Paediatric dermatology Flashcards
1
Q
Features of eczema?
A
red, dry, itchy skin
- familial tendency
- atopic march - asthma, hayfever
2
Q
Atopic eczema before 3 months.. suspicion of?
A
cows milk allergy
3
Q
Triggers of eczema?
A
illness stress teething environmental heating
4
Q
the barrier defect of eczema
A
- increased permeability to irritants and allergens
- water loss
5
Q
key proteins identified with eczema?
A
Filaggrin - often more severe eczema
- lot of lines over the themar eminence
6
Q
management of eczema? (3)
A
- topical steroids
moisturiser/emollient to help with itch
- soap substitutes
7
Q
1 Finger tip unit is?
A
0.5g
8
Q
3-6 months FTU = 1 , what is covered
1.5?
A
- face, neck
- arm and hand
- front of chest
- leg and foot
- back and bum
9
Q
1-2 year old FTU of steroid measurements?
1.5?
2?
3?
A
face and neck
arm and hand
- leg and front
chest and abdomen - back and legs
10
Q
3-5 year old FTU
1.5?
2?
3?
3.5?
A
face and neck
arm and hand
leg and foot +front chest and abdo
back and bum
11
Q
6-10 year old FTU
2? 2.5? 3.5? 4.5? 5?
A
face and neck
arm and hand
chest and abdo
leg and foot
back and bum
12
Q
how to use topical steroids?
A
one day for 1-2 weeks
- if improved step down
stubborn areas - twice weekly
13
Q
mild steroid?
A
hydrocortisone
14
Q
moderate steroid?
A
Eumovate
15
Q
potent steroid
A
betnovate
16
Q
very potent steroid
- when might it be used?
A
dermovate
- sclerosis
17
Q
if child needs to use topical steroid on face regularly.. what can you add?
A
- topical tarcolimus
only use steroids for 3-5 days
18
Q
when do topical steroids not help? - triggers?
A
- allergy
- contact allergy
- photoaggravation
19
Q
when topical steroids do not help, what can you give? (2)
A
protopic ointment or Eidel cream
phototherapy UVB
b
20
Q
IMMUNOSUPRESSION options when steroids don’t work ?
A
- methotrexate
- ciclosporin
- mycofenalate
- mofetil
- azathioprine
21
Q
Example of biologic you can use?
A
Dupilomab (IL4)
22
Q
When to suspect food allergy? - type 1 reaction
A
lip swelling, facial redness, itching
23
Q
what reaction is eczema
A
type IV hypersensitivity
24
Q
Late reactions associated with cows milk allergy?
A
worsening of eczema after ingestion
- Gi problems
- failure to thrive
- unresponsive to treatment
- severe itching
25
what is discoid eczema?
scattered, circular - itchy
- can be isolated
26
treatment of discoid eczema?
potent - betnovate C
- give with antibacterial component
apply for 14 days
27
Seborrheoic dermatitis is seen in babies of what age?
- what does it affect?
associated with?
under 3 months
- often resolves by 1 year
- mainly the scalp and face
- cradle cap
28
Seborrheoic dermatitis is associated with what yeast?
malassezia
29
treatment of Seborrheoic dermatitis?
emollients
- daktocorts
- protopic
30
young child presenting with flare up and potential CMPA - what is the treatment plan?
Eumovate - face - once daily for 5 days
betonovate - body - once daily for 7-10 days
(7.5 FTU) per application = 4g
hydromol ointment
- bath and shower
31
impetigo features?
pustules and honey-coloured crusted erosions
32
Treatment of impetigo?
topical - fucidin
oral antibiotic - flucolxacillin - not improving, or child is unwell
33
what causes impetigo?
staph aureus
34
what are molluscs caused by?
molluscipox virus
35
molluscum - transmission , what do they look like?
to close contacts
- pearly papule, umbilicate centre
- can take a year to clear
36
molluscum - possible treatment
5% potassium hydroxide - causes irritation
37
viral warts are transmitted by?
direct skin contact
38
how are viral warts caused?
HPV virus
39
treatment of viral warts?
no treatment
- topical
- salicylic acid
- cryotherapy
- oral zinc
40
viral exanthems is associated with?
viral illness, fever, malaise, headache
41
viral exanthems is due to ? (3)
toxin produced
damage to skin
immune response
42
viral exanthems - examples (5)
chicken pox
measles
rubella
rosella - herpes 6
erythema infectiosium - slap cheek, parovirus B19
43
chicken pox (varicella zoster virus) - who is susceptible to flare ups?
immunocompromised individuals
44
chicken pox (varicella zoster virus) - clinical features
red papaulesm progressing to blisters - crusted
- itchy
- viral symptoms
45
what is the incubation period of chicken pox?
10-21 days
46
when are children contagious with chicken pox?
1-2 days before rash appears and until lesions have crusted
47
chicken pox can be rarely associated with ?
pneumonia and encephalitis
48
parovirus - slapped cheek - clinical features and incubation period
7-10 days
- 5th disease
- viral symptoms
- erythematous rash cheeks and then lace like network to limbs and trunk
49
what does parovirus target?
red cells in the bone marrow
50
paroivirus can rarely cause ?
aplastic crisis (if haemolytic disorders)
51
parovirus - risk to?
pregnant women
- spontaneous abrotion, intrauterine death and hydrops fetalis
52
hand, foot and moth virus cause?
enterovirus
| - coxsackie virus A16
53
Clinical features of hand, foot and mouth?
blisters on hand and feet
- mouth involvement
- late summer/autumnn
54
eczema coxsackium is?
- associated viral symptoms
- children are relatively well
- flared sites
- self limiting
55
Eczema coxsackium treatment?
swab lesion - can you culture
- aciclovir
56
eczema herpticum clinical features
- what must you withhold?
children are unwell
- monomorphic punched out lesions
topical steroids for 24 hours
57
eczema herpticum - treatment?
aciclovir - oral or iv
- opthamology near the eyes
58
orofacial granulomatosis patients present with ?
lip swelling and fissuring
| - oral mucosal lesions - ulcers and tags
59
orofacial granulomatosis is associated with?
Crohn;s disease
60
orofacial granulomatosis - investigations ?
treatment?
faecal calprotectin if GI symptoms
- patch testing
- benzoate and cinnamate free diet
61
Erythema nodosum clinical features?
painful, sucutanous nodules over the shins
- slow resolution - like bruse
- 6-8 weeks
62
Erythema nodosum- CAUSES? (5)
infections - streptococcus, URTI
- IBD
- Sarcoidosis
- mycobacterial infections
- idiopathic
63
what drugs can cause Erythema nodosum? (3)
OCP, sulphonamides, penicillin
64
Dermatitis herpiforms has been associated with?
coeliac disease
65
Erythema nodosum treatment?
NSAIDS
66
Dermatitis herpiforms clinical features
blisters in clusters over the knees and elbows, shoulders, scalp
67
Dermatitis herpiforms - investigations
- history
- coeliac disease - TTG
0 skin biopsy
68
Dermatitis herpiforms- treatment
- emollients
- gluten fre diet
- topical steroids
- dapsone
69
Urticaria causes ? <6 weeks
infection
70
Urticaria clinical features?
weaves/hives
- associated angiodema
- rash can last up to 24 hrs
71
the causes of acute Urticaria ? (5)
- viral inefctions
- bacterial infections
- fungal or drug allergy
- NSAIDs, OPITES
- VACCINATIONS
72
Treatment of acute Urticaria?
triggers - withdraw
- antihistamines - 3x daily
73
Urticaria - antihistamine examples?
*Deslortadine*
reanitidine
montelukast
omalizumab - over 12 yrs
ciclosporin - younger children
74
infantile haemangioma are more common in?
- premature infants
- girls
- low birth weight
- family history
75
infantile haemangioma - what can speed up evolution?
bet blockers
76
infantile haemangioma - treatment
typical - Timollol 5% gel
- oral - propranolol (can cause drop in bp and blow sugar)
77
infantile haemangioma - when is treatment indicated?
- enlarging
- central face
- ulcerating - - bum and genitals
- posterior shoulder
78
Phaces - is due to abnormality with?
- pituitary fossa abnormality
- haemangioma
- arterial anomalies
- cardiac anomalies or coarctation of aorta
- eyes
- sternal cleft
79
treatment of Phaces?
low dose propranolol - can improve segmental haemangioma
