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Paediatrics > Paediatric dermatology > Flashcards

Paediatric dermatology Flashcards

1
Q

Features of eczema?

A

red, dry, itchy skin

  • familial tendency
  • atopic march - asthma, hayfever
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2
Q

Atopic eczema before 3 months.. suspicion of?

A

cows milk allergy

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3
Q

Triggers of eczema?

A 
illness
stress
teething
environmental 
heating
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4
Q

the barrier defect of eczema

A
  • increased permeability to irritants and allergens

- water loss

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5
Q

key proteins identified with eczema?

A

Filaggrin - often more severe eczema

- lot of lines over the themar eminence

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6
Q

management of eczema? (3)

A
  • topical steroids

moisturiser/emollient to help with itch

  • soap substitutes
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7
Q

1 Finger tip unit is?

A

0.5g

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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
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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
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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

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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

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12
Q

how to use topical steroids?

A

one day for 1-2 weeks

  • if improved step down

stubborn areas - twice weekly

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13
Q

mild steroid?

A

hydrocortisone

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14
Q

moderate steroid?

A

Eumovate

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15
Q

potent steroid

A

betnovate

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16
Q

very potent steroid

- when might it be used?

A

dermovate

  • sclerosis
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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

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18
Q

when do topical steroids not help? - triggers?

A
  • allergy
  • contact allergy
  • photoaggravation
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19
Q

when topical steroids do not help, what can you give? (2)

A

protopic ointment or Eidel cream

phototherapy UVB

b

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20
Q

IMMUNOSUPRESSION options when steroids don’t work ?

A
  • methotrexate
  • ciclosporin
  • mycofenalate
  • mofetil
  • azathioprine
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21
Q

Example of biologic you can use?

A

Dupilomab (IL4)

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22
Q

When to suspect food allergy? - type 1 reaction

A

lip swelling, facial redness, itching

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23
Q

what reaction is eczema

A

type IV hypersensitivity

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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
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25
Q

what is discoid eczema?

A

scattered, circular - itchy

  • can be isolated
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26
Q

treatment of discoid eczema?

A

potent - betnovate C

  • give with antibacterial component

apply for 14 days

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27
Q

Seborrheoic dermatitis is seen in babies of what age?

  • what does it affect?
    associated with?
A

under 3 months
- often resolves by 1 year

  • mainly the scalp and face
  • cradle cap
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28
Q

Seborrheoic dermatitis is associated with what yeast?

A

malassezia

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29
Q

treatment of Seborrheoic dermatitis?

A

emollients

  • daktocorts
  • protopic
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30
Q

young child presenting with flare up and potential CMPA - what is the treatment plan?

A

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

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31
Q

impetigo features?

A

pustules and honey-coloured crusted erosions

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32
Q

Treatment of impetigo?

A

topical - fucidin

oral antibiotic - flucolxacillin - not improving, or child is unwell

33
Q

what causes impetigo?

A

staph aureus

34
Q

what are molluscs caused by?

A

molluscipox virus

35
Q

molluscum - transmission , what do they look like?

A

to close contacts

  • pearly papule, umbilicate centre
  • can take a year to clear
36
Q

molluscum - possible treatment

A

5% potassium hydroxide - causes irritation

37
Q

viral warts are transmitted by?

A

direct skin contact

38
Q

how are viral warts caused?

A

HPV virus

39
Q

treatment of viral warts?

A

no treatment

  • topical
  • salicylic acid
  • cryotherapy
  • oral zinc
40
Q

viral exanthems is associated with?

A

viral illness, fever, malaise, headache

41
Q

viral exanthems is due to ? (3)

A

toxin produced
damage to skin
immune response

42
Q

viral exanthems - examples (5)

A

chicken pox

measles

rubella

rosella - herpes 6

erythema infectiosium - slap cheek, parovirus B19

43
Q

chicken pox (varicella zoster virus) - who is susceptible to flare ups?

A

immunocompromised individuals

44
Q

chicken pox (varicella zoster virus) - clinical features

A

red papaulesm progressing to blisters - crusted

  • itchy
  • viral symptoms
45
Q

what is the incubation period of chicken pox?

A

10-21 days

46
Q

when are children contagious with chicken pox?

A

1-2 days before rash appears and until lesions have crusted

47
Q

chicken pox can be rarely associated with ?

A

pneumonia and encephalitis

48
Q

parovirus - slapped cheek - clinical features and incubation period

A

7-10 days

  • 5th disease
  • viral symptoms
  • erythematous rash cheeks and then lace like network to limbs and trunk
49
Q

what does parovirus target?

A

red cells in the bone marrow

50
Q

paroivirus can rarely cause ?

A

aplastic crisis (if haemolytic disorders)

51
Q

parovirus - risk to?

A

pregnant women

  • spontaneous abrotion, intrauterine death and hydrops fetalis
52
Q

hand, foot and moth virus cause?

A

enterovirus

- coxsackie virus A16

53
Q

Clinical features of hand, foot and mouth?

A

blisters on hand and feet
- mouth involvement

  • late summer/autumnn
54
Q

eczema coxsackium is?

A
  • associated viral symptoms
  • children are relatively well
  • flared sites
  • self limiting
55
Q

Eczema coxsackium treatment?

A

swab lesion - can you culture

  • aciclovir
56
Q

eczema herpticum clinical features

  • what must you withhold?
A

children are unwell
- monomorphic punched out lesions

topical steroids for 24 hours

57
Q

eczema herpticum - treatment?

A

aciclovir - oral or iv

  • opthamology near the eyes
58
Q

orofacial granulomatosis patients present with ?

A

lip swelling and fissuring

- oral mucosal lesions - ulcers and tags

59
Q

orofacial granulomatosis is associated with?

A

Crohn;s disease

60
Q

orofacial granulomatosis - investigations ?

treatment?

A

faecal calprotectin if GI symptoms

  • patch testing
  • benzoate and cinnamate free diet
61
Q

Erythema nodosum clinical features?

A

painful, sucutanous nodules over the shins

  • slow resolution - like bruse
  • 6-8 weeks
62
Q

Erythema nodosum- CAUSES? (5)

A

infections - streptococcus, URTI

  • IBD
  • Sarcoidosis
  • mycobacterial infections
  • idiopathic
63
Q

what drugs can cause Erythema nodosum? (3)

A

OCP, sulphonamides, penicillin

64
Q

Dermatitis herpiforms has been associated with?

A

coeliac disease

65
Q

Erythema nodosum treatment?

A

NSAIDS

66
Q

Dermatitis herpiforms clinical features

A

blisters in clusters over the knees and elbows, shoulders, scalp

67
Q

Dermatitis herpiforms - investigations

A
  • history
  • coeliac disease - TTG
    0 skin biopsy
68
Q

Dermatitis herpiforms- treatment

A
  • emollients
  • gluten fre diet
  • topical steroids
  • dapsone
69
Q

Urticaria causes ? <6 weeks

A

infection

70
Q

Urticaria clinical features?

A

weaves/hives

  • associated angiodema
  • rash can last up to 24 hrs
71
Q

the causes of acute Urticaria ? (5)

A
  • viral inefctions
  • bacterial infections
  • fungal or drug allergy
  • NSAIDs, OPITES
  • VACCINATIONS
72
Q

Treatment of acute Urticaria?

A

triggers - withdraw

  • antihistamines - 3x daily
73
Q

Urticaria - antihistamine examples?

A

Deslortadine

reanitidine

montelukast

omalizumab - over 12 yrs

ciclosporin - younger children

74
Q

infantile haemangioma are more common in?

A
  • premature infants
  • girls
  • low birth weight
  • family history
75
Q

infantile haemangioma - what can speed up evolution?

A

bet blockers

76
Q

infantile haemangioma - treatment

A

typical - Timollol 5% gel

  • oral - propranolol (can cause drop in bp and blow sugar)
77
Q

infantile haemangioma - when is treatment indicated?

A
  • enlarging
  • central face
  • ulcerating - - bum and genitals
  • posterior shoulder
78
Q

Phaces - is due to abnormality with?

A
  • pituitary fossa abnormality
  • haemangioma
  • arterial anomalies
  • cardiac anomalies or coarctation of aorta
  • eyes
  • sternal cleft
79
Q

treatment of Phaces?

A

low dose propranolol - can improve segmental haemangioma

Paediatrics (49 decks)

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