Paediatric Dermatology Flashcards
name the different types of eczema/dermatitis seen in children
- atopic dermatitis
- seborrheic dermatitis
- discoid dermatitis
- pompholyx dermatitis
- contact/irritant dermatitis
which three conditions characterise the atopic march?
- atopic eczema
- hayfever
- anaemia
what is the most common type of eczema seen in children?
atopic eczema
where does atopic dermatitis often present in infants vs older children?
infants: face/cheeks
older children: flexural pattern (antecubital/popliteal fossae, wrists, ankles)
abnormality of which gene is associated with atopic eczema?
abnormality in filaggrin gene
how is atopic eczema managed?
- emollients
- topical steroids
- UVB therapy
name a few factors which could precipitate a flare of childhood eczema
- temperature changes
- infections
- pets
- teething
- stress
what characterises seborrheic dermatitis and where is it often found?
characterised by greasy scales
normally found on scalp/face
which which organism are discoid and seborrheic dermatitis associated?
malassezia yeast
what is the treatment for seborrheic dermatitis in children?
- emollients
- antifungal creams/shampoos
- steroid creams
what characterises discoid eczema?
circular patches, very itchy
how is discoid eczema treated?
- emollients
- potent topical steroids with antifungal properties
long treatment regime
where is pompholyx eczema often found?
on hands and soles of feet
what is a characteristic of pompholyx eczema?
vesicles on hands and soles of feet, often very itchy
what investigation is done for contact/allergic dermatitis?
patch testing for type IV hypersensitivity
if a child presents with intense itching with no evidence of eczema, or severe eczema not relieved by treatment, what differential should be considered?
delayed food allergy reaction (type 4 hypersensitivity)
what characterises an immediate food allergy reaction?
urticaria - swelling of lip, face
anaphylaxis
for an immediate allergic reaction causing eczema, what investigations should be done?
- serum IgE antibody (RAST)
- skin prick test
what investigations are done for late allergic reactions?
none are available - if possible food allergy, try removing potential culprit foods one at a time
generally speaking, what are the management options for eczema in children?
- emollients
- steroid creams (mild to v potent)
- calcineurin inhibitors
- UVB therapy
- immunosuppression
how should steroid creams be taken in terms of frequency and duration for eczema in children?
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
what is the dosage for creams in dermatology?
finger tip unit
how does impetigo present?
golden scaly crusts, often on mouth
what causes impetigo?
staph aureus
