paediatric dermatology Flashcards
What is eczema
Red, dry and itchy skin eruption that comes in flares
What is the presentation of atopic eczema
- Widespread diffuse scaly red eruption
- Itchy
- Onset anytime
- Fluctuates in severity
How does eczema occur
- There is an increased permeability to irritants and allergens
- Leads to water loss which causes the dry and itchy skin
- Associated with a fillagrin deficiency
What is the management of eczema
- Topical steroids once a day for 1-2 weeks
- Emollients
- Soap substitutes to prevent drying out
Describe the topical steroid ladder
Mild - hydrocortisone
Moderate - eumovate
Potent - betnovate
Very potent - dermovate
What is the immediate (type 1) reaction to food allergy
- Lip swelling
- Facial redness
- itchiness
- anaphyactoid symptoms
What are the late reactions of a food allergy (Type IV hypersensitivity)
- Worsening of eczema 1-2 days after ingestion
- GI problems
- Failure to thrive
- Severe unresponsive eczema
- Severe itching
What is the presentation of discoid eczema
- Scattered annular(circular) patches of itchy eczema
- Stubborn response to treatment
What is the treatment for discoid eczema
- Potent topical steroid with a combination of antibacterial component e.g betnovate C ointment
What is the presentation of seborrheoic dermatitis
- babies under 3 months
- Associated with cradle cap in infants
- Affects the scalp and face - yellow greasy scalp and face
What is the treatment of seborrheoic dermatitis
- Emolients
- Daktocort ointment
- protopic ointment
What is the presentation of impetigo and what causes it
Pustules and golden crust - caused by staph aurus
What is the treatment of impetigo
- Topical fucidin
- Oral flucloxacillin
What is the presentation of molluscum contagiosum
- Pearly papules with an umbilicated centre
- Self limiting
What causes molluscum contagiosum
Molluscipox virus
What is the presentation of viral warts
Papillomatous with finger like projections coming out from it
What is the management of viral warts
- No treatment as it can be self limiting
- Topical salicylic acid to alert the body to the virus so it can fight it
What is the presentation of chicken pox
Red papules that progress to vesicles which start on the trunk and are itchy
When does chicken pox become uncontagious
When the lesions crust over
What is the presentation of parovirus (slapped cheek)
- Erythematous rash initially which then spreads to the trunk and limbs
- It is usually self limiting
Describe hand foot and mouth presentation and what causes it
- Caused by coxsackie virus A16
- presents with blisters on hands, feet and mouth as well as viral symptoms
- Self limiting
What is the presentation of eczema herpeticum
- Child appears unwell
- History of eczema
- Monophormic punched out lesions
What is the management of ecaema herpeticum
- Withold steroids for 24 hours and give aciclovir either oral or IV
What is the presentation of orofacial granulomatosis
- Lip swelling and fissuring
- Ulcers and tags with a cobblestone appearance in their oral mucosa
What is orofacial granulomatosis associated with
Crohns disease
What is the presentation of erythema nodosum
- Painful erythematous nodules over the shins usually
What are the causes of erythema nodosum
- Infections like strep
**- IBD ** - sarcoidosiss
What is the presentation of dermatitis herpetiformis
- Itchy blisters that appear in clusters
- Symmetrical
- Scalp, shoulders, buttocks, elbows and knees
What is associated with dermatitis herpetiformis
Coeliac disease
What is the presentation of urticaria
- Hives - appear for few minutes up to 24 hours
What is the treatment of urticaria
- avoid triggers
- Antihistamines are first line e.g desloratadine
What is an infantile haemangioma
- Very common vascular birth mark
- Occurs after birth
- dark red raised mark
What is PHACES and management
- Pituitary fossa abnormality
- Haemangioma
- Arterial anomalies
- Cardiac anomalies or coarctation of the aorta
- Eyes
- Sternal cleft
Treated with low dose propranolol
