

115
Q

What is ringworm on the foot called?

A

Tinea pedis (athlete’s foot)

116
Q

What is ring worm on the groin called?

A

Tinea cruris

117
Q

What is ringworm on the body called?

A

Tinea corporis

118
Q

What is ringworm on the nail called?

A

Onychomycosis

119
Q

What is the rash associated with ringworm like?

A

Well demarcated, scaly, erythematous itchy rash. With rings/ circles spreading outwards - centre is lighter than border

120
Q

How else might tinea capitis present?

A

Hair loss

121
Q

Where is tinea pedis found on the foot?

A

Between the toes

122
Q

How does onychomycosis present?

A

Thickened discoloured (white/ yellow) deformed nails

123
Q

How is ringworm treated?

A
  • Lifestyle advice (keep areas dry, don’t share towels etc…)
  • Anti-fungal creams/ shampoos
  • Oral anti-fungals
124
Q

What is an example of an anti-fungal cream?

A

Miconazole

125
Q

What is an example of an oral anti-fungal?

A

Fluconazole

126
Q

How should onychomycosis be treated?

A
  • Amorolifine (nail cream)
  • Oral terbinafine (send nail clipping to confirm)
127
Q

What is important to do when prescribing patients oral terbinafine?

A

Monitor LFTs before and during treatment

128
Q

What is a complication of ringworm if it is mistaken for dermatitis and steroid creams are prescribed?

A

Tinea incognito
Steroid cream suppresses immune system, when stopped the rash comes back bigger and better

129
Q

What is scabies?

A

Parasitic infection where tiny 8 legged creatures burrow under skin

130
Q

How long can the intubation period of scabies be?

A

Up to 8 weeks

131
Q

What is the presentation of scabies?

A

Small itchy red spots with track marks where the mites have burrowed

132
Q

Where does scabies typically affect?

A

Between the fingers (although can spread to whole body

133
Q

How is scabies treated (2)?

A
  • Permethrin cream
  • Oral ivermectin
134
Q

What parasite causes head lice?

A

Pediculus humanus capitis

135
Q

What are nits?

A

Unviable eggs or eggs that have hatched

136
Q

What is the presentation of a child with head lice?

A
  • Itchy scalp
  • Visible nits
137
Q

How are head lice treated (2)?

A
  • Dimeticone
  • Fine comb
138
Q

What is an inflammatory condition that affects the skin, particularly the sebaceous glands known as?

A

Seborrhoeic dermatitis

139
Q

Which parts of the body are often affected by seborrhoeic dermatitis (3)?

A
  • Scalp
  • Nasolabial folds
  • Eyebrows
140
Q

What is thought might cause seborrhoeic dermatitis?

A

Yeast colonisation (improves with anti-fungals)

141
Q

How can seborrhoeic dermatitis present in babies?

A

Crusty, flaky scalp

142
Q

What is seborrhoeic dermatitis in babies known as?

A

Infantile seborrhoeic dermatitis (cradle cap)

143
Q

When does cradle cap usually resolve by?

A

4-12 months

144
Q

What can seborrhoeic dermatitis cause when it infects the scalp of older children/ adults/ those with hair?

A

Dandruff!!!

145
Q

How is seborrhoeic dermatitis treated (2)?

A
  • Ketoconazole shampoo (if in hair)
  • Anti-fungal cream e.g. miconazole (if on face)
146
Q

What sometimes causes patchy hair loss from the scalp in children?

A

Alopecia areata

147
Q

What is alopecia areata?

A

Autoimmune condition where the body attacks hair follicles

148
Q

How does alopecia areata present?

A

Spot/ patchy baldness without inflammation + short hair regrowth around the edge

149
Q

How is alopecia areata managed?

A

Not much is usually done, topical corticosteroids can be given

150
Q

Where may suggest a poor prognosis for alopecia areata?

A

Early onset hair loss

151
Q

What skin condition may cause depigmentation of the skin leading to white patches?

A

Vilitigo

152
Q

What is the pathophysiology of vilitigo?

A

Autoimmune destruction of melanocytes

153
Q
A

Phase 3a conditions list flashcards (25 decks)

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