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Paediatrics > Paediatric Dermatology > Flashcards

Paediatric Dermatology Flashcards

1
Q

What is the most common childhood skin condition?

A

eczema (dermatitis)

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2
Q

What are the 5 endogenous types of eczema (caused by internal factors)?

A
  • atopic
  • seborrhoeic
  • discoid
  • pomphylx
  • varicose
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3
Q

What are 3 exogenous types of eczema (caused by external factors)?

A
  • allergic contact dermatitis
  • irritant contact dermatitis
  • photosensitive/ photoaggravated eczema
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4
Q

What can cause flares of childhood eczema?

A
  • infections/ viral illness
  • environment e.g. heating, cold air
  • pets: if sensitised/allergic
  • teething
  • stress
  • idiopathic
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5
Q

What is the most common type of eczema?

A

atopic eczema

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6
Q

What 3 conditions are associated with atopic tendency?

A
  • eczema
  • asthma
  • hayfever
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7
Q

What distribution of atopic eczema is common in infancy?

A

typically starts on the face/neck (cheeks common), can spread more generally

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8
Q

What distribution of eczema is common in older children?

A

Flexural pattern predominates (antecubital fossae, popliteal fossae, wrists, hands, ankles). Facial eczema also possible/can recur.

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9
Q

What is the pathophysiology of atopic eczema?

A

thought to be problem with skin protein filagrin which means that the skin barrier isn’t as efficient and prone to irritation as allergens and irritants better able to penetrate sin barrier

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10
Q

What is seborrhoeic dermatitis?

A
  • eczema affecting mainly scalp and face
  • often affects babies <3 months and resolves by 1 year
  • associated with proliferation of malassezia yeast
  • looks yellow and crusty
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11
Q

What treatment is there for seborrhoeic dermatitis?

A
  • emollients
  • antifungal cremas
  • antifungal shampoos
  • mild topical steroids
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12
Q

What is discoid eczema?

A

scattered annular/circular patches of itchy eczema (can be a part of atopic eczema or a separate entity)

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13
Q

What is pomphylx eczema?

A

hand and foot eczema characterised by vesicles and can be very itchy

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14
Q

What is varicose eczema?

A
  • affects legs in association with venous insufficiency

- oedema causes imitation

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15
Q

How is varicose eczema treated?

A
  • emollients
  • topical steroids
  • compression stockings
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16
Q

What kind of testing is helpful if you suspect allergic eczema?

A

patch testing

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17
Q

What would make you suspect a food allergy?

A
  • Immediate reactions (lip swelling, facial redness/itching, anaphylactoid symptoms)
  • Late reactions (worsening of eczema 24/48 hours after ingestion) – especially if pattern with specific food (food diaries encouraged).
  • GI problems
  • Failure to thrive
  • Severe eczema unresponsive to treatment
  • Severe generalised itching – even when the skin appears clear
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18
Q

What are the 2 ways to test for for allergy?

A
  • blood test for specific IgE antibodies to certain foods

- skin prick testing

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19
Q

What are the most common food allergies?

A
  • milk/dairy
  • soy
  • peanuts
  • eggs
  • wheat
  • fish
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20
Q

What are possible treatments for eczema?

A
  • emollients
  • topical steroids
  • calcineurin inhibitors
  • UVB light therapy
  • immunosuppressive medication
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21
Q

What is something you should be aware of when prescribing topical steroids for skin conditions?

A

think about where it is to be put - if it is to reused for areas of thinner skin such as the face then consider using less potent steroid

22
Q

What are some examples of topical steroids used to treat childhood skin problems?

A
  • Very potent (Dermovate)600x
  • Potent (Betnovate)100x
  • Moderate (Eumovate) 25x
  • Mild (Hydrocortisone)
23
Q

How would you describe what amount of topical steroid to use?

A

by finger tip units

24
Q

How would you advise to use the steroids?

A
  • once daily for 1-2 weeks
  • if improvement then use alternate days for a few more days
  • then if stubborn/ persistent areas can use twice weekly in these areas
  • if at any point the eczema starts flaring, go back to daily applications
25
Q

What is a very common skin infection in children and what is it caused by? What does it look like?

A
  • impetigo
  • staph aureus
  • pustules and honey coloured crusted erosions
26
Q

How would you treat impetigo?

A
  • topical antibacterial if it isn’t too extensive (fucidin)

- oral antibiotic if extensive or severe (flucloxacillin)

27
Q

What is molluscum contagiosum and what does it look like?

A
  • common benign self limiting infection
  • casued by molluscipox virus
  • can be transmitted to direct contacts
  • peraly papules with an umbilicated centre
28
Q

What is the prognosis of molluscum contagiosum?

A

can take up to 24 months to clear, just reassure and no treatment required

29
Q

What do viral warts look like and what are they caused by?

A
  • often skin coloured
  • if on the sole of the foot they are called verrucas
  • caused by HPV and can be transmitted by direct skin contact
30
Q

How are viral warts treated?

A

by stimulating your own immune system to respond e.g. by cryotherapy or salicylic acid

31
Q

What do we mean by ‘viral exanthems’?

A

An exanthem is any eruptive skin rash that may be associated with fever or other systemic symptoms e.g. fever, malaise, headache

32
Q

What are common viral exanthems in children?

A
  • chicken pox
  • measles
  • rubella
  • roseola
  • erythema infectiosum
33
Q

What organism causes chicken pox?

A

varicella zoster virus

34
Q

What does chicken pox look like?

A

red papules (small bumps) progressing to vesicles and often starts on the trunk

35
Q

How does chicken pox present?

A
  • itchy rash

- associated viral symptoms

36
Q

When is chicken pox contagious?

A

1-2 days before rash appears and until lesions have crusted over

37
Q

How would chicken pox be treated?

A
  • self limiting
  • maybe use calamine lotion to soothe itching
  • infection control - keep away from pregnant mothers and take child out of nursery
38
Q

What are 2 conditions that chicken pox can rarely be associated with?

A
  • pneumonia

- encephalitis

39
Q

What is parvovirus (slapped cheek)?

A
  • skin condition which presents with erythematous appearance on cheeks initially and then lace like network rash on trunk and limbs
  • usually a mild self limiting illness
40
Q

What are 2 complications of parvovirus infection?

A
  • parvovirus can target RBCs in bone marrow

- risk to pregnant mothers

41
Q

What is the hand, foot and mouth condition?

A
  • an enterovirus (usually coxsackie virus A16) results in rash of blisters on the hands, feet and in the mouth and also has viral symptoms
  • self limiting
42
Q

The is it common for hand foot and mouth condition to present?

A

epidemics late summer or autumn months

43
Q

What is systemic disease that may present with orofacial granulomatosis?

A
  • Crohn’s disease

- may see lip swelling and fissuring or oral mucosal lesions

44
Q

What are clinical features of erythema nodosum?

A
  • painful, erythematous subcutaneous nodule, often found over skins
  • slow resolution over 6-8 weeks
45
Q

What can cause erythema nodosum?

A
  • Infections – Streptococcus, Upper respiratory tract
  • Inflammatory bowel disease
  • Sarcoidosis
  • Drugs – OCP, Sulphonamides, Penicillin
  • Mycobacterial Infections
  • Idiopathic
46
Q

What is dermatitis herpetiformis?

A
  • associated with coeliac disease
  • rash of itchy blisters that may appear in clusters
  • often symmetrical
  • affects scalp, shoulders, buttocks, elbows and knees
47
Q

How would you treat dermatitis herpetiformis?

A
  • emollients
  • gluten free diet
  • topical steroids
  • dapsone
48
Q

What is urticaria?

A
  • wheals/hives

- areas of rash that can last fro a few minutes up to 24 hours (acute < 6 weeks, chronic >6 weeks)

49
Q

What are possible causes of urticaria?

A
  • Viral infection
  • Bacterial infection
  • Food or drug allergy
  • NSAIDS, OPIATES,
  • Vaccinations
  • Chronic urticaria – idiopathic often no cause found. Likely autoimmune cause.
50
Q

What can be done to treat urticaria?

A
  • consider posible triggers and possibly withdraw medications
  • antihistamines 3x daily

Paediatrics (25 decks)

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