Paediatric Dermatology Flashcards
Name the different types of eczema
- Atopic
- Seborrheoic
- Discoid
- Pomphylx
- Varicose
- Contact allergic dermatitis
- Contact irritant dermatitis
- Photoaggravated
What are the features of atopic eczema?
- Overactive immune response to environmental stimuli
- Atopic march: eczema, asthma and hayfever
- Flexural pattern of distribution
- Found on the face and neck in infants
- Loss of water and penetration of irritants and allergens
What can cause flares of childhood eczema?
- Infections/viral illness
- Central heating/cold air
- Pets
- Teething
- Stress
- Sometimes no cause
What are the features of seborrheoic dermatitis?
- Mainly on the scalp and face
- Usually on babies under 3 months
- Associated with proliferation of malassezia in its yeast form
How can seborrheoic dermatitis be managed?
- Emollients
- Antifungal creams and shampoos
- Mild topical steroids
What are the features of discoid eczema?
- Scattered annular/circular itchy patches
- Can occur as part of atopic eczema or in isolation
What are the features of pomphylx eczema?
- Hand and foot eczema
- Vesicles
- Intensely itchy
How can late reactions to allergens be tested for?
Dietary restrictions/eliminations for 6-8 weeks
How can eczema be treated?
- Emollients
- Topical steroids
- Calcineurin inhibitors
- UVB light therapy
- Immunosuppressive therapy
Name some commonly used topical steroids (from mild to very potent)
- Hydrocortisone
- Eumovate
- Betnovate
- Dermovate
What are the features of impetigo?
- Pustules
- Honey coloured crusted erosions
- Usually caused by staph aureus
- Children are usually well
How is impetigo treated?
- Topical antibacterial (fucidin)
- Oral antibiotic (fluclox)
What are the features of molluscum contagiosum?
- Self limiting viral infection
- 2wks - 6 months
- Transmission to close direct contacts
- Pearly papules, umbilicated centre
- Can take up to 24 months to clear
How can molluscum contagiosum be treated?
-Potassium chloride: molutrex or molludab
What are the features of viral warts?
- Skin coloured
- Caused by HPV
- Verrucas on sole of foot
- Transmitted by direct contact
How can viral warts be treated?
- Salicylic acid and paring
- Cryotherapy
What is a viral exanthems?
A rash caused by a viral illness
What are the features of chicken pox infection?
- Varicella-zoster virus
- One infection confers lifelong immunity (not in immunocompromised people)
- Red papules progressing to blisters which often start on the trunk
- Itchy
- Associated with viral symptoms
- Self limiting
- Contagious - avoid nursery etc.
What are the features of parvovirus?
- Slapped cheek
- Viral symptoms
- Erythematous rask on cheeks and then a lace like rash on the trunk and limbs
- Can take 6 weeks to fully fade
- Usually mild and self limiting
- Can cause aplastic crisis in patients with haemolytic disorders
- Risk to pregnant women (spontaneous abortion, IUD etc.)
What are the features of hand, foot and mouth?
- Coxsackie virus A16
- Blisters on hands, feet and mouth
- Viral symptoms
- Epidemics in late summer and autumn
- Self limiting
- Supportive treatment
What is eczema coxsackium?
- Coxsackie A16 infection in a patient with a history of infection
- Flared sites pick out areas of eczema
- Self limiting
What are the features of eczema herpeticum and how can it be treated?
- Unwell child
- History of eczema
- Monomophic punched out lesions
- Withhold steroids for 24hrs
- Aciclovir
- Ophthalmology review if near the eye
What is orofacial granulomatosis and which disease is it associated with?
- Lip swelling, fissures, ulcers and tags in the mouth
- Crohn’s disease
What are the features of erythema nodosum?
- Painful, red SC nodules
- Over shins
- Slow resolution
What are the causes of erythema nodosum?
- Infections: strep and URTI
- IBD
- Sarcoidosis
- Drugs: OCP, sulphonamides and penicillin
- Mycobacterial infections
- Idiopathic
How can erythema nodosum be treated?
- Rest and elevation
- Compression
- ?topical steroids
- NSAIDs
- Immunosuppression if persistent
What are the features of dermatitis herpetiformis and which disease is it associated with?
- Itchy blisters that can appear in clusters
- Often symmetrical
- Affects scalp, shoulders, buttocks, elbows and knees
- Coeliac disease
What are the features of urticaria?
- Wheals/hives
- Angioedema
- Can last a few minutes to 24hrs
What are the causes of urticaria?
- Viral/bacterial infection
- Food or drug allergy
- NSAIDs/opiates
- Vaccines
What are the treatment options for urticaria?
- Consider possible triggers and withdraw them
- Antihistamines
- Ranitidine
- Montelukast
- Omalizumab
- Ciclosporin
