Paediatric Dermatology Flashcards
What is eczema?
Itchy, dry inflammatory skin disease
What is the normal gene expression in eczema?
Abnormality in filaggrin expression
What is the function of filaggrin?
Proteins bind keratin filaments together and help maintain moisture
What is the distribution of eczema?
Flexural in older children
Face, neck, hands in infants
Discoid, generalised
What can eczema flares be associated with?
Infections/ viral illness Central heating, cold air Pets Teething Stress
What is seborrheoic dermatitis also known as?
Cradle cap
Where is seborrheoic dermatitis found?
Scalp and face
Flexures- neck, wirst, hands
What is the treatment for seborrheoic dermatitis?
Emollients
Antifungal cream and shampoo
Mild topical steroids
What does discoid eczema look like?
Scattered annular/circular patches
What are the features of pompholyx eczema?
Hand and foot eczema
Vesicles, bullae
Intensely itchy
What is the treatment for pompholyx eczema?
High potency steroid
What type of reaction is allergic eczema?
Type 4 hypersensitivity
How can allergic eczema be tested for?
Patch testing
What can cause irritant eczema?
Water, saliva
Soaps, bubble baths
Irritant foods (citrus, tomatoes)
Chemical irritants
When should a food allergy be suspected?
Angioedema, facial rash Worsening of eczema 24/48 hours after ingestion GI symptoms (vomiting) Failure to thrive Severe eczema unresponsive to treatment Severe generalised itching
What are the most common food allergies?
Milk/diary Soy Peanuts Eggs Wheat
What are the common airborne allergies?
House dust mite
Pet dander
Pollens
How can allergies be tested for?
Blood test for specific IgE antibodies
Skin prick testing
Dietary restrictions/ eliminations >8 weeks
Alter one food at a time
What are the treatment options for eczema?
Emollients (creams or ointments) Soap substitutes Topical steroids Calcineurin inhibitors UVB light therapy Immunosuppressive medication
What is the steroid stepwise approach for eczema flare ups?
Mild -hydrocortisone Moderate - eumovate Potent - betnovate Very potent - dermovate Once daily for 7-10 days, then reduce
What are the potential adverse effects of topical steroids?
Skin thinning with prolonged use
Systemic absorption
What is the common bacterial cause of impetigo?
Staph aureus
What are the symptoms of impetigo?
Pustules
Honey-coloured crusted erosions
What is the treatment for impetigo?
Topical antibiotic Oral antibiotic (flucloxacillin)
What causes molluscum contagiosum?
Mulluscipox virus
What are the symptoms of molluscum contagiosum?
Pearly papules
Umbilicated centre
What is the common organism that causes viral warts or veruccas?
HPV
What conditions can cause viral exanthema?
Chicken pox Measles Rubella Roseola Erythema infectiosum (slapped cheek)
What are the symptoms of chicken pox?
Red papules progress to vesicles, rupture and crust
Itchy and viral symptoms
What are the symptoms of parovirus?
Viral symptoms
Lace like rash
Red cheeks
What virus usually affect the hands, feet and mouth?
Enterovirus
Coxsackie virus A16
What is the appearance of orofacial granulomatosis?
Lip swelling and fissuring
Ulcers and tags, cobblestone appearance
What disease is orofacial granulomatosis linked to?
Crohn’s disease
What are the clinical features of erythema nodosum?
Painful, erythematous subcutaneous nodules
Shins
Slow resolution, usually 6-8 weeks
What are the causes of erythema nodosum?
Infections - strep, URTI IBD Sarcoidosis Drugs - OCP, sulphonamides, penicillin Mycobacterial infections Idiopathic
What disease is dermatitis herpetiformis linked to?
Coeliac disease
What are the clinical features of dermatitis herpetiformis?
Itchy blisters in clusters
Scalp, shoulders, buttocks, elbows, knees
What is the treatment for dermatitis herpetiformis?
Emollients
Gluten free diet
Topical steroids
Dapsone
