Paediatric dermatology Flashcards
What are the 2 categories of birthmarks in children
vascular
pigmented
What are features of a salmon patch
central / midline location facial or nuchal due to persistent foetal circulation aka angels kisses common, completely benign macular erythematous very likely to disappear
How can vascular birthmarks be divided
vascular malformation
haemangioma
what are the groups of vascular malformation
Abnormality of any vessel arterial - fast flow, dangerous, rare venous - more common, slow flow Capillary lymphatic mixture
what are haemangiomas
vascular tumours confined to childhood
rapid growth then regression
vascular malformations are more likely to regress than haemangiomas, true or false
false, haemangiomas have rapid growth but then regress in comparison to vascular malformations which do not resolve or may even progress
vascular malformations are more likely to regress than haemangiomas, true or false
false, haemangiomas have rapid growth but then regress in comparison to vascular malformations which do not resolve or may even progress
give an example of a capillary vascular malformation
port wine stain / naevus flammeus
features of port wine stain (PWS)
dark red macular lesion do not extend beyond original borders lifelong persistence usually unilateral may thicken and darken described in relation to the trigeminal nerve
what syndromes may be associated with port wine stains?
Sturge weber syndrome especially in CNV1
risk of epilepsy development
what syndromes may be associated with capillary malformation?
- Sturge weber syndrome PWS in CNV1 and ipsilateral vascular malformation in the brain –> seizures, glaucoma
- Klippel-Trenauney syndrome - capillary venous malformation and capillary-lymphatic-venous malformation, progressive limb overgrowth
PWS on lower limb
features of venous malformation/anomaly
bluish stain
if left untreated can progress severely
Mx with injection of sclerosants and coils
another name for infantile haemangiomas
strawberry naevi
what is the commonest vascular tumour in children
infantile haemangioma
benign soft tissue tumour
Can be superficial, deep to the skin or combined
epidemiology of infantile haemangiomas
90% appear within the first month of life
80% single lesion
commonest on H+N
commoner in prems and females
most undergo total/partial resolution
if they occur across the midline - concerning
complications of haemangiomas
pain infection bleeding ulceration visual obstruction airway/swallowing obstruction
complications of peri ocular haemangiomas and their management
visual obstruction glocal compression retrobulbar expansion fast growing oral propranolol
management of infantile haemangiomas
topical/IL steroids
topical propranolol
systemic: steroids, propranolol
propranolol needs
what is the proper name for mongolian blue spots
slate grey naevus / congenital dermal melanocytosis
features of slate grey naevi
bluish grey appearance
normal in black and asian skins
usually fade over a number of years
differential of slate grey naevi
NAI
what is a melanocytic naevus more commonly known as
mole
features of melanocytic naevi
can become warty and hairy
larger than acquired naevi
grouped as small, medium and large
what are bathing trunk naevi
giant congenital naevi
what are Cafe Au Lait Macules (CALMS)
well defined light brown macules
normal in 10-20%
2 CALMS under 2yo suggests neuroectodermal disease
what is NF1 and what is its inheritance
commonest genodermatosis
multisystem disorder
AD inheritance with variable penetrance
cutaneous features of NF1
neurofibromas
Cafe au lait macules
axillary (and groin) freckling = Crowe’s sign
what are Lisch nodules
hamartomas seen in the iris
not harmful
useful clinical sign for NF1
list non-cutaneous features of NF1
ocular CNS skeletal tumours vascular fibrosing alveolitis
describe an ash leaf macule and with which condition is it synonymous
oval shaped area of hypopigmentation
tuberous sclerosis
can use a wood’s lamp to examine this
inheritance of tuberous sclerosis
AD
features of tuberous sclerosis
infantile seizures - cortical tubers ash leaf macule Shagreen patches facial angiofibromas periungal fibromas hamartomas angiomyolipomas CALMS bone cysts enamel pits in teeth
What are shagreen patches
connective tissue naevi
orangey
what are common inflammatory skin conditions in paediatrics
eczema psoriasis fungal infection acne vitiligo molluscum lichen sclerosis vulovaginitis morphea
what is PWS described in relation to
CNV
why is it important to distinguish between salmon patch and PWS
PWS in the CNV1 can have underlying epilepsy
precursor lesion for haemangiomas
can appear slightly red and benign looking but it is underlying
monitoring for propranolol
regular glucose and cardiac monitoring - HR and BP
