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Paediatrics > Paediatric Dermatology > Flashcards

Paediatric Dermatology Flashcards

1
Q

name the different types of eczema/dermatitis seen in children

A
  • atopic dermatitis
  • seborrheic dermatitis
  • discoid dermatitis
  • pompholyx dermatitis
  • contact/irritant dermatitis
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2
Q

which three conditions characterise the atopic march?

A
  • atopic eczema
  • hayfever
  • anaemia
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3
Q

what is the most common type of eczema seen in children?

A

atopic eczema

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4
Q

where does atopic dermatitis often present in infants vs older children?

A

infants: face/cheeks

older children: flexural pattern (antecubital/popliteal fossae, wrists, ankles)

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5
Q

abnormality of which gene is associated with atopic eczema?

A

abnormality in filaggrin gene

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6
Q

how is atopic eczema managed?

A
  • emollients
  • topical steroids
  • UVB therapy
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7
Q

name a few factors which could precipitate a flare of childhood eczema

A
  • temperature changes
  • infections
  • pets
  • teething
  • stress
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8
Q

what characterises seborrheic dermatitis and where is it often found?

A

characterised by greasy scales

normally found on scalp/face

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9
Q

which which organism are discoid and seborrheic dermatitis associated?

A

malassezia yeast

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10
Q

what is the treatment for seborrheic dermatitis in children?

A
  • emollients
  • antifungal creams/shampoos
  • steroid creams
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11
Q

what characterises discoid eczema?

A

circular patches, very itchy

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12
Q

how is discoid eczema treated?

A
  • emollients
  • potent topical steroids with antifungal properties
    long treatment regime
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13
Q

where is pompholyx eczema often found?

A

on hands and soles of feet

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14
Q

what is a characteristic of pompholyx eczema?

A

vesicles on hands and soles of feet, often very itchy

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15
Q

what investigation is done for contact/allergic dermatitis?

A

patch testing for type IV hypersensitivity

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16
Q

if a child presents with intense itching with no evidence of eczema, or severe eczema not relieved by treatment, what differential should be considered?

A

delayed food allergy reaction (type 4 hypersensitivity)

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17
Q

what characterises an immediate food allergy reaction?

A

urticaria - swelling of lip, face

anaphylaxis

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18
Q

for an immediate allergic reaction causing eczema, what investigations should be done?

A
  • serum IgE antibody (RAST)

- skin prick test

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19
Q

what investigations are done for late allergic reactions?

A

none are available - if possible food allergy, try removing potential culprit foods one at a time

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20
Q

generally speaking, what are the management options for eczema in children?

A
  • emollients
  • steroid creams (mild to v potent)
  • calcineurin inhibitors
  • UVB therapy
  • immunosuppression
21
Q

how should steroid creams be taken in terms of frequency and duration for eczema in children?

A

daily for 1-2 weeks
if improvement, use every other day for a few more days
for any stubborn areas, keep applying twice a week
if flare-up, go back to daily applications

22
Q

what is the dosage for creams in dermatology?

A

finger tip unit

23
Q

how does impetigo present?

A

golden scaly crusts, often on mouth

24
Q

what causes impetigo?

A

staph aureus

25
Q

how is impetigo treated?

A 
topical antibiotics (fucidin)
oral antibiotics (flucloxacillin)
26
Q

what does molluscum contagiosum look like?

A

round papules with central depression

27
Q

how is molluscum contagiosum treated?

A

self-limiting (can take up to 24 months), no treatment needed
if parent doesn’t want to wait, 5% potassium hydroxide to cause inflammation and recruit immune system

28
Q

what is the incubation period for molluscum contagiosum?

A

2 weeks - 6 months

29
Q

what causes viral warts?

A

HPV

30
Q

how are viral warts spread?

A

through direct skin contact

31
Q

how are viral warts managed?

A

self-limiting (up to 2 years)
salicylic acid and paring
cryotherapy

32
Q

what are viral exanthems?

A

skin manifestations of systemic viral infections (eg chicken pox, rubella, measles)

33
Q

what characterises chicken pox lesions?

A

very itchy red papules that evolve into vesicles

34
Q

what is the incubation period for chicken pox?

A

10-21 days

35
Q

when is a child with chicken pox contagious?

A

from two days prior to rash until the vesicles have crusted

36
Q

what does parvovirus look like on presentation?

A

red rash on cheeks with a lace-like network rash on trunk and limbs

37
Q

what is the incubation period of parvovirus?

A

7-10 days

38
Q

what do parvovirus cells affect?

A

red cells in bone marrow

39
Q

what causes hand foot and mouth disease, how does it present and how is it treated?

A
  • caused by enterovirus (coxsackie A16)
  • presents with vesicles on hands, feet and mouth, viral symptoms
  • treated supportively
40
Q

how does eczema herpeticum present in children, and how is it treated?

A

child very unwell

treat with aciclovir

41
Q

what is orofacial granulomatosis associated with?

A

crohn’s disease

42
Q

how does orofacial granulomatosis present with in children?

A

swollen lips, fissures

ulcers in oral mucosa

43
Q

how is orofacial granulomatosis treated?

A

calcineurin inhibitors

steroids

44
Q

what does erythema nodosum look like?

A

very painful red nodules, common on shins

45
Q

name a few systemic conditions associated with erythema nodosum

A
  • idiopathic
  • infection (URTI)
  • sarcoidosis
  • tuberculosis
  • IBD
46
Q

what is dermatitis herpetiformis associated with?

A

coeliac disease

47
Q

name a few causes of urticaria

A

viral/bacterial infections
food/drug allergy
NSAIDS/opiates
vaccination reaction

48
Q

how is urticaria managed?

A

remove trigger
antihistamines
immunosuppression

49
Q

what can eczema herpeticum cause, if untreated?

A

encephalitis

Paediatrics (10 decks)

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